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From Access to AI: Cancer in America with Dr. Douglas Flora

In this episode of the Precision Medicine Podcast, host Karan Cushman does some time traveling with Dr. Douglas Flora through his lifetime journey with cancer. Dr. Flora is the Medical Director of Oncology Services at St. Elizabeth Healthcare and Editor-in-Chief of AI in Precision Oncology, a peer-reviewed research journal dedicated to advancing artificial intelligence applications in clinical and precision oncology.

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Karan begins the episode by taking Dr. Flora back to his young adult years when he lost his mother to breast cancer. That experience inspired Dr. Flora to become a doctor and the oncology leader he is today. Dr. Flora’s work in northern Kentucky is at the epicenter of cancer in America, as his community ranks number one for two of the deadliest cancers: colon and lung cancer. He is specifically concerned about issues of equity and access. He says, “In 2024, Black and Hispanic patients are still 3.4 times less likely to be represented in clinical trials. Cancer mortality rates are 13% higher for Black versus White patients. Uninsured women are 33% less likely to have routine breast screening.” In response to these challenges, Dr. Flora has become a driving force behind large-scale solutions that emphasize early screening. For instance, he helped found the Lung Cancer Screening Center of Excellence in his own community.


Another group that Dr. Flora is concerned about is the baby boomer generation, which is currently entering a high-risk window for cancer.

He says, “New diagnoses are expected to climb to two-and-a-half million cancer patients by the end of the decade… So, we’re going to have 22 million survivors by 2030. Where do we go with that? There’s only 19,000 cancer doctors and fewer radiation oncologists. So, I just started to think about, the math doesn't work.”

Dr. Flora believes technology, specifically AI, is critical for easing the overwhelm. He sees a future in which it will no longer matter if someone is being treated in the community or at a large hospital like M.D. Anderson Cancer Center because there will technologies and clinical decision-support tools that will provide all the information oncologists need at the point of care. He envisions a day when he will “have all the MRI results, all the CT results, pathology results, family history, social history, sexual history, all accumulated for me.”


Karan asks Dr. Flora how he and his team prioritize new decision-making technologies when there may not be a use case available. Dr. Flora says, “We might start with simpler things just to show proof of principle in healthcare systems like ours. Instead of going straight into life-and-death clinical decision-making, which is probably still five years away, how about medical documentation? How about instead of my brother, who’s also an oncologist downstairs, typing every night until 11:45 at night – can we use this natural language processing?”


Karan and Dr. Flora go on to discuss some of the obstacles of putting together an AI strategy. He says he’s excited about what’s to come and believes AI is already having an impact on equity in precision oncology. “AI is helping improve cancer screening. It’s improving our ability to reach those patients in disparate areas or disadvantaged areas. I would say that for that population, screening is the number one way to prevent colorectal cancer.”


When asked about his drive to start a second career in publishing as Editor-in-Chief of AI in Precision Oncology, Dr. Flora shares his personal experience with kidney cancer. He is also quick to recognize the team of experts at his side and because he is a part-time administrator, part-time physician, he now has more time to dig into technology. He says, “I want to deliver super-digestible, manageable, short, readable articles that are practical for my partners across the country who don’t have time to read two hours of AI a night. I just want them to tear out this two- or three-page article saying, this is how you design a prompt, or this is a tool that can save you four hours of typing a day, etc.”


There’s much more to learn from Dr. Flora and his commitment to equity in cancer care and the technologies that are improving the quality of screening and treatment for cancer patients. We hope you’ll tune in to the full episode to hear Dr. Flora’s inside view of the potential impact of AI in medicine and his optimism about the future of cancer care.

Download the full transcript of the episode here (pdf).


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About Our Guest

Douglas Flora, MS, LSSBB, FACCC

Executive Medical Director of Oncology Services, St. Elizabeth Healthcare Cancer Center

Dr. Doug Flora is Executive Medical Director of Oncology Services, and The Robert and Dell Ann Sathe Endowed Chair in Oncology at the St. Elizabeth Healthcare Cancer Center headquartered in Edgewood, Kentucky. He graduated from The Ohio State University College of Medicine in 1999 and went on to a distinguished career spanning over two decades. Dr. Flora is a steadfast advocate for whole-person care and medical innovation.  His leadership and vision have led to cutting-edge technology and treatment protocols and improved patient outcomes.


As the Editor-In-Chief for the pioneering peer-reviewed research journal AI in Precision Oncology, Dr. Flora plays a pivotal role in medical education and research, nurturing the next generation of healthcare leaders. His perspective is enriched by personal experience as a practicing oncologist, senior healthcare executive and, most importantly, a cancer survivor. 

Dr. Flora is a Board Member of the American Cancer Society, serves on the Executive Board of the Association of Community Cancer Centers as Treasurer, and is a Board Member of the Kentucky Society of Clinical Oncology.  He enjoys international travel with his family in his spare time.


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