So I'm about four weeks out from my surgery and I spent way too much time in October and November trying to figure out who actually knew what they were doing with multimodal treatment. Not just surgery, not just the chemo after, but the whole thing working together.
First thing I did was call three major cancer centers on the West Coast. UC San Diego, City of Hope, Stanford. I didn't ask "do you do mesothelioma" because yeah they all say yes. I asked "who is the thoracic surgeon leading your multimodal protocol for pleural meso right now and can I talk to them." Two of them transferred me three times. One got me on the phone with Dr. Marcus Chen in two business days and he actually answered my questions instead of reading from a pamphlet.
Here's what mattered when I talked to him. He knew the difference between EPD and P/D without me having to explain it. He said "your case looks like a candidate for surgery followed by chemo and we'll reassess for radiation" instead of "we'll do surgery." He had numbers. Not percentages, actual numbers of how many pleural meso patients he'd done multimodal on in the last three years. He said 34 in the last two years. When I asked what happened to them he didn't dodge it.
I also asked about the chemo oncologist he works with. If your surgeon doesn't have a name ready, that's a red flag. They should be coordinating. Dr. Chen named Dr. Patricia Reeves and said they meet weekly on cases. That's real collaboration, not just "we have an oncology department."
One thing nobody tells you is to ask about the gaps between treatments. I asked "how long after surgery do we start chemo" and he said 4 to 6 weeks, depends on recovery. Then I asked "what if I'm not recovered, do we push it" and he said sometimes yes sometimes no and here's why we make that call. That's the answer that made me trust him.
I also checked the VA records thing because I'm a Camp Lejeune guy from 78 to 82 and I wanted to know if my service exposure meant anything to him. He asked the right questions about the barracks and the ship. He knew asbestos was in the steam lines on the Iwo Jima. He didn't pretend he was a VA expert but he said "I've worked with enough vets that I know how to document this for your claim." That mattered to me.
The surgery was December 6th at UC San Diego and yeah it was rough but I knew going in that this team had done this before and they had a plan for what came next. Don't just pick the closest hospital or the one your regular doctor says. Make three calls. Ask for the surgeon. Ask about the oncologist. Ask what happens between treatments. If they won't give you specifics you don't want them.