Top Docs Q&A: Raphael Bueno

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, current research, and life as a doctor. 

Name: Raphael Bueno

Hospital Affiliation: Brigham and Women’s Hospital

Title: Chief of the division of thoracic surgery, co-director of Brigham and Women’s Lung Center, vice chairman of surgery for cancer and translational research, professor at Harvard Medical School

Field: Thoracic and Cardiac Surgery

Specialty: Lung cancer, mesothelioma, minimally invasive esophageal surgery, and minimally invasive thoracic surgery

Your current research focuses on using CT imaging to better treat lung cancer. How will this treatment be effective for cancer patients?

This CT imaging technique uses a CAT scan machine that almost every hospital already owns and uses in the operating room. During a typical surgery for lung cancer, doctors hang a static image of the nodule they want to remove in the operating room. But since the image is static, it’s hard to see exactly where the problem areas are. So we created a technique that allows doctors to perform a live scan using CT imaging during the operation when the patient is asleep. This way, when you have the live scan in front of you, it’s not hard to direct your surgery so you only take out what you need to.

What makes this treatment different?

There isn’t a previous treatment like this. In the last 50 years, lung cancer surgery focused on big spots, big cancers, and we did big surgeries to remove it. In the last two decades, there has been a movement to develop screening technologies to be able to find the small nodule and benign tumors. But we weren’t able to test them or treat them without removing a large portion of the lung, so a lot of the times we just watched them by doing scans.

When will this CT imaging technique be used in hospitals?

Currently, we are writing up the research for publication. My goal is to get this hopping in the next sixth months. I’ve started teaching people the technique, and I presented the data for the first time in Canada last April. After the publication goes through, we’re going to officially start teaching people how to use the technique in surgery.

In addition to researching the CT imaging technique, you have also been studying drug treatments for the mesothelioma. What does this research look like?

This cancer, mesothelioma, is an uncommon cancer that is based on genetic mutations. We are doing a clinical trial to test how well drugs take care of the cancer. We believe these different drugs tested can help patients by 10 to 20 percent, but we have to go through each individually to learn who will benefit from what. In the clinical trial, we are enrolling patients who have the cancer and are candidates for surgery, putting them on the drug for two weeks, then seeing how well they respond to it. This way, we can find a full armor of drugs that we can use for this cancer.

You’re working to get the Brigham and Women’s Hospital Lung Center launched. What will this center accomplish?

We created a multidisciplinary team, in my field of lung specialists, that round the spectrum and put together a center involving surgeons, radiologists, medical specialists, pathologists, nurses, and others to focus on the patient independently of any health care providers. This way we can schedule and help the patient’s needs and use all the technology in a collaborative way to do what’s best of the patient.