In December 2023, Park Young-cheol (alias, 79) visited Inha University Hospital after a health examination indicated an abnormality in his lung. Tests revealed a tumor approximately 5 cm in size in the upper right lung. A biopsy confirmed it as squamous cell carcinoma, a common form of non-small cell lung cancer occurring in the bronchus of the lung.

Park had significantly reduced lung function due to long-term smoking and was in a state where conventional surgery would be difficult due to his advanced age. Typically, stage 1 and 2 lung cancer patients undergo lobectomy (surgery to remove part of the lung), but Park's poor lung function made surgery impossible.

Inha University Hospital conducted a multidisciplinary consultation involving specialists from respiratory medicine, thoracic surgery, pathology, and radiation oncology. After comprehensively reviewing the tumor's location and size, as well as the patient's lung function and overall condition, the medical team decided to perform 'radiotherapy surgery' instead of surgery. Radiotherapy surgery is a treatment method that focuses high-intensity radiation precisely on the tumor area using high-precision radiation equipment.

Professor Kim Heon-jeong of the Department of Radiation Oncology at Inha University Hospital administered a total of 5,000 cGy (centigray) of radiation to the tumor area over five sessions in January 2024. The tumor began to shrink gradually immediately after treatment, and two years post-treatment, a CT scan confirmed that the tumor had completely disappeared. The only remaining sign is the sclerosis of surrounding tissue due to radiation exposure. Although at least five years of follow-up is required for a complete cure diagnosis, the interim results exceeded expectations.

Professor Kim stated, “In the past, radiation therapy required 30 to 40 sessions over more than six weeks, but with advancements in medical equipment, treatment results can now be achieved in just three to five sessions,” adding, “It offers great hope for patients like Park, who are elderly or have reduced lung function, making surgery difficult.”

Lung cancer often lacks distinct symptoms, making early detection challenging. By the time symptoms such as coughing or hemoptysis appear, the disease is often advanced. Many cases, like Park's, are discovered incidentally during health check-ups or examinations for other conditions. The speed and accuracy of diagnosis and treatment decisions at this point are crucial for patient survival.

The multidisciplinary consultation system operated by Inha University Hospital involves multiple departments reviewing the patient's condition comprehensively to find the optimal treatment method. This approach allows patients to receive the best treatment without unnecessary trial and error. Radiotherapy surgery, based on such consultations, has the advantage of minimizing damage to normal tissue surrounding the tumor.

Tumors move slightly within the lung with breathing. The latest radiation equipment tracks the patient's breathing rhythm in real-time, administering radiation only when the tumor is in a specific position. This is called 'respiratory motion radiation therapy,' which reduces unnecessary damage to normal tissue and maximizes treatment efficacy. Each treatment session takes about 20 to 30 minutes, and patients can safely receive treatment on an outpatient basis without general anesthesia or hospitalization.

However, radiotherapy surgery has its limitations. If the tumor has already metastasized to lymph nodes or other organs, surgery or radiotherapy surgery alone is insufficient, and chemotherapy must be combined. Nevertheless, for patients in the early stages without metastasis, radiotherapy surgery achieves results comparable to surgery. It is often the only viable treatment option for elderly patients or those with comorbidities.

The incidence of lung cancer in South Korea remains high. As of 2022, lung cancer was the third most common among 32,313 total cancer cases. It occurs predominantly in the elderly population aged 65 and above. However, with the selection of the optimal treatment method suited to the patient's condition and supported by precise technology, lung cancer is considered a conquerable disease.

Professor Kim emphasized, “Lung cancer treatment requires comprehensive consideration of various factors, including the patient's lung function, comorbidities, and age,” and added, “For early-stage lung cancer patients for whom surgery is difficult, radiotherapy surgery is an important alternative with a cure rate similar to surgery. We will actively utilize the latest radiation therapy technologies to ensure patients receive safer and more effective treatment.”

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