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Focus on Steven Strasberg, MD

Steven Strasberg, MD, is the Pruett Professor of Surgery. His areas of specialties include liver and pancreas surgery, biliary surgery, and gallbladder surgery, and particularly surgery for cancer of these organs. Dr. Strasberg sees patients at Barnes-Jewish Hospital in GI Center in the Center for Advanced Medicine, 4921 Parkview Place, 8th floor, Suite C, St. Louis, MO; and at Barnes-Jewish West County Hospital at Olive and Mason Road.

PLEASE CALL 314 362-7147 FOR AN APPOINTMENT.

What happened in the course of schooling to make you choose your specialty?

I chose general surgery because I enjoyed helping patients deal with serious problems. Of course, one is always influenced by the people one works with. I knew and admired several surgeons who specialized in abdominal surgery -- I wanted to emulate them.

Liver disease was my area of research, and I realized a fair amount of my time would be spent in the lab. In order to maintain expertise in an area of abdominal surgery, I narrowed my specialty to liver, pancreas and biliary surgery. In those days there was no subspecialty called hepatobiliary pancreatic surgery -- but I did it to focus on and remain skillful in a narrow area related to my research. That’s how I became a hepatobiliary pancreatic surgeon.

Dr. Strasberg and his family
What influenced your decision to come to Washington University?

I was at the University of Toronto for a number of years where I rose to the level of professor. In 1992 I felt that I needed a change and could grow more in a different university. I spoke to friends who had come to Washington University. Sam Wells, MD, who was chairman of surgery at the time, called me --and that’s how I came here.

Which aspect of your practice do you find most interesting?

I find all aspects fascinating. It is interesting from the diagnostic side -- a lot of unusual cases are sent here. It is challenging to diagnose and stage patients so that they become good operative candidates. Because we deal with difficult and unusual tumors of the liver and pancreas, post-operative care is also very crucial.

What new developments in your field are you most excited about?

Of course as a surgeon, I’m very interested in the technical aspects of our craft. There are a lot of innovations making operations less invasive. We’re also getting our hands on all kinds of new instruments, like robots which may make surgery easier for us and our patients.

What is very promising is the research we’re doing to find tumors earlier. This will enable us to destroy all of the tumors using a combination of surgery and adjunctive therapy. While we are very good at removing 99.99% of a cancerous tumor, sometimes we miss a tiny bit that may have drifted off into another area of the body before surgery. When this happens, patients get reoccurrences. The prospect of being able to cure someone completely of cancer, using a chemo-like drug or vaccine hand-in-hand with surgery, is very exciting.

Are those adjunctive therapies available now?

We’ve made a great deal of progress. For instance, we operate on a lot of people who have colorectal cancer that has gone to the liver. We’re extremely good at removing those cancers from the liver and we now have very good chemotherapy to kill off any cells that are left anywhere in the body. Our cure rates have skyrocketed in the past ten years.

On the other hand, the story is much different for pancreatic cancer. The surgical operation may be a success by every criterion; we get negative margins, the patients do well and they have few complications -- but there are still recurrences. The cure rate of pancreatic cancer is about 25% --but that means 75% of people get recurrences and die of their disease, even after surgery. RAMPS is a new procedure for cancer of the body or tail or the pancreas. In our most recent analysis 35% of patients who had this procedure were long-term survivors.

Where are you from?

I’m from Toronto, Canada. My four children live there. They did make the journey down here, but over the past 18 years they have all drifted back to Toronto.

Which particular award or achievement is most gratifying?

The achievement that is most gratifying is being able to bring procedures into surgery to increase safety and efficacy. The described method of doing laparoscopic cholecystectomy (removal of gall bladder), is called the Critical View of Safety -- this has increased the safety of the operations.

We’ve introduced new operations for cancer of the pancreas – one of them is a novel approach for resection called RAMPS, mentioned above. Also, for many years I did research on gallstone formation and organ preservation. But if I had to pick what I am most pleased with when I look back on my career, it would be having a direct impact on surgery in terms of safety.

What is the best advice you’ve ever received?

That’s would be when my mother told me to marry my wife. We’ve been married 47 years.

If you weren’t a doctor, what would you like to be doing?

I can’t remember ever wanting to be anything else other than a physician. I used to kid my mother that she must have been whispering in my ear when I was a baby about being a doctor.

I was actually very influenced by our family doctor. In those days, doctors used to make house calls and I was very impressed with all the paraphernalia he brought with him.

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Copyright 2013 Washington University School of Medicine