IN JAMAICA: Historic surgery on stage-four cancer patient who is in his 60s.....Jamaica becomes third Caribbean island to undertake procedure. “The prognosis for a patient with stage-four cancer is never good,” Dr Cherian said. “But with the Sugarbaker procedure, his chances have increased tremendously.”

BY ANIKA RICHARDS Sunday Observer staff reporter richardsai@jamaicaobserver.com  Sunday, July 06, 2014    

WHEN cancer spreads to the lining of the abdomen, the disease is considered to be in its fourth stage. In fact, if a group of patients with stage-four cancer is left alone, as is, allowing the disease to progress, most will perhaps not be around in another six months.

Dr Cherian Cherian (left), general surgeon; Dr Jason
 Copeland (centre), resident in general surgery;
 and general surgeon and surgical oncologist
Dr Wesley Francis during the first ever Sugarbaker
 procedure at the Kingston Public Hospital on Friday, June 20.

This is according to general surgeon Dr Cherian Cherian, a member of a team of Jamaican doctors at the Kingston Public Hospital, who, just over two weeks ago, with the assistance of general surgeon and surgical oncologist Dr Wesley Francis from The Bahamas, performed the first ever Sugarbaker procedure on the island. According to Dr Cherian, outside of The Bahamas and The Cayman Islands, no other Caribbean country has done the procedure.

It was performed on a stage-four cancer patient who is in his 60s.

In an interview with the Jamaica Observer, Dr Cherian, admitting that the patient is not yet out of the woods, said that he is doing well and that they are taking it one step at a time.

“The prognosis for a patient with stage-four cancer is never good,” Dr Cherian said. “But with the Sugarbaker procedure, his chances have increased tremendously.”

The general surgeon explained that the Sugarbaker procedure targets malignancy from the abdominal cavity that has spread to the lining of the abdomen.

“We remove the peritoneal surface, which is the lining of the abdominal cavity; we remove any deposits that may be on organs, including the spleen,” Dr Cherian asserted. “The aim is to actually shrink the tumour mass to a volume such that chemotherapy, which is instilled in the abdomen at the typical temperature of 40 degrees Celsius, will be able to sufficiently manage in terms of oblation.

“So physically we oblate or remove, and chemically, with the use of chemotherapy, we further oblate,” Dr Cherian continued.

General surgeons (from left) Dr Cherian Cherian and
Dr Turkessa Cherrie, anaesthesiologist Suzanne McDonald,
 and Dr Wesley Francis, general surgeon and surgical oncologist,
 pose for a photograph after the surgical procedure at the
 Kingston Public Hospital on Friday, June 20.

Formally called cytoreductive surgery, which is followed by hyperthermic intraperitoneal chemotherapy, the Sugarbaker procedure also removes “any obvious disease anywhere else”. For example, if the condition reaches the liver in a limited sense, then a piece of the liver is taken out and if it’s “a bowel, but it’s any significant bowel, we will take that segment of bowel.

“So literally it is a debulking procedure, but we debulk to its maximum in order to allow chemotherapy, with the aid of a pump, to sort of bathe the organs of the peritoneal cavity for at least an hour,” Dr Cherian disclosed.

The general surgeon said that the procedure is a technical one that carries a morbidity rate of up to 25 per cent and a mortality rate close to 20 per cent. Therefore, patient selection and cancer origin are factors that must be carefully considered before such a procedure.

Dr Cherian stressed that the patient must be otherwise well, to be considered for the procedure. more