Key personnel making their mark in the world of lung cancer - 3:
Professor Young Tae Kim is Professor and Chair of the Department of Thoracic and Cardiovascular Surgery, Seoul National University, South Korea.
Professor Young Tae Kim graduated from Seoul National University College of Medicine and trained at Seoul National University Hospital Cardiovascular Surgical Residency Program, before taking an Advanced General Thoracic Surgical Fellowship at the Mayo Clinic, Rochester, MN, USA.
He is an active member of the American Association for Thoracic Surgery (AATS), the Society of Thoracic Surgeons (STS) and the International Association for the Study of Lung Cancer (IASLC). Professor Kim’s clinical practice and research interests are focused on the surgical technique of lung cancer and genomic studies of thoracic malignancies.
What first motivated you to work in thoracic surgery and lung cancer?
I suppose the decision to work in thoracic surgery, and lung cancer specifically, was a matter of personal preference. I was initially interested in cardiac surgery as it is a reconstructive surgery but on the other hand, I did not want to give up my interest in oncology, so I chose thoracic surgery focused on lung cancer.
What is different about your role today from when you started your career?
A lot has changed with the availability of new treatments and technologies. In the past, there were only a few chemotherapy treatments available and radiation treatment was not well established. The only available curative treatment for early-stage lung cancer was surgery, while a late-stage diagnosis was effectively a death sentence for many patients.
Today things have improved. We have better diagnostics for tracking cancer in the early stages. For advanced stage patients, we have targeted therapies as well as immunotherapies, which have transformed lung cancer survivorship a great deal. These advances have changed the role of the surgeon quite significantly.
What have been the biggest advances in thoracic surgery?
The most significant advance in thoracic surgery has been in the technology. Minimally invasive surgery has been a real step forward. We are now seeing video-assisted and robot-assisted surgical procedures as a standard surgical practice for lung cancer.
Also, the lung cancer screening program has resulted in an increased number of early diagnosed cases, and recently, we are seeing more candidates for surgical resections. All together, these advances provide the best chance of a cure to lung cancer patients.
Multidisciplinary team practice is another adance. As surgeons, we are also working more closely with both radiation oncologists and medical oncologists. For example, we might work with our colleagues to shrink a tumour to make it easier to remove with surgery or to provide treatment after surgery to eliminate any last cancer cells and reduce the risk of cancer recurring.
What do these advances mean for people with lung cancer?
For the first time, there is now a real chance of patients being cured of lung cancer with early diagnosis and advanced treatment. However, treatment pathways have become much more complicated than in the past.
Patients are faced with many different routes to treatment, from traditional therapy to various clinical trials including new drugs. While treatment is more complicated than before, it is also more effective and there is more hope of survival than ever. But the patients may need increased support throughout their cancer journey.
What do you see as the most significant challenges in your field?
In my opinion, there are three major challenges facing lung cancer treatment. Firstly, treatment is expensive and paying for advanced approaches to diagnosis and treatment can be challenging: screening, targeted therapies, immunotherapy, personalized medicine – these are all very expensive and the financial burden can be significant.
Secondly, there is still more that we need to do concerning smoking cessation so that we continue to drive down the number of cases of lung cancer associated with smoking. We have to also bear in mind that e-cigarettes may yet create new lung-related issues in the future.
And thirdly, the incidence of non-smoking patients continues to rise. This has the potential to pose a significant challenge in the future as the genetic profile of the tumours from patients who have never smoked is significantly different from those of smokers.
What are you most excited about in your field?
Genomics offers exciting possibilities for lung cancer treatment. I have been participating in the development of sophisticated gene panel tests for lung cancer, through which we can choose appropriate target agents by detecting mutations in the ALK, EGFR and ROS1 genes, for example.
As a surgeon, a priority for me is educating the next generation of surgeons. Teaching young surgeons is both fun and deeply rewarding. I believe that the development of an effective education program in lung cancer treatment is the key point to develop in the future.
What role do you see international collaboration playing in advances in lung cancer treatment?
International collaboration has been very productive in lung cancer. For instance, the IASLC staging committee, on which I have served for some time, has been vital for improving cancer staging systems.
I believe that international collaboration represents an important opportunity for education too. As clinicians from different nations and disciplines, we all have a lot to learn from each other and I believe we can achieve our goal through IASLC.