By the time Dr. Daniel Boffa was ten years old he knew that he wanted to be a surgeon. This childhood dream was fostered by watching the television show M*A*S*H, and continued throughout his education until he entered medical school at the University of Chicago Pritzker School of Medicine. His specialty now revolves around minimally invasive surgery for thoracic cancers.
Before entering medical school Dr. Boffa worked as a carpenter and has always enjoyed working with his hands. He pursued a fellowship in thoracic surgery at the Cleveland Clinic because it combined one of the busiest and challenging thoracic surgical practices with close proximity to the Rock and Roll Hall of Fame. Although minimally invasive thoracic surgery was not well established, he saw it as an opportunity to contribute to the field, and sought additional exposure and training in the latest minimally invasive techniques at Cedars Sinai Medical Center in Los Angeles and the University of Pittsburgh.
Dr. Boffa is currently an Assistant Professor of Thoracic Surgery at Yale Cancer Center and the Director of the Esophageal Cancer Program. When asked about the particular challenges in treating thoracic cancers, he explained that patients often have limitations with their lungs and heart resulting from years of smoking, such as emphysema and coronary artery disease. “It is important to balance treatment with quality of life. Occasionally the best approach from the perspective of curing a patient’s cancer would leave the patient unable to participate in activities important to their life. In those instances you realize how specific the goals of cancer care are to each individual; communication is key,” Dr. Boffa said.
Over the years, minimally invasive techniques have allowed surgery to become much safer for a broader range of patients. Surgery used to be far and away the most intimidating and therefore memorable part of cancer care, commented Dr. Boffa, but that is very different today. Recovery is faster, side effects have decreased, and patients do better overall. At present, 85% of the procedures done in thoracic oncology at Smilow Cancer Hospital are performed using minimally invasive techniques. Dr. Boffa explained that the important thing is to use minimally invasive techniques to achieve the same outcomes as with traditional techniques, and the team at Yale has the experience to achieve that goal. “One of the unique aspects of our practice is that all three surgeons have extensive experience with both traditional and minimally invasive techniques. Therefore, we are able to apply all of the oncologic principles that have evolved over the past century of open surgery, to operations performed using newer techniques.”
Dr. Boffa’s laboratory research is interested in the question of how and why cancer spreads. “For most patients we have pretty effective treatment for cancer where it starts, it is the spreading of cancer through the blood stream more often than not that separates the curable from the incurable. As complicated as this process appears to be, all we need to do is disrupt one of the key steps, and we would dramatically improve the outlook for cancer patients,” Dr. Boffa said.
At home, Dr. Boffa enjoys spending time with his wife and their two-year old son. His family and career take up most of his time now, but he insists that at one time he was an extremely interesting person. In his youth, he backpacked throughout much of Southeast Asia, New Zealand, South and Central America, and parts of Australia, traveling by foot, sailboat, skis, railroad, horse, elephant, camel, motorcycle, and once a bamboo raft belonging to a Burmese soldier. His wife and he have trudged for miles through the waist high waters of the Pantanal in Brazil teeming with crocodiles, slithering with snakes and plush with piranhas, which they later caught and ate. Among some of his other adventures, he described having survived an avalanche while hiking the closed trails of the Milford Trek in New Zealand (closed because of avalanches), receiving a partially paralyzing insect bite while up in a tree spying on a rhinoceros in Nepal, and a tire blowout during the landing of a single engine propeller plane at Angel Falls in Venezuela. He currently enjoys a much tamer hobby, cooking.
At the end of his third year at Yale, Dr. Boffa is extremely excited by the momentum of Yale Cancer Center. He said that while much credit is owed to the leadership, it is the day to day effort of the support staff that distinguishes the Cancer Center as truly extraordinary.
In Dr. Boffa’s office, he is rarely the last to leave. Dr. Boffa explained that members of the thoracic oncology staff, Betsy Finan, PA-C, Sue Porto, Program Assistant, and Linda David, RN, go over last minute details into the evening to make sure all the tests are arranged and patients are taken care of. Robin Qualls, Senior Administrative Assistant in the thoracic surgery section, comes in on Saturdays, and members of Dr. Boffa’s surgical team, Kathy Sutowski, Kathy Beaury and Tonya Campbell, do everything possible to help during difficult surgeries. Mary Pierson, the manager of the floor, along with seasoned nurses Kathy Caliendo, Karen Troiano, and Guy Dufresne, go the extra mile with educational activities and mentoring of younger staff. He described the ICU team as being equally dedicated and so far these efforts have paid off and their results are among the best in the country. Dr. Boffa commented that he believes being ‘the best’ is the wrong goal to have. “Our team strives to get every single patient through treatment safely and cured of their disease.”
When asked about the best part of being a thoracic surgeon Dr. Boffa responded, “Most patients that come to our team have had their world completely turned upside down and they are scared about the prospect of major surgery. With every patient we consent for surgery, we ask them to put their lives in our hands. To be able to tell them that it is going to be okay, and then have a team that can deliver, is greatly rewarding. We are not perfect, but as a team we get better every day."