Dr. Robert Cameron
Executive Summary
Dr. Robert B. Cameron is a thoracic surgeon at UCLA who has been instrumental in promoting lung-sparing surgical approaches for pleural mesothelioma, fundamentally changing how surgeons treat this disease. As director of thoracic surgery at Ronald Reagan UCLA Medical Center and founder of the UCLA Comprehensive Mesothelioma Program, Cameron has spent more than two decades refining pleurectomy with decortication (P/D) as an alternative to the more radical extrapleural pneumonectomy (EPP).[1] His advocacy for preserving the lung anticipated the direction of the randomized evidence that followed. The 2011 MARS feasibility study randomly assigned 50 patients to EPP or to no EPP within trimodal therapy, and reported median overall survival of 14.4 months in the EPP group against 19.5 months in the no-EPP group (unadjusted hazard ratio 1.90, 95% CI 0.92-3.93, p=0.082; adjusted HR 2.75, 95% CI 1.21-6.26, p=0.016). Its authors concluded that the data, "although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients".[2] Dr. Cameron also serves as chief of thoracic surgery at the West Los Angeles VA Medical Center, providing specialized mesothelioma care to veterans who were exposed to asbestos during military service.[3]
The lung-sparing philosophy Dr. Cameron championed represents a fundamental shift in mesothelioma surgical thinking. While extrapleural pneumonectomy removes the entire affected lung along with the pleura, pleurectomy with decortication removes only the diseased pleural lining while preserving lung function. This approach results in faster recovery, fewer complications, and better quality of life for patients—benefits that Cameron argued outweighed any theoretical advantage of more radical surgery.[4]
Dr. Cameron's dual role at UCLA and the West LA VA Medical Center reflects the disproportionate impact of mesothelioma on military veterans, who account for approximately 30% of all cases due to widespread asbestos use in naval shipyards, aircraft, and military installations. The UCLA Comprehensive Mesothelioma Program offers these patients access to clinical trials testing novel combinations of immunotherapy, targeted therapy, and surgical approaches that may not be available at other institutions.[5]
At a Glance
- Lung-sparing pioneer — Championed pleurectomy with decortication (P/D) when most surgeons still favored removing the entire lung
- MARS trial supported his position — The 2011 randomized feasibility study found no benefit from lung removal, though its authors described their own data as limited[2]
- Randomised evidence favored lung preservation — In the MARS feasibility study median survival was 14.4 months with EPP against 19.5 months without it, and the authors judged that EPP "offers no benefit and possibly harms patients"[2]
- UCLA program founder — Built one of the West Coast's leading mesothelioma treatment and research centers from the ground up
- Veterans' surgeon — Serves as chief of thoracic surgery at the West LA VA, treating the population with the highest mesothelioma rates
- Multidisciplinary approach — Combines surgery with immunotherapy, targeted therapy, and clinical trials at UCLA
- Two decades of specialization — Has practiced mesothelioma surgery at UCLA for more than twenty years
- Quality of life focus — Demonstrated that preserving the lung leads to faster recovery, fewer complications, and better breathing
Key Facts
| Metric | Finding |
|---|---|
| Primary Institution | UCLA Ronald Reagan Medical Center |
| Signature Procedure | Pleurectomy with decortication (P/D) and extended P/D |
| Surgical Experience | More than two decades specializing in mesothelioma |
| Program Founded | UCLA Comprehensive Mesothelioma Program |
| VA Role | Chief of Thoracic Surgery, West Los Angeles VA Medical Center |
| Key Randomised Evidence | MARS (2011) compared EPP with no EPP — not with P/D — and found no benefit from EPP |
| MARS Median Survival | 14.4 months (EPP) vs 19.5 months (no EPP) |
| Surgical Philosophy | Lung preservation with comparable cancer control and better quality of life |
| Veteran Patient Population | Approximately 30% of mesothelioma cases occur in military veterans |
| Clinical Trial Access | UCLA program offers novel immunotherapy and targeted therapy combinations |
Who Is Dr. Robert Cameron and Why Is He Called the Champion of Lung-Sparing Surgery?
Dr. Robert B. Cameron is a thoracic surgeon who challenged the prevailing surgical dogma for mesothelioma treatment. At a time when extrapleural pneumonectomy (EPP)—removing the entire lung along with surrounding tissues—was considered the standard approach, Cameron argued that a less radical surgery could achieve comparable cancer control while preserving the patient's lung and quality of life.[6]
His position was initially controversial. Many surgeons believed that more aggressive surgery was necessary to remove all possible disease. Cameron's contention that preserving the lung could achieve similar outcomes while reducing operative risk and maintaining quality of life was met with skepticism by some colleagues.[7]
| "Dr. Cameron's willingness to question conventional wisdom has benefited thousands of mesothelioma patients. When the MARS trial found no survival benefit from removing the lung, it took the argument away from the operation he had spent years questioning. Many of our clients have better quality of life because of his pioneering work." |
| — Paul Danziger, Founding Partner, Danziger & De Llano |
What Is Pleurectomy with Decortication (P/D)?
Pleurectomy with decortication is a lung-sparing surgical procedure that removes diseased pleural tissue while preserving the underlying lung.[8]
Standard P/D
The basic procedure involves:
- Removal of the parietal pleura (outer lining of the chest cavity)
- Removal of the visceral pleura (lining around the lung)
- Preservation of the lung itself
- Removal of visible tumor from pleural surfaces
Extended P/D
Dr. Cameron helped develop the extended version, which adds:
- Resection of the diaphragm (similar to EPP)
- Resection of the pericardium when involved
- More complete removal of all diseased tissue
- Reconstruction of removed structures
| Procedure | Lung Preserved? | Operative Risk | Recovery Time |
|---|---|---|---|
| P/D (Lung-Sparing) | Yes | Lower | Faster |
| EPP (Lung Removal) | No | Higher | Longer |
| ✅ Quality of Life Advantage: Patients who keep their lung can breathe more easily, have fewer complications, and recover faster. This quality of life benefit is a major advantage of the lung-sparing approach Dr. Cameron championed. |
What Did the MARS Trial Actually Test?
The Mesothelioma and Radical Surgery (MARS) trial, published in 2011, tested whether extrapleural pneumonectomy (EPP) added benefit within trimodal therapy. It did not compare EPP against P/D, so it cannot speak to lung-sparing surgery directly; what it did was undercut the rationale for the aggressive approach Dr. Cameron had argued against. This randomized controlled trial compared EPP with no EPP in patients receiving chemotherapy.[9]
Key MARS Trial Findings:
- EPP offered no survival benefit compared to non-EPP approaches
- EPP potentially harmed patients through higher operative mortality
- Recruitment completed as planned; the authors concluded a larger trial was not feasible given the morbidity observed
- Results weakened the case for routine EPP, the approach Dr. Cameron had argued against — the trial did not test P/D
| ℹ️ Paradigm Shift: Following the MARS trial publication, many mesothelioma treatment centers moved away from routine EPP in favor of extended P/D. Within MARS itself, median overall survival was 14.4 months in the EPP group against 19.5 months in the no-EPP group, and ten serious adverse events were reported after EPP against two without it.[2] |
The MARS trial did not test Cameron's preferred operation, but by finding no benefit and higher operative risk for EPP it removed much of the argument for it, and the surgical approach to mesothelioma shifted accordingly.[10]
| "The MARS trial was a turning point for mesothelioma treatment. For years, surgeons assumed more aggressive surgery meant better outcomes. Dr. Cameron understood that preserving function while controlling cancer was the right balance. The trial never tested his operation directly, but it took the survival case away from the one he opposed." |
| — Rod De Llano, Founding Partner, Danziger & De Llano |
What Is the UCLA Comprehensive Mesothelioma Program?
Dr. Cameron founded the UCLA Comprehensive Mesothelioma Program, creating one of the West Coast's leading centers for mesothelioma treatment and research.[11]
Program Features:
- Multidisciplinary Team: Thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, and pathologists collaborate on each case
- Advanced Surgical Techniques: Expertise in both P/D and, when appropriate, EPP
- Clinical Trials: Access to novel therapeutic combinations not available elsewhere
- Research Programs: Investigation of new treatments and approaches
- Patient Support: Comprehensive services for patients and families
The program combines advanced surgical approaches with clinical trials testing novel therapeutic combinations, making cutting-edge treatments available to patients who might otherwise lack access.[12]
How Does Dr. Cameron Serve Veterans with Mesothelioma?
Dr. Cameron's work extends beyond UCLA to encompass comprehensive mesothelioma care for veterans as chief of thoracic surgery at the West Los Angeles VA Medical Center.[13]
This role is particularly significant because veterans have disproportionately high rates of mesothelioma due to:
- Naval Service: Asbestos was extensively used in ship construction and insulation
- Shipyard Work: Navy shipyards were among the highest-exposure environments
- Military Construction: Barracks and military buildings contained asbestos materials
- Vehicle Maintenance: Military vehicles used asbestos in brakes and clutches
| ⚠️ Veterans' Higher Risk: Veterans are significantly more likely to develop mesothelioma than civilians due to military asbestos exposure. Dr. Cameron's work at the West LA VA ensures these patients have access to specialized surgical expertise. |
Through the VA system, Dr. Cameron provides the same high-quality, lung-sparing surgical care to veterans that patients receive at UCLA.[14]
What Is Dr. Cameron's Current Surgical Philosophy?
Dr. Cameron's approach to mesothelioma surgery emphasizes individualized treatment decisions based on each patient's specific situation.[15] His published research has demonstrated favorable outcomes from extended P/D combined with multimodal therapy.[16]
Key Principles:
- Patient Selection: Not every patient is a surgical candidate; careful evaluation is essential
- Lung Preservation: When possible, preserve the lung to maintain quality of life
- Complete Cytoreduction: Remove all visible disease regardless of surgical approach
- Multimodal Integration: Combine surgery with chemotherapy and/or immunotherapy
- Quality of Life: Consider functional outcomes, not just survival statistics
| "Dr. Cameron's philosophy aligns with what we see families want: not just longer survival, but survival with quality. Our clients want to spend time with their families, not just exist. The lung-sparing approach he pioneered helps make that possible." |
| — David Foster, Client Advocate, Danziger & De Llano |
What Is Dr. Cameron's Legacy?
Dr. Robert Cameron's contributions have fundamentally changed mesothelioma surgery:[17]
Immediate Impact:
- Established lung-sparing surgery as a viable alternative to EPP
- Demonstrated that less aggressive surgery could achieve comparable outcomes
- Improved quality of life for mesothelioma patients
- Provided specialized care for veterans at the West LA VA
Lasting Influence:
- The MARS trial found no benefit for EPP, the operation he had argued against
- Most centers now prefer P/D over EPP for appropriate candidates
- Patient-centered surgical philosophy has become mainstream
- Training programs emphasize lung preservation when possible
His willingness to challenge surgical orthodoxy when patient outcomes suggested a better approach exemplifies how evidence-based medicine should evolve.[18]
Frequently Asked Questions
What type of surgery does Dr. Cameron specialize in?
Dr. Cameron specializes in pleurectomy with decortication (P/D), a lung-sparing surgical procedure for pleural mesothelioma. Unlike extrapleural pneumonectomy (EPP), which removes the entire lung, P/D removes only the diseased pleural lining while preserving lung function. Dr. Cameron also performs extended P/D, which includes resection of the diaphragm and pericardium when involved.
Why is lung-sparing surgery considered better for mesothelioma patients?
Lung-sparing surgery preserves respiratory function, leading to faster recovery, fewer post-operative complications, and better overall quality of life. The 2011 MARS trial demonstrated that removing the lung offered no survival advantage over lung-preserving approaches, while carrying higher operative risks. Centers that transitioned from EPP to P/D saw median survival improve by approximately 4 months.
Where does Dr. Cameron practice?
Dr. Cameron holds dual appointments at UCLA Ronald Reagan Medical Center, where he serves as director of thoracic surgery, and at the West Los Angeles VA Medical Center, where he is chief of thoracic surgery. His VA role is particularly significant because approximately 30% of mesothelioma patients are military veterans exposed to asbestos during service.
What is the UCLA Comprehensive Mesothelioma Program?
The UCLA Comprehensive Mesothelioma Program is a multidisciplinary center founded by Dr. Cameron that brings together thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, and pathologists. The program offers access to clinical trials testing novel combinations of immunotherapy, targeted therapy, and surgical approaches not available at many other institutions.
Can veterans receive mesothelioma treatment from Dr. Cameron?
Yes. Dr. Cameron serves as chief of thoracic surgery at the West Los Angeles VA Medical Center, providing the same specialized lung-sparing surgical care to veterans that civilian patients receive at UCLA. Veterans diagnosed with mesothelioma may also qualify for VA disability benefits and additional compensation through asbestos trust funds.
What did the MARS trial prove about mesothelioma surgery?
The MARS trial, published in 2011, was a randomized feasibility study that compared extrapleural pneumonectomy (EPP) with no EPP within trimodal therapy. It was not a comparison of EPP against P/D. Fifty patients were randomized, and median overall survival was 14.4 months in the EPP group against 19.5 months in the no-EPP group; the difference was not statistically significant before adjustment (HR 1.90, 95% CI 0.92-3.93, p=0.082). Recruitment completed as planned, and the authors concluded that a larger study was not feasible given the morbidity observed, adding that their data, "although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients". The findings supported the lung-sparing approach Dr. Cameron had advocated for years.[2]
How long has Dr. Cameron been treating mesothelioma?
Dr. Cameron has spent more than two decades specializing in mesothelioma surgery at UCLA. During that time, he has been one of the most prominent advocates for the lung-sparing surgical approach and has trained the next generation of thoracic surgeons in these techniques.
Quick Statistics
- 19.5 months — Median overall survival in the MARS no-EPP group[2]
- 14.4 months — Median overall survival in the MARS EPP group[2]
- 50 — Patients randomized in MARS, a feasibility study rather than a definitive trial[2]
- 30% — Approximate share of all mesothelioma patients who are military veterans
- 2011 — Year the MARS trial was published, finding no survival benefit for EPP[2]
- 20+ years — Duration of Dr. Cameron's specialization in mesothelioma surgery at UCLA
- 2 institutions — UCLA Medical Center and West LA VA Medical Center where Dr. Cameron practices
- 5 disciplines — Number of specialties collaborating in the UCLA Comprehensive Mesothelioma Program
- 3,000+ — Estimated new mesothelioma diagnoses in the United States each year
Patients diagnosed with mesothelioma benefit from accessing specialized surgical care — including the lung-sparing approaches Dr. Cameron pioneered — which can significantly impact both survival and quality of life. Compensation may also be available from the companies responsible for asbestos exposure.
Related Pages
- Pleurectomy and Decortication
- Extrapleural Pneumonectomy
- Mesothelioma Surgery Overview
- Dr. David Sugarbaker
- Pleural Mesothelioma
- Veterans Mesothelioma Quick Reference
- Clinical Trials
- Mesothelioma Survival Statistics
- Mesothelioma Specialists
- History of Mesothelioma Research
External Links
- Danziger & De Llano — Mesothelioma attorneys.
- Mesothelioma Lawyers Near Me — Directory for finding an attorney by location.
- Mesothelioma.net — Patient and family resources.
References
- ↑ Mesothelioma Cancer Centers, Mesothelioma.net
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Treasure T, Lang-Lazdunski L, Waller D, et al. Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study. Lancet Oncology 2011;12(8):763-772. PMID 21723781.
- ↑ VA Asbestos Exposure, U.S. Department of Veterans Affairs
- ↑ Surgery to Treat Cancer, National Cancer Institute
- ↑ UCLA Mesothelioma Clinical Trials, ClinicalTrials.gov
- ↑ Mesothelioma, National Cancer Institute
- ↑ Mesothelioma, National Cancer Institute
- ↑ Pleurectomy Definition, NCI Dictionary of Cancer Terms
- ↑ MARS Trial: Mesothelioma and Radical Surgery, ClinicalTrials.gov
- ↑ Clinical Trials Information, National Cancer Institute
- ↑ Mesothelioma Treatment Centers, Mesothelioma.net
- ↑ NCI-Designated Cancer Centers, National Cancer Institute
- ↑ VA Health Care, U.S. Department of Veterans Affairs
- ↑ VA Disability Compensation Rates, U.S. Department of Veterans Affairs
- ↑ Malignant Mesothelioma Lawyers, Danziger & De Llano
- ↑ Lee T, Everett D, Shu H, Jahan T, Roach M, Speight J, Cameron R, Phillips T, Chan A, Jablons D. Radical pleurectomy/decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma. *J Thorac Cardiovasc Surg*. 2002;124(6):1183-9. PMID 12447185
- ↑ Asbestos, Occupational Safety and Health Administration
- ↑ Asbestos, CDC/NIOSH