Stephen D. Cassivi, M.D.

Lung cancer

Early Detection of Lung Cancer:
Along with our colleagues in the Department of Radiology and Pulmonary Diseases, we are involved in the use of low dose spiral CT scans for detection of asymptomatic and early stage lung cancer.

Clinical trials for the treatment early and advanced Lung Cancer:
Currently, the Mayo Clinic division of Chest Surgery (General Thoracic Surgery) is involved in a number of clinical trials looking into the optimal surgical and post-operative treatment of early and late stage lung cancer. These trials are conducted here at Mayo Clinic with the collaboration of the American College of Surgeons Oncology Group (ACOSOG), the North Central Cancer Treatment Group (NCCTG), and other major cancer study groups. Many of our patients are potential candidates for these on-going trials.

Esophageal diseases

Esophageal Cancer and Barrett's Esophagus:
The Barrett's Esophagus Genomic Study group, is comprised of 154 physicians from varying practice environments who collaborate to identify families in which 3 or more members have classic long segment Barrett's esophagus, (a pre-malignant disorder) with or without esophageal cancer, in order to collect blood specimen for genetic linkage analysis.

The Mayo Clinic Esophageal Adenocarcinoma and Barrett's Esophagus (EABE) Registry is an unprecedented resource combining phenotype, genotype and environmental risk factor analysis. This collaborative venture represents the efforts of 48 Mayo Clinic physicians from the Divisions of Gastroenterology & Hepatology, Genetic Epidemiology, Biostatistics, Medical Oncology, Molecular Biology & Genetics, Pathology, Pulmonary Medicine, Psychology, Radiation Oncology, Thoracic (Chest) Surgery, and the Mayo Clinic Cancer Center. The aims of the EABE Registry loosely include identification of candidate loci for GERD symptoms and its complications, and to contribute to the scientific literature regarding the genomic steps necessary for the transformation from Barrett's esophagus to invasive cancer. The registry has begun to be utilized for gene discovery projects. In addition, identification of genomic polymorphisms that are associated with distant metastasis or that confer survival benefit may also prove possible using the EABE registry resource.

Lung transplantation and end-stage lung diseases

Gene Therapy:
I continue to be generally involved and interested in the utility and feasibility of Gene Therapy strategies in the area of Lung Transplantation. With proper application, genetically targeted therapies may be able to decrease or prevent the two main hurdles of clinical Lung Transplantation: Ischemia-Reperfusion injury and Obliterative Bronchiolitis, a manifestation of chronic graft dysfunction.

Donor Organ Allocation Strategies:
In our attempt to make the most of a precious yet scarce resource, the Mayo Clinic Cardiothoracic Transplant Team continues to study and investigate optimal donor organ utilization, both on a system-wide scale as well as on the micromanagement of the individual donor.

Emphysema (COPD):
I continue to have a particular interest in the management of end-stage emphysema, both acquired and genetic (Alpha-1). Mayo Clinic Chest surgeons continue to be actively involved in the National Emphysema Treatment Trial which studied the benefits of Lung Volume Reduction Surgery (LVRS). For patients with end-stage lung disease due to Emphysema (COPD), LVRS or lung transplantation may provide improvements in quality of life or survival.