Brigham and Women's Hospital

International Mesothelioma Program
World's first formal mesothelioma program
Founded	2002
Location	Boston, MA
NCI Designation	Comprehensive
Founder	Dr. David Sugarbaker
Annual Patients	180-200
VA Partnership	VA Boston Healthcare
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Executive Summary

The International Mesothelioma Program (IMP) at Brigham and Women's Hospital in Boston stands as the world's first formally established dedicated mesothelioma treatment program, founded in 2002 by the legendary thoracic surgeon Dr. David J. Sugarbaker. Operating within the Dana-Farber Brigham Cancer Center—ranked among the top five cancer centers nationally—the IMP treats approximately 180-200 patients annually and provides over 300 consultations per year, making it one of the largest mesothelioma programs in the world.

Dr. Sugarbaker's groundbreaking work in the 1990s transformed mesothelioma from a disease with virtually no treatment options to one where selected patients could achieve meaningful long-term management through aggressive multimodal therapy combining surgery, chemotherapy, and radiation. His 1992 refinement of the extrapleural pneumonectomy procedure and subsequent development of trimodal treatment protocols established the paradigm that mesothelioma centers worldwide would follow.

Today, under the leadership of Dr. Raphael Bueno, the program continues advancing mesothelioma care through genomic research, novel surgical techniques, and clinical trials exploring immunotherapy combinations. The IMP maintains close collaboration with the VA Boston Healthcare System, serving the significant veteran population affected by military asbestos exposure. Patients seeking treatment at Brigham can also pursue substantial legal compensation through asbestos trust funds and other recovery options.

Key Facts

Key Facts: International Mesothelioma Program at Brigham and Women's Hospital

Program Founded: 2002 — world's first formally dedicated mesothelioma program Founding Director: Dr. David J. Sugarbaker (1953-2018), nicknamed "Mr. Mesothelioma" Current Director: Dr. Raphael Bueno (assumed leadership 2014) Annual Patient Volume: 180-200 patients treated, 300+ consultations Program Staff: Over 80 caregivers, scientists, and support staff dedicated to mesothelioma Hospital Affiliation: Brigham and Women's Hospital, Dana-Farber Brigham Cancer Center Academic Affiliation: Harvard Medical School (principal teaching affiliate) NCI Designation: Comprehensive Cancer Center (Dana-Farber Brigham) U.S. News Ranking: #4 in cancer care nationally (2025-26) VA Partnership: VA Boston Healthcare System collaboration Research Focus: Genomic profiling, four-gene ratio test, immunotherapy trials Historic Innovation: Pioneered modern multimodal therapy (surgery + chemo + radiation)

What Is the History of Mesothelioma Treatment at Brigham?

The International Mesothelioma Program's history is inseparable from the institutional history of Brigham and Women's Hospital and the pioneering career of Dr. David Sugarbaker.

Hospital Foundation and Merger

Today's Brigham and Women's Hospital resulted from a 1980 merger of three prestigious Harvard teaching hospitals: Peter Bent Brigham Hospital (founded 1913), Robert Breck Brigham Hospital (founded 1914), and Boston Hospital for Women (created 1966 from earlier institutions dating to 1832). The hospital has a distinguished history of medical firsts, including the first successful kidney transplant (1954) and first heart transplant in New England (1984).

The David Sugarbaker Era (1989-2014)

Dr. David Sugarbaker joined Brigham and Women's Hospital in 1989 as Chief of Thoracic Surgery and would spend 25 years building the institution's mesothelioma expertise. At a time when most surgeons had abandoned aggressive surgical treatment for mesothelioma due to poor results, Dr. Sugarbaker took a different approach.

1992: The EPP Revolution

In 1992, Dr. Sugarbaker published his redesigned extrapleural pneumonectomy (EPP) technique in the Annals of Thoracic Surgery. While EPP—removing the entire affected lung along with the pleura, diaphragm, and pericardium—was not a new procedure, most centers had stopped performing it due to high mortality rates and poor outcomes. Dr. Sugarbaker's refinements dramatically improved safety and established EPP as a viable option for selected patients.

1996: Multimodal Therapy Landmark

Dr. Sugarbaker's landmark 1996 article in the Annals of Surgery reported results in 120 consecutive patients receiving multimodal therapy—the combination of surgery, chemotherapy, and radiation that would become the standard approach at specialized centers worldwide. This work demonstrated that aggressive, coordinated treatment could extend life for mesothelioma patients in ways that single-modality approaches could not.

"Dr. Sugarbaker's work transformed how the medical community approached mesothelioma. Before his innovations, patients had virtually no options. He showed that with the right expertise and coordinated care, meaningful treatment was possible."

— Paul Danziger, Founding Partner, Danziger & De Llano

2002: The International Mesothelioma Program

Building on over a decade of experience, Dr. Sugarbaker formally established the International Mesothelioma Program in 2002. This was the first dedicated mesothelioma program in the world (UCLA had founded their program in 1997, but Brigham's IMP was the first to be formally designated as such with dedicated infrastructure and multidisciplinary team).

The IMP quickly became the largest program of its kind globally, bringing together specialists from multiple disciplines under one organizational umbrella focused exclusively on mesothelioma research and treatment.

2014-Present: The Raphael Bueno Era

When Dr. Sugarbaker departed for Baylor College of Medicine in 2014, Dr. Raphael Bueno—who had worked alongside Sugarbaker for over a decade—assumed leadership of the IMP. Under Dr. Bueno's direction, the program has expanded its genomic research initiatives and adapted its surgical approach to favor lung-sparing procedures in many cases.

Dr. Sugarbaker passed away on August 29, 2018, leaving behind a legacy that transformed mesothelioma treatment worldwide.

Which Physicians Lead the Mesothelioma Program?

Dr. David J. Sugarbaker, MD (1953-2018) — Founder

Dr. Sugarbaker earned the nicknames "Mr. Mesothelioma" and "Dr. Mesothelioma" for his pioneering contributions to the field. His legacy includes:

• Founder and Director of the International Mesothelioma Program (2002-2014)
• Chief of Thoracic Surgery, Brigham and Women's Hospital
• Chief of Surgical Services, Dana-Farber Cancer Institute
• Professor of Surgery, Harvard Medical School
• Redesigned and refined extrapleural pneumonectomy surgery (1992)
• Developed modern trimodal therapy approach
• Pioneered use of intraoperative heated chemotherapy (HIPEC) for mesothelioma
• Published over 200 peer-reviewed articles on thoracic malignancies

Dr. Raphael Bueno, MD — Current Director

Dr. Bueno assumed leadership of the IMP in 2014 and continues advancing the program's research and clinical missions.

• Chief, Division of Thoracic Surgery, Brigham and Women's Hospital
• Co-Director, The Lung Center
• Director, International Mesothelioma Program (2014-present)
• Board-certified in general surgery, thoracic surgery, and surgical critical care
• Harvard Medical School: MD 1985; Harvard College undergraduate in biochemistry

Research Focus:

• Genomics to predict, detect, and treat thoracic cancers
• Genetic engineering for improved detection and prognosis
• Investigation into gender differences in mesothelioma (men more likely to develop it, women tend to have longer management periods)
• Development of the four-gene ratio test for prognostic assessment

ℹ️ Program Depth: The IMP maintains over 80 dedicated caregivers, scientists, and support staff focused exclusively on mesothelioma—one of the largest concentrations of mesothelioma expertise anywhere in the world.

What Treatment Approaches Does Brigham Offer?

The International Mesothelioma Program offers comprehensive treatment options, with a philosophy rooted in aggressive multimodal therapy tailored to each patient's specific disease characteristics.

Surgical Options

• Extrapleural Pneumonectomy (EPP): The procedure Dr. Sugarbaker refined—removing the lung, pleura, diaphragm, and pericardium—for appropriate candidates
• Extended Pleurectomy/Decortication (EPD): Lung-sparing surgery removing diseased tissue while preserving the lung, increasingly favored for many patients
• Cytoreductive Surgery with HIPEC: For peritoneal mesothelioma, combining surgery with heated intraoperative chemotherapy

Medical Oncology

• Chemotherapy regimens including pemetrexed/cisplatin combinations
• Immunotherapy with checkpoint inhibitors
• Novel biological drugs based on tumor genetics
• Clinical trial access for cutting-edge therapies

Radiation Therapy

• Intensity-modulated radiation therapy (IMRT)
• Post-surgical adjuvant radiation
• Hemithoracic radiation protocols

Specialized Capabilities

The IMP has developed particular expertise in both pleural and peritoneal mesothelioma—unusual among mesothelioma programs, which typically specialize in one or the other. The program also maintains:

• Comprehensive diagnostic services including advanced imaging
• Expert pathology review (crucial for accurate diagnosis)
• Second opinion services for patients seeking confirmation
• Patient liaisons and social workers for care coordination

What Clinical Trials Can Patients Access?

The IMP maintains an active clinical research program, building on Dr. Sugarbaker's legacy of advancing mesothelioma treatment through rigorous investigation.

Current and Recent Trials

MAGIC AKI Trial: Studying magnesium for the prevention of hyperthermic intraoperative chemotherapy-associated acute kidney injury in mesothelioma patients undergoing cytoreductive surgery.

Keytruda + Defactinib Combination: Evaluating pembrolizumab (Keytruda) combined with defactinib prior to surgical resection, exploring whether immunotherapy before surgery can improve outcomes.

Prognostic Biomarker Study: Investigating pleural mesothelioma prognostic biomarkers from prospectively collected pleural biopsies to better predict disease behavior.

Four-Gene Ratio Test Development: Research into molecular testing that may help determine prognosis and guide treatment decisions.

Genomic Research Initiative

The IMP maintains a comprehensive genomic project that catalogs and shares mutations associated with mesothelioma, contributing to the broader scientific understanding of the disease and informing targeted therapy development.

✓ Research Partnerships: The IMP collaborates with Dana-Farber Cancer Institute, Massachusetts General Hospital, Boston VA Health Care System, and Harvard School of Public Health, creating one of the most robust mesothelioma research networks in the world.

How Can Veterans Access Care at Brigham?

Approximately 30% of all mesothelioma patients are military veterans, primarily due to extensive asbestos use in naval vessels, military facilities, and equipment through the 1970s. The IMP maintains an important partnership with the VA Boston Healthcare System to serve this population.

VA Boston Healthcare System Partnership

The VA Boston Healthcare System operates multiple campuses in the Boston area and maintains a collaboration with Brigham and Women's Hospital, providing veterans access to IMP expertise. This partnership allows veterans to receive care from Harvard Medical School-affiliated physicians while utilizing their VA healthcare benefits.

VA Benefits for Mesothelioma Patients

Veterans diagnosed with mesothelioma may be eligible for:

• VA Disability Compensation: Up to $3,700+ monthly for 100% disability rating
• VA Healthcare: Comprehensive medical care at no or reduced cost
• Special Monthly Compensation: Additional payments for severe disabilities
• Aid and Attendance Benefits: For veterans requiring assistance with daily activities

"Veterans can pursue VA benefits and legal compensation simultaneously—these are separate systems. Many families don't realize they may be entitled to both forms of recovery."

— Rod De Llano, Founding Partner, Danziger & De Llano

New England Military Asbestos Exposure Sites

Veterans in the Boston area may have been exposed to asbestos at numerous military and industrial installations, including:

• Boston Naval Shipyard (Charlestown Navy Yard)
• Fore River Shipyard (Quincy)
• Portsmouth Naval Shipyard (Kittery, Maine)
• General Dynamics Electric Boat (Groton, Connecticut)
• Various power plants and industrial facilities throughout New England

What Support Services Help Patients and Families?

The IMP provides comprehensive support services recognizing that mesothelioma affects the entire family unit.

Patient Care Coordination

• Patient Liaisons: Dedicated staff to coordinate appointments and navigate the healthcare system
• Social Workers: Professional support for emotional, practical, and financial concerns
• Multidisciplinary Team: Each patient's case is reviewed by specialists across multiple disciplines
• Care Coordination: Seamless communication between surgical, medical, and radiation oncology teams

Housing and Travel Assistance

The program offers special housing assistance for patients and families traveling to Boston for treatment. Resources include:

• American Cancer Society Hope Lodge locations in the Boston area
• Extended Stay America partnerships
• Social work assistance identifying local housing options
• Travel grant programs for qualifying patients

International Patient Services

As the "International" Mesothelioma Program, the IMP regularly treats patients from around the world and offers:

• Worldwide telemedicine consultations
• International patient coordination services
• Medical record review and second opinion services
• Treatment planning for patients who may receive care closer to home

What Financial Resources Are Available for Treatment?

Mesothelioma treatment costs can exceed $400,000, creating significant financial stress for patients and families. Multiple resources exist to help offset these costs.

Asbestos Trust Funds

Over $30 billion remains available in 60+ asbestos bankruptcy trust funds established by companies that manufactured or used asbestos products.

• Average Trust Fund Payment: $300,000 - $400,000 total
• Processing Time: Some trusts pay within 90 days
• Multiple Eligibility: Most patients qualify for 5+ trusts; high-exposure workers may access 20-40+

Legal Compensation Options

Beyond trust funds, mesothelioma patients may pursue:

• Personal Injury Lawsuits: Against companies responsible for asbestos exposure
• Wrongful Death Claims: For families who have lost loved ones
• Settlement Negotiations: Often faster than going to trial
• VA Benefits: For veterans (can be pursued simultaneously with legal claims)

⚠️ Important: Massachusetts has specific statutes of limitations for asbestos claims. The time to file may be limited from the date of diagnosis. Consulting with an experienced mesothelioma attorney promptly can help protect your legal rights.

How Does Treatment Connect to Legal Compensation?

Patients focused on treatment often don't realize that the medical documentation generated during their care can become critical evidence for legal claims.

Medical Records as Legal Evidence

The diagnostic process at specialized centers like Brigham generates detailed documentation supporting compensation claims:

• Pathology Reports: Expert confirmation of mesothelioma diagnosis and cell type
• Imaging Studies: Documentation of disease extent and characteristics
• Treatment Records: Establishes medical expenses and ongoing care needs
• Work History Documentation: Often gathered during medical intake

Why Brigham's Expertise Matters for Legal Claims

Treatment at an NCI-designated comprehensive cancer center with dedicated mesothelioma expertise provides several advantages:

• Expert pathology review from physicians who have examined thousands of mesothelioma cases
• Detailed documentation reflecting deep understanding of the disease
• Access to physicians who can provide authoritative testimony if needed
• Comprehensive treatment records supporting damages claims

"The detailed work history documentation that specialized mesothelioma centers gather during treatment often identifies exposure sources patients didn't even realize were relevant. This information can significantly expand compensation recovery."

— Paul Danziger, Founding Partner, Danziger & De Llano

Get Help Today

If you or a loved one has been diagnosed with mesothelioma and are seeking treatment at Brigham and Women's Hospital or any specialized cancer center, you may be entitled to significant compensation for your asbestos exposure.

Free Case Evaluation

The experienced mesothelioma attorneys at Danziger & De Llano offer free, confidential case evaluations to help you understand your legal options. With decades of experience representing mesothelioma patients and their families, we can help you:

• Identify all potential sources of compensation
• File trust fund claims efficiently
• Pursue legal action against responsible parties
• Coordinate legal efforts with your medical treatment

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