Dr. John Brems was a high school senior in the early 1970s around the time Sherman Hospital in Elgin performed its first open-heart surgery – one of the first ever in the country to be performed at a community hospital.

In the intervening decades, Sherman continued to build a reputation as a community hospital with a world-class focus and Brems became a renowned pancreatic and liver surgeon, achieving recognition year after year as one of America’s top doctors.

This February, the hospital announced that Brems had joined its staff and would lead its new Center for Advanced Liver & Pancreatic Care at The Center for Cancer Care at Sherman Health.

The center offers progressive procedures and techniques to treat a broad range of liver and pancreatic cancers and diseases. Brems’ team includes a gastroenterologist with clinical expertise in biliary endoscopy, an interventional radiologist, oncologists, a radiation oncologist, and a nurse navigator.

“We have a program that’s comparable to any university program, and can provide whatever is needed short of transplantation. Transplantation evaluations can be facilitated with other Chicago-area transplant hospitals,” Brems said. “Our program is in the beginning stages, but it is growing rather quickly.”  

Brems received his medical degree from St. Louis University School of Medicine and served as chief resident at St. Louis University Hospital. Though he went into general surgery with the intention to specialize in cardiac surgery, he soon became fascinated by the liver, which he describes as a mysterious organ with more than 100 different functions. He completed his fellowship in hepatobiliary surgery and liver transplantation at UCLA Medical Center, and was the first liver fellow in UCLA history.  

Following that, Brems went on to Scripps Clinic in La Jolla, Calif., where he was part of the medical team that cared for Nobel Peace Prize recipient Mother Teresa, who was known worldwide for her work with the destitute.

Brems founded and directed Scripps’ Center for Liver Disease. In his career, he has performed more than 800 liver transplants, 1,000 major liver resections and two liver-heart transplants.  

For the past 14 years, Brems was professor of surgery and director of intra-abdominal organ transplantation for Loyola University Medical Center (Maywood, Ill.). He still maintains his clinical professor of surgery title at Loyola and says that many of his Loyola colleagues are already sending patients to him at Sherman.  

Brems can’t help but note the similarities between La Jolla’s Scripps Clinic and Elgin’s Sherman Health. Both are private hospitals without a university association. “Scripps is a relatively small hospital, but it’s the largest private research institution in the world,” he said. “They’re doing groundbreaking research.

“The liver center I started at Scripps was so successful, it gave me the confidence to start one at Sherman,” he added. “I am extremely confident that this liver center will be the model for other liver centers in the country.”     

Promising New Treatments
Brems notes that although liver cancer is the fastest-growing cause of mortality due to cancer, it is no longer the automatic death sentence it was years ago. Patients now have more liver based therapies available to them than ever before.  

Recent advances in the treatment of liver and pancreatic disease make it possible for patients to receive treatment closer to home. And, many of these procedures can be done on an outpatient basis.

The program for advanced liver and pancreatic care at Sherman includes leading-edge diagnostic tools and therapies such as endoscopic ultrasound, radiofrequency ablation, chemoembolization, liver recession, chemotherapy and radiation, radiation oncology, and surgery (including minimally invasive procedures).“The important thing about this program is that it is multidisciplinary,” Brems said. For example, we can “cook a tumor,” Brems said, by having interventional radiology insert a probe in the tumor or we can surgically remove the tumor.  With a multidisciplinary approach, we select the therapy that is best for the patient.

He added that Dr. Rajesh Pillai, the biliary endoscopist in the group, can perform biopsies guided by ultrasound, as well as stenting to open ducts.  

Among the latest technological tools that give doctors an increased ability to detect and treat disease is a miniature fiber-optic probe known as SpyGlass®. The device is part of a direct visualization system that allows the endoscopist to look directly into a patient’s bile duct and see beyond any obstruction, correct it or make a diagnosis via an optically-guided biopsy.   

Looking to the future, Brems said, “[In terms of the pancreas] we’re getting much more skilled at transplanting islet cells, which are the cells that produce insulin. Being able to produce islet cells means we can take care of patients with diabetes.”

And stem cell technology promises to give doctors even more weapons in the battle against disease, including the ability to grow a partial liver.

Guiding Patients Through Treatment
For patients who are facing a critical illness, finding out how to get to the place they need to be can be a challenge. A patient might only require an initial consultation, might be in mid-treatment for an advanced disease or might have been told he or she might have cancer leading them to the center for verification. It is the role of nurse navigator Holly Koc to help them through the process.  

“The patient comes into the system for a reason,” said Koc, who was a member of the liver transplant team at Loyola. “Some have had multiple therapies, some have followed Dr. Brems from Loyola. My goal is to minimize a patient’s fear and anxiety through communication and accessibility to the multidisciplinary team.”  

Her workday begins as she reviews patients’ charts, meets Brems for rounds and then plans for the patient’s return for follow-up care. She is there to answer questions, and she lets patients know that if she doesn’t have an immediate answer, she soon will. “Dr. Brems is always accessible,” she noted, “and that makes it very easy to answer a patient’s question.”

Easier Access, Personalized Care
Because The Center for Cancer Care at Sherman Health is not associated with a university hospital, a patient is able to see the attending physicians directly, without having to deal with all the residents and fellows, according to Brems.

“It’s easier to schedule patients and get an opinion right away,” he said. We’re small enough to have control over scheduling, so I can see a patient any time I want. And that patient can see me, or whoever else is appropriate. One of us is always available.”

The advanced liver and pancreatic care program is designed to provide patients individual attention and personalized treatment plans, as well as coordination of care in one location, and access to support resources and education.

Of no small importance is the ability to access this level of care close to home. “If we performa liver resection and you live in this area, your family is able to be here with you,” Brems said. “I think it makes a difference in a patient’s recovery.”

>> For more information about Center for Advanced Liver & Pancreatic Care, visit http://shermancancercare.com/the-center-for-advanced-liver-pancreatic-care.