Diagnosing and eliminating the smallest of lung cancers is the mission of Toronto General Hospital’s Dr. Kazuhiro Yasufuku. He performed the first minimally invasive robotic surgical procedure in Canada to treat early stage lung cancer. He continues to push the boundaries. Some lung cancer tumours are so small you can’t even see them. They can’t be felt or detected by standard medical tests yet they pose enormous risk. The best way to stop the progression of this deadly disease is to find new ways to diagnose lung cancer in its earliest stages, when treatments have the best chance of success. “More than 70% of lung cancers have an excellent chance of being cured if we can catch them early enough,” explains Dr. Yasufuku.
Dr. Yasufuku is developing new techniques and technology for early lung cancer diagnosis and ultra-minimally invasive treatments. He and his team are finding new ways of detecting and treating very small early stage lung cancer – so small some nodules are not even a solid tumour yet.
By employing a special imaging technique called Endo-Cytoscopy (ECS), which uses a powerful microscope to examine the inner surface lining of the lung, Dr. Yasufuku can distinguish normal lung cells, pre-cancerous cells and tumor cells in real-time without surgery. This novel technique can provide immediate diagnosis during examination, reducing the waiting times for treatment from months to mere hours.
One of the major challenges during minimally invasive surgery is real-time localization of small, non-visible tumors.
Dr. Yasufuku is testing the image-guided localization of small lung tumours by blending indocyanine green – a fluorescent green dye which concentrates at the site of a tumour – and imaging during surgery. By administering the dye to the patient just prior to surgery, and using special imaging techniques during surgery to detect the tumor, the tracking system acts like a GPS, enabling real-time, precise identification of tumours.
Inventing the future today
Dr. Yasufuku and his team are also researching how nanotechnology can be unleashed to make early lung cancer treatment even more safe and effective. First, the team targets the tumour using intravenously administered nanoparticles (porphysomes) that become fluorescent when taken up by the tumour. Then nearinfrared laser energy will be deployed through fine optical fibers inserted through the airway into the tumour to deliver photothermal therapy as an alternative to surgery – effectively heating and killing the cancer while leaving healthy tissue behind. If this procedure succeeds in clinical trials it will drastically improve health outcomes for patients, especially those whose age or condition make traditional surgery too risky.
‘‘As we develop new technologies, we will be able to detect early-stage cancer more effectively, treat more people, and prevent their cancer from returning.’’