This past Thursday marked the start of the three-day E.E. Just Symposium held here on campus. One presentation of interest, “Making Something out of nothing: The Journey in Establishing a New Operation for Children With a Rare Cancer”, was given by Dr. Andrea Hayes-Jordan ’87, DMS ’91. A remarkable individual with a captivating presence, Dr. Hayes-Jordan was the first female African American pediatric surgeon in North America and remains one of only a few specialists in pediatric surgical oncology.
Dr. Hayes-Jordan began her talk by outlining the top twenty inventions or discoveries made in medicine over the last ten years as determined by the World Conference of Physicians in 2010. Sadly, on the list, only advances in vaccinations were applicable to children. As Dr. Hayes-Jordan noted, pediatric care is one of the more neglected areas in this country for many reasons, but especially lack of funding and attention.
Of particular significance, due to Dr. Hayes-Jordan and her colleagues’ work, the rate of childhood cancer related mortality has plummeted in the last ten years, especially in the area of soft tissue sarcomas. Originating from mesenchymal cells, sarcomatosis describes a cancer involving dozens to hundreds of tumor nodules in patients.
Desmoplastic small round cell tumor, as Dr. Hayes-Jordan went on to describe, is a type of soft tissue sarcoma that has been largely ignored by treating physicians due to the hundreds of tumor nodules present in patients, predominantly in the abdominal cavity. The complete surgical removal of these nodules is often deemed impossible by other surgeons and patients are frequently offered only palliative care. An incredibly daunting task, the cytoreductive surgeries that Dr. Hayes-Jordan performs can involve up to twenty hours in the operating room. The multitudes of tumors sit on other organs, making removal intricate. Dr. Hayes-Jordan mentioned that in much of her surgical training, she was taught the traditional approach, which involves removing the organ around the tumor in order to eliminate all of the cancer cells. Her procedures, however, utilize an organ sparing technique that in many ways goes against this normal paradigm. Eradicating the tumors without removing the surrounding structures is a principle that Dr. Hayes-Jordan has largely pressed on in developing this procedure.
In order to eradicate the microscopic disease that is left behind after surgery, Dr. Hayes Jordan has utilized hot chemotherapy. This method, known as Hypothermic intraperitaneal chemotherapy (HIPEC), has a supralethal affect on cancer cells at certain temperatures, but minimizes toxicity because the healthy cells are left unharmed at these levels of about 50 degrees Celsius. This minimization also occurs by Dr. Hayes-Jordan’s use of capillary diffusion instead of capillary flow, allowing her to deliver about 10 times more chemotherapy directly in to the abdomen than through an intravenous treatment.
With Dr. Hayes Jordan’s new methodology and treatment, the survival rates of patients with this disease has gone from 0% chance to a 50% chance of surviving at 100 months. No deaths from her surgeries have occurred, and side affects such as renal failure that once existed have been eliminated by Dr. Hayes-Jordan’s reevaluation and modification of the therapy. This new treatment option and Dr. Hayes Jordan’s incredible work have perfect manifestations of the talk’s theme, making something out of nothing, and have unquestionably given those who were once given a death sentence a true chance at life.