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More About Mesothelioma Specialist Dr. Raja Flores
Mesothelioma is a rare type of cancer caused by exposure to asbestos. Most people are exposed through their jobs working with asbestos-containing materials or in manufacturing plants that contain asbestos in machinery.
Most cases of mesothelioma are pleural mesothelioma, which forms in the lining of the lungs. This is Dr. Flores’ area of expertise.
Dr. Flores is the lead thoracic surgeon at Mount Sinai Health System. The hospital’s Tisch Cancer Institute is affiliated with the Icahn School of Medicine, making it one of the many top cancer centers with academic resources. Dr. Flores, as the Director of Thoracic Oncology, is a major asset to the hospital.
High Volume of Mesothelioma Cases
Dr. Flores, as the Director of Thoracic Oncology, is a major asset to the hospital. He sees around 80 mesothelioma cases a year, and 50 of them are operable.
Dr. Flores previously worked as a thoracic surgeon at Memorial Sloan Kettering Cancer Center, which is also in New York City. He learned from experts at Memorial Sloan Kettering Cancer Center and joined Mount Sinai Health System. His research revolved around trying to find more information about how mesothelioma forms, spreads and is defeated.
“A patient many years ago asked me, ‘What made you go into it?’” Dr. Flores said. “I told her my training and how I started getting patients because I knew how to talk to blue-collar patients due to my background. I talked about how the research happened and I stumbled on mentors who were trained in mesothelioma. She said, ‘Oh, so it chose you?’ And I said, ‘You’re right.’”
“When I got to Mount Sinai, the asbestos program and occupational health program here, it basically chose me,” he continued. “I thought that explained it more than anything else. I was going through life and wanted to be a thoracic surgeon. Around every corner, mesothelioma kept crossing my path. It just happened that way.”
In addition to being a top thoracic surgeon, Dr. Flores is:
- Director of Surgical Oncology Division at Mount Sinai Health’s Tisch Cancer Institute
- Professor of thoracic surgery at Icahn School of Medicine
- Medical Degree from Albert Einstein College of Medicine of Yeshiva University, 1992
- Residency in General Surgery at Columbia-Presbyterian Medical Center, 1992-1997
- Residency in Cardiothoracic Surgery at Brigham and Women’s Hospital
- Fellowship in Thoracic Oncology Clinical Research at Brigham and Women’s Hospital
- Certified in Thoracic Surgery by the American Board of Surgery
Get Connected to Dr. Raja Flores
Dr. Raja Flores is one of the best surgeons in the world for pleural mesothelioma. He strongly believes in using pleurectomy with decortication for this cancer, even if tumors have reached the surface of the lungs. He sees around 50 surgery cases each year and has helped many patients beat this cancer.
Why Choose Dr. Flores?
- Skilled in both P/D surgery and EPP surgery
- Video-assisted techniques for less-invasive surgery
- Located in New York City for easy travel access
Leading Research in EPP vs. P/D for Surgery
Mesothelioma treatment has four main options: surgery, chemotherapy, immunotherapy and radiation therapy. Dr. Flores is skilled at both aggressive surgeries for pleural mesothelioma:
Extrapleural pneumonectomy (EPP) is the original surgery for pleural mesothelioma. Doctors began using it during the first half of the 20th century. EPP removes the lung affected by tumors to eliminate the most cancer possible.
However, removing a lung is a radical decision, especially for older patients. The average age for mesothelioma is around 65, so doctors looked for alternatives to taking out the lung. This led to the emergence of pleurectomy with decortication (P/D).
Dr. Flores is one of the leaders in researching which surgery is better overall. While each case is different, he has found P/D to improve survival and quality of life.
“An extrapleural pneumonectomy is a big hit on their quality of life,” Dr. Flores said. “When patients have two lungs, they tolerate chemotherapy, targeted therapy and radiation therapy better. When you have one lung, those therapies hit them hard. They can’t tolerate the adverse effects and can’t finish the therapy.”
It also causes complications for recurrence a few years after surgery. Mesothelioma has high recurrence rates, which is why even surgery isn’t a cure.
“The recurrence occurs in the other lung,” he said. “So now you’ve painted yourself into a corner. You have no reserves.”
From 2007-2017, doctors used P/D 81% of the time for pleural mesothelioma surgery. EPP accounted for the other 19%. This is a dramatic shift from years past when EPP was the preference. The mortality rates and survival rates also favor P/D surgery.
Palliative Surgeries for Pleural Mesothelioma
Dr. Flores can also provide mesothelioma palliative treatment, such as pleurodesis or thoracentesis. These surgeries drain fluid and possibly close the pleural space to block future fluid buildup against the chest.
The purpose of palliative surgeries is to improve patients’ quality of life. This is a key part of Dr. Flores’ approach to treatment.
Comparing Chemotherapy and Immunotherapy
Mesothelioma chemotherapy and mesothelioma immunotherapy are other treatment options. They are usually part of a multimodal treatment plan for mesothelioma. There are chemotherapy drugs and immunotherapies approved by the U.S. Food and Drug Administration for pleural mesothelioma.
Dr Flores said patients should take the therapy “with less side effects,” which is usually immunotherapy. Neither option is a life-saving treatment, but immunotherapy often leads to a longer life expectancy and less severe side effects.
“When we see differences of 2-5 months, we think it’s a huge deal,” Dr. Flores said. “It’s better than nothing, but a lot of it depends on the type of tumors you have.”
Advocate for Asbestos Research and Regulation
Dr. Flores is the principal investigator of the Libby Epidemiology Research Program (LERP). This program, funded by the Agency for Toxic Substances and Disease Registry, has the goal of learning more about how asbestos causes mesothelioma.
Libby, a small mining town in Montana, had at one time more cases of mesothelioma per capita than anywhere else in the United States. This was due to the mining of asbestos-laden vermiculite by employees of W.R. Grace Company. Dr. Flores is researching why some people exposed to asbestos in Libby developed mesothelioma, yet others exposed did not.
In 2024, the U.S. Environmental Protection Agency banned chrysotile asbestos, which is the most common type of asbestos. It was also the only type still imported, manufactured, and sold in the United States. It was primarily used for chlor-alkali products
Building Trust With Patients
There’s a lot of misinformation on the internet about mesothelioma. Many websites push harmful theories about untested therapies, or assume a therapy may work since it did for a completely different cancer.
People know Dr. Flores will provide an honest and thorough assessment of their cancer, their prognosis and their therapeutic options. He also knows how to inspire hope when some patients seemingly have none.
“I could tell the patients were very much in distress and weren’t getting the information they were looking for,” he said. “It just so happened I knew so much about it because I got so much experience in my younger career.”
How to Connect With Dr. Raja Flores
Dr. Flores sees patients from anywhere in the United States. The location of the Mount Sinai Health System cancer center in New York City means people in the northeast can access it easily. It’s also a main destination for any major airline in the United States. If you want to meet Dr. Flores personally, please send us your information through our free Doctor Match program.
You can also email our registered nurse, Karen Ritter, at karen@mesotheliomaguide.com for patient advocacy help.
Sources & Author
- Raja M Flores, MD. Mount Sinai. Retrieved from: https://www.mountsinai.org/profiles/raja-m-flores. Accessed: 09/21/2021.
- Extrapleural Pneumonectomy versus Pleurectomy/Decortication for Malignant Pleural Mesothelioma. Annals of Surgical Oncology. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33971174/. Accessed: 05/21/2021.
- VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes. MDPI. Retrieved from: https://www.mdpi.com/2072-6694/13/5/1068/htm. Accessed: 04/06/2021.