Dr. Raphael Bueno
Chief of the Division of Thoracic and Cardiac Surgery at Brigham and Women’s Hospital
Dr. Raphael Bueno leads mesothelioma treatment at one of the best cancer hospitals in the world: Brigham and Women’s Hospital. With multiple decades of medical experience treating this cancer, he is one of the best mesothelioma doctors in the world.
Pleural Mesothelioma
Brigham and Women's Hospital/Dana-Farber Cancer Institute
450 Brookline Avenue, Boston, MA 02115
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More About Mesothelioma Specialist Dr. Raphael Bueno
Dr. Bueno is Chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital in Boston, Massachusetts. He sees patients at Dana-Farber/Brigham and Women’s Cancer Center and Brigham and Women’s Faulkner Hospital. This cancer program has the highly regarded International Mesothelioma Program, which Dr. Bueno oversees.
Mesothelioma is a rare type of cancer that forms primarily in the lining of the lungs, abdominal cavity or heart. There are a select few doctors who specialize in treating this cancer.
Dr. Bueno primarily sees cases of pleural mesothelioma due to his knowledge of thoracic cancers. Pleural mesothelioma is a rare cancer of the lining around the lungs. This lining allows the lungs to expand and contract as needed against the chest wall. Dr. Bueno sees 80-100 cases a year, and around half are appropriate for surgery.
He’s also part of the hospital’s gastrointestinal cancer department. This division covers peritoneal mesothelioma, which is a cancer forming in the lining around the abdominal cavity.
Aside from Chief of the Division of Thoracic and Cardiac Surgery, he’s also a professor of surgery at Harvard Medical School.
- Medical Degree from Harvard Medical School, 1985
- Residency in General Surgery at Brigham and Women’s Hospital, 1993
- Residency in Thoracic Surgery at Massachusetts General Hospital, 1995
- Board-certified in General Surgery
- Board-certified in Surgical Critical Care
- Board-certified in Thoracic Surgery
Get Connected to Dr. Raphael Bueno
Dr. Bueno is the chief of thoracic and cardiac surgery at Brigham and Women’s Hospital. He is the director of mesothelioma treatment at the affiliate cancer center, Dana-Farber Cancer Institute. He’s a highly regarded specialist who has co-authored medical articles related to treatment and survival of mesothelioma.
Why Choose Dr. Bueno?
- Trained under Dr. David Sugarbaker
- Experienced specialist sees 80-100 cases a year
- Achieves extraordinary survival rates with surgery
Proponent of Surgery in Many Cases
Dr. Bueno helps lead mesothelioma treatment at Brigham and Women’s Hospital. He is an expert in treating pleural mesothelioma with surgery.
The two surgery options for pleural mesothelioma are extrapleural pneumonectomy surgery and pleurectomy/decortication surgery. Both can extend patients’ lives by many years, sometimes for a decade or more. Dr. Bueno prefers pleurectomy/decortication, which spares both lungs for the patient.
“I did an initial analysis and found that for people over 65 or 70, having a pneumonectomy is an independent risk factor for mortality,” Dr. Bueno said. “I demonstrated in comparing two series that the outcomes for pleurectomy are not inferior, and possibly even superior, to pneumonectomy.”
His goal as a surgeon is complete resection of the cancer. This requires removing the diaphragm and pericardial lining in most cases. These resections are in addition to removing the pleural lining and any visible tumors in the chest cavity.
There’s also data supporting the use of heated intrathoracic chemotherapy (HITHOC). Dr. Bueno said he was part of a study comparing use of HITHOC versus not using it. HITHOC led to better survival in most cases.
Busting Myths About Mesothelioma
Dr. Bueno considers himself a “myth-buster” when it comes to mesothelioma, particularly survival.
“The myth that everyone dies in a few years is false,” he said, noting a patient of his from 1996 is still alive today thanks to surgery. The patient is a 25-year survivor of pleural mesothelioma.
“The myth is that mesothelioma is different from any other solid cancer and surgery shouldn’t have a role,” he said. “That’s the myth. The answer is it’s like lung cancer and breast cancer and colon cancer. You identify the disease early and operate on them.”
Dr. Bueno said a diagnosis of mesothelioma cancer not the death sentence many say it is for patients. He also believes surgery is the best option for most patients, including a subset of those with sarcomatoid cell type.
He mentioned some of his patients with sarcomatoid mesothelioma have reached 5-year survival after multimodal treatment (surgery, chemotherapy and immunotherapy). Many surgeons don’t operate on sarcomatoid mesothelioma cases because the cells spread in a unique way and are difficult to find in the lung cavity. Recurrence rates are also high for sarcomatoid mesothelioma.
The main task in using surgery effectively for sarcomatoid mesothelioma is patient selection. When determining surgical candidacy, Dr. Bueno looks at a few things:
- Tumor volume in the lung cavity
- Tumors reaching lymph nodes
- Tumor invasion of the chest wall
- Patient’s physical health
- Lung/respiratory functioning
“We have some ideas for how we can select and identify them,” Dr. Bueno said. “Everything is nuanced. The focus of this decade in mesothelioma is to hone down selection strategies for patients who will do well.”
‘Most Important Clinical Commitment’
Quality of life and communication are key elements of why Dr. Bueno is a top specialist. He relays all facts about mesothelioma and the treatment options to patients. He also explains the process if they choose surgery.
This process requires 2-3 weeks in the hospital for surgery and recovery, then 6-8 weeks recovery at home. Chemotherapy follows and lasts a few months.
If there are no complications from surgery or during chemotherapy, the patient’s quality of life after 4-5 months “will be almost back to normal.”
The caveat is no recurrence of disease. Recurrence happens often with mesothelioma, which is why complete resection is so essential. Dr. Bueno’s skilled hand as a surgeon has led to a five-year survival mark above 20%, which is outstanding compared to most centers.
This mark is something he takes pride in — and isn’t settled on, as he continues to improve outcomes for patients.
“This (treatment of mesothelioma) is my most important clinical commitment,” he said.
Importance of a Large Center With Multimodal Team
Dr. Bueno stressed the importance of patients going to centers like Brigham and Women’s Hospital. He gets many patients coming from doctors who cannot perform surgery — and possibly just recommend chemotherapy.
“You’re going to get better outcomes if you go to busy centers with expertise,” he said. “Expertise isn’t one person doing something. It requires a team. If you have a serious operation, you have a team. That’s what I would say is key. The outcome depends on how well your team is. It’s true for mesothelioma and many other things.”
How to Connect With Dr. Raphael Bueno at Brigham and Women’s Hospital
We can help you connect with Dr. Bueno and his mesothelioma team by contacting our registered nurse, Karen Ritter. You can email her at karen@mesotheliomaguide.com or fill out our free Doctor Match form with your name, email address and other information.
Sources & Author
- Raphael Bueno, MD. Dana-Farber Cancer Institute. Retrieved from: https://www.dana-farber.org/find-a-doctor/raphael-bueno. Accessed: 10/28/2021.
