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Cancer that occurs in the lungs and originates in the lung itself is called primary lung cancer (lung cancer). Early-stage lung cancer is almost asymptomatic and is often discovered by chance through CT scans during checkups, follow-up observations for other illnesses, or treatment. Such early-stage lung cancer has a high chance of being completely cured with surgery. Therefore, for early detection of lung cancer, it is recommended to have CT screening as an option during checkups or health checkups.
On the other hand, as lung cancer progresses, symptoms such as coughing, phlegm, bloody phlegm, difficulty breathing, and chest pain appear. As the disease progresses, it infiltrates surrounding tissues and metastasizes. Lung cancer is likely to metastasize to lymph nodes, lungs, brain, liver, bones, and adrenal glands.
When treating lung cancer, the first step is a comprehensive examination.
(1) Tests to check for lung cancer. Where and what kind of lesions are present, and to what extent lung cancer is suspected.
(2) A test to check the progression (stage) of lung cancer, including whether the cancer has infiltrated the surrounding tissues and metastasized to lymph nodes or other organs.
(3) Understanding the patient's overall condition. We check not only respiratory function but also the presence or absence of heart disease, diabetes, etc.
Based on the results of these systemic examinations, our hospital regularly conducts multifaceted reviews of treatment plans for each individual patient in collaboration with the respiratory medicine, radiology, and oncology departments. Among these, if there are preoperative complications such as emphysema or interstitial pneumonia, we cooperate with the respiratory medicine department, if there is heart disease, with the cardiology department, and if there is diabetes, we cooperate with the diabetes and endocrinology department to thoroughly control these conditions preoperatively and prepare for safe surgery.
For patients who are suitable for surgery, we actively pursue surgical treatment. For preoperative imaging tests, we have introduced respiratory two-phase CT and the SYNAPS VINCENT 3D image analysis system. We use respiratory two-phase CT to evaluate the presence or absence of adhesions between the lung and chest wall and determine the surgical approach procedure. We also use SYNAPS VINCENT to understand the structure of the pulmonary arteries, pulmonary veins, and bronchi in 3D before surgery and determine safe surgical procedures.
Additionally, for small lung lesions, we perform bronchoscopic lung marking (VAL-MAP) the day before surgery, which helps identify the lesion at the time of surgery. The basic surgical method (procedure) is "lobectomy + regional lymph node dissection." However, in the case of very small lung cancers or when respiratory or cardiac function is poor, we also perform "reduced surgery" such as segmental resection or partial resection. Our department has established standardization of basic techniques (such as parallel dissection) for thoracoscopic surgery and open chest surgery, and strives to provide safe surgical treatment (Parallel dissection thoracoscopic surgery).
For early-stage lung cancer, minimally invasive thoracoscopic surgery is the standard surgical procedure. For advanced-stage lung cancer, we use a mediastinoscopy to check for mediastinal lymph node metastasis, and then perform multidisciplinary treatment tailored to each patient, including surgical resection, chemotherapy (anticancer drugs), and radiation therapy.
Regarding drug treatment, we evaluate biomarkers related to the effectiveness of molecular targeted therapy, immune checkpoint inhibitors, and anticancer drugs, and select drug treatments that are likely to be effective for each patient.Biomarker-guided personalized chemotherapy for lung cancer). Along with aggressive treatment for lung cancer, symptom relief and psychological care are also essential. We provide proactive care in cooperation with palliative care teams and local medical service centers.
