EPP vs Pleurectomy vs Decortication - Mesothelioma Surger
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... touched upon ... there's a little controversy in the meso world of the EPPs versus the pleurectomies, versus, you know, whatever.

Yes. So every patient's different. Every disease is different. To say that one treatment fits all is wrong. I mean, we do have passionate people both sides of the screen, right? We have people passionate about EPPs. We have people passionate about pleurectomies. If you really select your patient appropriate to the disease stage with the correct treatment, it really isn't different in survival, okay?
Now the different comes from two points: One is staging. Again, the early diagnosed staging of the disease is paramount to the survival of the patients. That's number one.
Number two: You can go and have an EPP and don't do well or do a pleurectomy and not do well. The issue there was wrong treatment for the wrong patient. You have to tailor that. A few patients will benefit from left extrapleural pneumonectomy, early stage, young patient, female, no questions about it, with good pulmonary function. Someone who is elderly and has got poor pulmonary function, to take a whole lung out, they might not do well. So you have to tailor your surgery.
Having said that, I, for one, have been a great advocate on saying, you really have to select the patients for the right operation. The results: survival - very little difference. What is different is sometimes you have early recurrence or more recurrence in the pleurectomy side, but now we know that we can go after those recurrences as well.
So, I don't know if I answered your question, but we have as many patients in one arm versus the other with long survival and doing extremely well.

Yeah, which is a good message to get out there-

Right.

There is patients surviving but, more importantly, they're doing well-

Correct.

They're living. They're living [crosstalk 00:02:27] a good life ... good quality of life.

Right.

And are you seeing younger patients, Dr. Dasilva?

Not yet. They haven't come my way yet. I'm getting the pipe feeders and the plumbers, and ... you know, when I came here, the pipe feeders, I thought they were extinct. I guess they are, except in Chicago. But you know, I hope, in all honesty, I hope I don't see young patients. You know? We're plenty busy, and we're passionate about mesothelioma cure, but mesothelioma, as we all know, is a dreadful disease, but we have hope. We have ways to treat those patients.

All right. So you think that would be ... that's, I think the important message that you want to get out here, that, you know, you're in Chicago, you're up and running, and there is hope.

Correct. There is hope. There is very intelligent, capable, educated physicians involved in the care of the patients. We understand much more about the disease now than we did ten years ago. We understand much more about which treatment is better toward every different patient than we knew ten years. I think the future for mesothelioma patients is really bright. I do not subscribe to a neolistic approach. I don't believe in it. I don't believe even some one official [inaudible 00:04:18] is the right treatment. I'll do it ... it might be for a few cases, but I don't believe in that. I don't subscribe to that. I'm one of those half-full glass type of guy, so I usually tell patients, "Let's go. If you're up for it ..."
I saw 85-year-old lady. She needed surgery. She said, "Am I too old for that, Sunny?" I said, "No, you're not! If you called me Sunny, you're not. You're on the schedule."

Again, positive attitude, always helps.

That's correct.

Thank you.

Thank you.

Well, that was very good.

Any other questions, Katie?

I think ... that's all the questions that I had, so if there's any questions from you or Ellie, feel free to ask them but, if there are no questions, we can conclude.

Dr. DaDilva, do you have a website?

I do. What I will do for you, is I will send it to you ...

Perfect.

Okay.

Great.

But it's a lot ... it's Loyola.something else ... I have to go back and get it, and I'll send it to you guys.

Just send it to us.

There is a website, and we trying to create a mesothelioma website. I'm in the Loyola website which has two of my interviews, with an interview about mesothelioma, and that would be www.loyolamadison ... one word ... .org, and then you have to search DaSilva, and that comes right up. So what I've been working with the hospital now as to create my own website within the hospital website for mesothelioma, but somehow that has become a challenge for me, believe it or not, within my old age, but I'm used to that already.

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