Dr. Brian Loggie
Chief of Surgical Oncology at CHI Health Creighton University Medical Center
Dr. Brian Loggie, now retired from practice, was a professor of surgery and the Chief in the Division of Surgical Oncology at CHI Health Creighton University Medical Center. He was a long-time proponent of cytoreductive surgery with HIPEC for peritoneal malignancies, including peritoneal mesothelioma.
Peritoneal Mesothelioma (Retired)
CHI Health Creighton University Medical Center
7500 Mercy Road, Omaha, NE 68124
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More About Mesothelioma Specialist Dr. Brian Loggie
Dr. Loggie’s medical training dates back to the 1970s, when he attended McGill University in Montreal, Canada. He completed his residency and fellowship training in the 1980s and began learning about peritoneal mesothelioma a few years later.
He has performed HIPEC with cytoreductive surgery for decades, starting his research in the 1990s. His clinical focus involves rare cancers, including peritoneal mesothelioma.
“When I started, there were only three in the country with real expertise,” he said, noting there are many more programs training surgical oncologists for peritoneal malignancies.
“I was responsible for starting some of those. I’ve had a national practice since the mid-1990s because that’s when the internet became available and useful.”
Before coming to CHI Health Creighton University Medical Center in 2002, Dr. Loggie worked at Wake Forest Baptist Health in Winston-Salem, North Carolina. The cancer center boasts one of the best HIPEC programs in the world. At the center, Dr. Loggie instituted the use of HIPEC and cytoreduction for peritoneal cancers.
Dr. Loggie retired from practice around the time of the COVID-19 pandemic.
Aside from Creighton University, he has held faculty positions at the:
- University of Illinois-Chicago
- Bowman Gray School of Medicine (Wake Forest)
- University of Texas Southwestern Medical Center
- Medical degree from McGill University in Montreal, Canada, 1979
- Surgery residency at Montreat General Hospital, 1986
- Fellowship in surgical oncology at University of Illinois-Chicago, 1988
- Certification in general surgery from the Royal College of Physicians and Surgeons of Canada and the American Board of Surgery
- Certification in training in surgical oncology from the University of Illinois School of Medicine
- Fellow of the Royal College of Surgeons of Canada, Society of Surgical Oncology, American College of Surgeons and Southeastern Surgical Congress
- Membership in the Canadian Association of General Surgeons, Association for Academic Surgery, American Medical Association, Southern Association for Oncology, American College of Surgeons, American Society of Clinical Oncology (ASCO) and International Society for Regional Cancer Therapy
National Mesothelioma Practice for Decades
Dr. Loggie has been part of the Creighton University HIPEC and peritoneal cancer program for decades. He saw patients from across the country, around 20-30 cases a year, up until the COVID-19 outbreak. The pandemic has limited travel and made reaching Dr. Loggie and his team more challenging.
For years, Dr. Loggie was a leader in treating peritoneal mesothelioma. He believes people should rely on the doctors with experience treating this specific cancer.
“Pleural mesothelioma is uncommon, but peritoneal mesothelioma is rare,” he said. “I think rare diseases should be treated by people who see enough cases to recognize the variety. They should be able to address the treatment issues because treatment has evolved.”
Protocol for Surgery
HIPEC with cytoreduction is often one aspect of peritoneal mesothelioma therapy. Dr. Loggie suggests patients receive neoadjuvant chemotherapy. This can slow the growth or even reduce tumor volume in the abdominal cavity.
Dr. Loggie would not remove the peritoneum.
“It doesn’t make a whole lot of sense,” he said. “There is a lot of surface there. It causes bleeding, scarring, and all sorts of problems.”
He was a proponent in using carboplatin as the sole chemotherapy drug in HIPEC. The therapy is an acronym for “hyperthermic intraperitoneal chemotherapy.” It delivers heated chemotherapy drugs into the abdominal cavity. This method washes the microscopic tumors left after surgery. It’s purpose is to reduce the chance of recurrence.
“When cisplatin is combined with alimta, we’ve seen dramatic renal failure, especially for older patients,” he said in support of carboplatin.
Treatment for Unresectable Peritoneal Mesothelioma
“For the majority of patients, you’re probably not going to be able to get complete resection,” Dr. Loggie said. “You’re dealing with so many surfaces.”
The inability to complete cytoreduction may lead to systemic therapy. This opens the door to try immunotherapy. The treatment is approved for pleural mesothelioma but not yet for peritoneal mesothelioma. The rarity of peritoneal mesothelioma — around 200-300 diagnosed cases each year — makes widespread acceptance of any one therapy difficult.
However, many peritoneal mesothelioma specialists support its use. Dr. Loggie was one of these doctors.
“We’re seeing responses in first-line, at times, and usually second-line immunotherapy for people who haven’t responded to chemotherapy,” he said.
“It’s combination therapy. Everything is moving towards combination therapy. That’s why we’ve made sure we’re working with a medical oncologist.”
Quality of Life: Focus on Inpatient Recovery Time
Going overboard with surgery can cause more problems than improve survival, and patients may not respond well to adjuvant therapies. This is why quality of life is so important.
“We have always put an onus on quality of life,” Dr. Loggie said, “because if you don’t hurt people and you preserve their quality of life, you preserve more treatment options.”
Inpatient recovery from cytoreductive surgery can take a week or more. It’s a lengthy debulking procedure and puts stress on the patient’s body.
“We’ve worked hard to apply the Enhanced Recovery After Surgery protocol for all HIPEC patients,” Dr. Loggie said. “Our median hospital stay is down to four days. It’s about the best in the world.”
Sources & Author
- Brian Loggie. LinkedIn. Retrieved from: https://www.linkedin.com/in/brian-loggie-5b538138/. Accessed: 11/05/2022.
- Brian W. Loggie, MD, CM, FRCSC, FACS. Creighton University. Retrieved from: https://www.creighton.edu/sites/default/files/2021-11/bwlbio.pdf. Accessed: 11/05/2022.
