CTOS Op Ed |
The importance of the molecular scalpel
Why surgeons should understand, or at least appreciate, the importance of learning how the master surgeon, Mother Nature, can dice (cut) and splice (sewing) the genome that results in a sarcoma removed by a Bard-Parker
An ESUN Article
Editor's Note: This is the second in the series of Op Ed pieces written by one of the members of the Board of Directors of the Connective Tissue Oncology Society (CTOS). These Op Ed pieces are intended to address important and controversial issues in the field. The “CTOS Questions, Comments & Counterpoint” column allows readers to express their opinions in response to these Op Ed pieces. Click here to send in an opinion.
In follow-up to CTOS President Ian Judson’s editorial in the last issue of ESUN emphasizing the importance of sarcoma patients being treated at centers with dedicated sarcoma teams, I wanted to take the opportunity to emphasize that while sarcomas are a surgical disease, every type of scalpel — from the stainless steel to the molecular — must be used to extirpate this deadly array of cancers. Yes, local control, or removal of the main tumor, is of paramount importance but often it is not the site of the original cancer that threatens a patient’s life. Rather, it is the systemic disease, or those cancer cells that break away, metastasizing to the lungs and other organs, that take away a beloved family member. Surgically resecting these metastatic foci may prolong or even save the lives of a few, but the bio-targeted agents, the “molecular scalpels” being brought into trials now hold the most promise for those sarcoma patients with advanced disease that has spread to other sites.
As such, it is critical that surgeons, who are often the first entry portal for sarcoma patients, be aware of the issues, provide adequate surveillance and have a working understanding of the protocols and latest modalities available to sarcoma patients. Patients should ask their surgeons about ongoing research at their centers, about institutional and (inter)national cooperative trials, and in general about the future of sarcoma care. While the sarcoma surgeon must be a technical master of the highly complex craft of sarcoma resection and reconstruction, he or she must also serve as chaperone for the patient as they embark on a phase in their life with many uncertainties and insecurities. The surgeon must be assiduous in facilitating, if not wielding, the molecular scalpel when his or her patient needs such assistance.
Therefore, in resonating with Dr. Judson’s editorial, sarcoma patients should seek their care at comprehensive centers where all modalities of therapy are readily available.
V4N2 ESUN Copyright © 2007 Liddy Shriver Sarcoma Initiative.