Surgical Oncology, Sentara Norfolk General Hospital and Sentara Princess Anne Hospital; Associate Professor, Department of Surgery, Eastern Virginia Medical School
As the child of a plastic surgeon, Eric Feliberti at first attempted to resist copying his father by going into medicine. The problem was that he always loved science classes, especially biology.
So he majored in biology in college and headed off to medical school, where he tried to at least resist becoming another surgeon. That didn’t work, either.
“Little by little, I just gravitated toward it,” he recalls. “I was drawn to the major operations, as well as to the challenge of helping cancer patients and their families. I found it was such fascinating and gratifying work, and I still feel that way today.”
As a general surgery oncologist, Feliberti treats all types of cancer, with colorectal cancer – along with breast cancer and melanoma – among the most common. He is attacking the disease from two sides: embracing minimally-invasive techniques but also introducing an aggressive two-part procedure called hyperthermic intraperitoneal chemotherapy, or HIPEC, to attack a deadly form of malignancy.
Effective new surgical techniques, particularly robotic surgery, have shortened recovery times and reduced side effects for many colorectal cancer patients. They also have allowed physicians to lower post-surgical pain medication, which can impede healing of the bowels and intestines. “Patients might only need two or three days in the hospital, compared to at least a week in the past,” Feliberti notes.
Patients with rare and complex tumors that have spread within the abdominal cavity, however, obviously need much more. In 2014, Feliberti became one of the first physicians in the region to offer HIPEC, which targets dangerous peritoneal surface malignancies shed by a variety of cancers, including colorectal adenocarcinoma. Fewer than 60 HIPEC programs exist in the United States.
The treatment begins with cytoreductive surgery to strip away all visible tumors within the abdomen. Surgeons then heat a liquid dose of chemotherapy drugs mixed in a sterile saline solution to more than 40 degrees Celsius – 104 degrees Fahrenheit – and pump it into the abdominal cavity, where it sits in place for 90 minutes.
“It essentially creates a bath that, hopefully, destroys any cancer cells remaining after surgery,” Feliberti says. “It’s designed to be a one-two punch, at maximum strength. We have found it can considerably increase life expectancy and reduce the rate of recurrence.” The only alternative for such patients would be traditional chemotherapy, which has very limited success, he adds.
The operation is grueling for patients, mainly due to its overall length and invasive nature, which makes local families even more grateful that they don’t have to travel to receive care. Yet because the chemotherapy portion targets only areas with cancer rather than diffusing into the bloodstream, there is minimum systematic toxicity and virtually no side effects. Other cancers that can cause peritoneal surface malignancies include appendiceal tumors, mesothelioma and primary peritoneal tumors.
Surgical oncology has proven to be a perfect fit for Feliberti, who enjoys getting to know patients and their families as well as teaching HIPEC and other advanced techniques to EVMS residents. He also has won multiple research grants, including three from Susan G. Komen for work on reducing breast cancer mortality among medically indigent women in Norfolk.
Born in New Orleans, Feliberti grew up in El Paso, Texas, as the youngest of four children; all of his older siblings became engineers. “I tell them that I’m an engineer of the body,” Feliberti jokes. After graduating from Cornell University, he completed his medical degree and a general surgery residency at the University of Texas Medical Branch in Galveston, followed by a surgical oncology residency at the City of Hope National Medical Center in California.
In 2006, Feliberti joined the EVMS faculty and is now Associate Director of Clinical Cancer Research at the school’s Leroy T. Canoles Jr. Cancer Research Center. He also holds multiple positions with Sentara, including Site Principal Investigator with Sentara Cancer Network’s Alliance for Clinical Trials in Oncology, and Co-Director of The Breast Center at Sentara Norfolk General Hospital. In addition, he is Chairman of the State Cancer Committee for the Virginia Chapter of the American College of Surgeons.
One current interest field is a national push to standardize treatment of rectal cancer. Sentara hospitals are collecting data for the Commission on Cancer’s National Accreditation Program for Rectal Cancer, or NAPRC, an effort to reduce variability in complication and recurrence rates and spare more patients from a permanent colostomy. “This is about both survival and quality of life,” Feliberti says.
As a busy physician, Feliberti spends much of his free time with his wife and four children – three girls and one boy, ages 7 through 14. A longtime soccer player, he has mostly stopped playing due to bad knees but still coaches his kids’ teams.
So will one of his kids follow in his career footsteps one day? It’s too soon to tell, of course, although Feliberti notes that they aren’t too attracted by glimpses of procedure photographs. “Pretty much all they say is, ‘that is so gross, Dad,’” he relates with a laugh.
Then again, Feliberti also wasn’t going to be a doctor, either. And now he considers that decision one of the best he’s ever made.
