The University of Florida College of Medicine’s division of surgical oncology, led by UF Health Cancer Center member Steven Hughes, M.D., provides a multidisciplinary approach to treating several cancers, such as pancreatic, stomach, colon, liver, skin and breast cancers.
“Surgery is kind of the front door for patients who have been newly diagnosed with cancer,” Hughes, the chief of surgical oncology, said. “The number of patients with cancer that are being treated by surgeons is very large, and very often the first interaction with UF Health is through surgery.”
Surgical oncologists support the UF Health Cancer Center by screening those cancer patients for possible accrual to clinical trials.
“We care about the mission of research and the UF Health Cancer Center is vital for that mission,” Hughes said. “We’ve been key contributors to screening and accrual of patients in Cancer Center clinical trials.”
UF Health Cancer Center member Ali Zarrinpar, M.D., Ph.D., a liver and hepatobiliary transplant surgeon, is one of many UF Health surgical oncologists contributing to cancer research.
“We’re all working to make surgery obsolete in terms of cancer care so that everyone can take some sort of magic bullet to treat cancer,” Zarrinpar said. “But until that happens, surgery will need to work together with medical and radiation oncology to deliver very precise, guided care for patients.”
Zarrinpar said surgeons are at the forefront of cancer research because of their ability to take tumors from the operating room into the lab to study investigational therapies.
Last year, Zarrinpar’s lab published a study on the link between ethnic disparities and liver cancer, in which they found that Hispanics, as well as the elderly and people with diabetes, have a higher risk of developing liver cancer. Currently, he is being funded by the National Institutes of Health to find novel drug combinations to treat liver cancer.
“We now have evidence that we have a much better three-drug combination for the treatment of liver cancer,” he said. “We’re in the process of planning a clinical trial.”
Zarrinpar has also set his sights on developing a liver center at the University of Florida. He is in the planning stages of a program where any patient seen at UF Health for liver disease could opt to have their genome sequenced.
“My big goal is to gather specialists from different specialties, departments and divisions to develop a liver program,” he said. “This would have to involve not just physicians but also scientists from different specialties to really provide liver care, not just in liver cancer but in liver diseases that end up developing into liver cancer.”
Similar programs are already established at UF Health for other cancers, such as the UF Health Breast Center, a nationally recognized center excellence and accredited by the National Accreditation Program for Breast Cancer Centers. UF Health Cancer Center member Lisa Spiguel, M.D., is the clinical director of the Breast Center and one of the center’s fellowship-trained surgeons, alongside Christiana Shaw, M.D.
“We offer a very strong, multidisciplinary approach to breast cancer treatment and really personalize the care that we provide each of our patients,” Spiguel said.
The Breast Center team includes a wide variety of specialties, from surgeons and medical oncologists to pathologists and physical therapists. Spiguel and Shaw provide patients with advanced surgical techniques, such as oncoplastic surgery and all types of mastectomies, including nipple sparing mastectomies.
“Our surgical goal in cancer care is multifaceted,” Spiguel said. “The biggest goal is to advance the understanding and surgical management of breast cancer treatment so that we can continue to provide the leading edge in surgical care.”
In 2014, Spiguel pioneered a lymphedema surveillance program at UF Health. In 2015, the Breast Center started preventative lymphedema surgery.
“My clinical research focus is looking at surgical approaches to reduction in lymphedema,” she said. “We pioneered a technique using a specific dye to help map out the lymphatics for the arm.”
Currently, Spiguel is leading a surgical clinical trial investigating preserving arm lymphatics during breast cancer surgery to prevent lymphedema after breast cancer treatment.
Every week, the Breast Center discusses patient cases at a team meeting, with the Clinical Trials Office and their clinical trials coordinator in attendance.
“We go over all the breast cancer patients to make sure that we are providing not only excellence in surgical and medical care but also evaluate eligibility for clinical trials,” she said. “We are very focused on advancing the understanding in the care of breast cancer treatment as a team.”
Cancer care is a team approach, and surgical oncology is an integral part of the team.