Lung cancer treatment in South Korea: diagnosis, therapy and surgery

Due to high technology and professional training of doctors, lung cancer treatment in South Korea is considered the most effective and safe in Asia.

Lung cancer is a malignant tumor that arises from bronchial and lung cells, mainly under the influence of external factors (tobacco smoke toxins, radon).

In Korea, the incidence of lung cancer increases every year, and the proportion of this disease in oncological practice is 12%, which is the second largest number after stomach cancer (annual report of the Korea Central Cancer Registry).

Currently, more than 50% of adult Koreans smoke, so it is expected that cancer incidence and mortality will increase in the near future.

Lung cancer is divided into two main types according to pathological signs: non-small cell lung cancer and so-called small cell lung cancer.

Biological characteristics, methods of treatment and prognosis for these two diseases are very different. This is why biopsy plays a key role in the diagnostic process.

According to statistics, non-small cell lung cancer (NSCLC) accounts for 80% cases, and small cell lung cancer (SCLC) accounts for the rest.

Small cell lung cancer has a very high rate of progression, it tends to spread throughout the body at an early stage, and is associated with smoking.

Best lung cancer clinics and hospitals in South Korea

The level of oncology development in this small country deserves respect. Built according to the best Western models, the Korean medical system offers over a dozen first-class lung cancer clinics and hospitals to foreign patients.

Most of these specialized medical institutions are university hospitals belonging to the best medical faculties of Seoul (Gangnam Severance Hospital at Yonsei University). Large private hospitals such as Samsung Medical Center also deserve attention.

Other lung cancer treatment centers in South Korea include:

• Seoul National University Hospital (SNUH)
• Kyung Hee University Hospital at Gangdong (KUIMS)
• University of Gachon Medical Center Gil in Incheon
• Soon Chun Hyang University Hospital in Bucheon
• Asan Medical Center in Seoul

In the centers listed above, medical tourists can get innovative cancer care at affordable prices. Private hospitals such as Samsung Medical Center are more expensive than most of the country's academic medical centers. The choice is yours.

We recommend considering the Yonsei Cancer Center in Seoul (Gangnam Severance Hospital), which offers modern equipment and high-precision methods for the early detection of cancer. Here you will find the professional and ethical attitude of the medical staff, as well as high standards of treatment, multiplied by the latest achievements of Korean science.

Diagnosis of lung cancer in Korea: prices and methods

As the disease progresses, different symptoms may appear, depending on the location of the tumor. Persistent coughing and sputum with blood are typical symptoms.

In addition, there is pain in the chest, hoarseness, and symptoms associated with distant metastases (for example, headache and seizures in brain metastases). However, some patients do not demonstrate any complaints at all. If cough with sputum persist for more than two weeks, or blood appears in the sputum, you should immediately contact a specialist for examination.

Oncologist's consultation in local clinics costs only $ 50-200.

Diagnostic imaging techniques

The following methods are used by Korean doctors in the diagnosis of lung cancer:

• Computed tomography (CT): $ 500-1500
• Positron emission tomography (PET): starting $ 1000
• Magnetic resonance imaging (MRI): starting $ 800
• Low dose chest computed tomography
• Chest x-ray: starting $ 200

The cost of medical services in Korea is much lower compared with Germany, Israel, or the United States. A complex examination for lung cancer may cost as little as $ 1500-3000.

Low dose chest computed tomography

Local clinics were among the first in the world to introduce a special method of computed tomography of the lungs with a lower radiation dose.

The advantage of this technology is that the patient is exposed to less radiation, and the cost of the examination is lower than conventional CT of the chest.

Currently, the method is used to detect lung cancer in the early stages of patients with high risk (primarily, smokers), since chest x-ray for different reasons is not suitable for this purpose.

Positron Emission Tomography - Computed Tomography (PET/CT)

Positron emission tomography (PET) is useful for differentiating benign and malignant tumors. However, the lack of a method is that the exact location of the tumor is not known. In this case, the latest equipment, PET / CT scanners, are used to search for primary tumors and metastases.

Histological examination of the tumor

The diagnosis of lung cancer is made by histopathology, just like any other cancer. In addition to sputum cytology, Korean doctors also perform bronchoscopy or fine needle aspiration biopsy for more accurate and precise diagnosis.

Bronchoscopy in South Korea

This is a procedure in which the doctor examines the airways and the affected bronchus directly by inserting a thin tube into the patient’s nose or mouth. In the area where pathological changes occur, a fragment of suspicious tissue is taken with forceps and sent for further analysis. Also, local doctors use bronchoalveolar lavage – a medical procedure that consists of flushing the bronchi with a special solution in order to obtain tumor cells.

Fine-needle aspiration biopsy

If the lung tumor is located in the distal bronchus, where bronchoscopy is useless, it is possible to penetrate the tumor through the skin with a long, thin needle. The tissue sample is specially stained and then examined under a microscope to determine if it is malignant or not.

The procedure takes 20 minutes, including disinfection and anesthesia, but the puncture time is a few seconds. Modern methods of local anesthesia make a fine-needle aspiration biopsy relatively comfortable for the patient. Complications of the procedure, such as bleeding, are observed in less than 1% of patients. In recent years, the safety of the procedure has been significantly improved by the simultaneous ultrasound or computed tomography control.

Endobronchial ultrasound

Endobronchial ultrasound (EBUS) is used to visualize the tumor or lymph nodes of the mediastinum, as well as to obtain tissue samples.

A tube equipped with an ultrasound probe and a special biopsy needle is inserted through the patient’s mouth. The tissue samples collected during the biopsy are sent for histopathological examinations for more accurate differential diagnosis. As a rule, the procedure takes from 30 to 60 minutes, depending on the patient's condition, as well as on the size and number of tumors. The accuracy exceeds 80%. Risks are similar to bronchoscopy. All of the above diagnostic procedures should be performed only by experienced doctors.

Lung cancer treatment options in South Korea

Surgery, chemotherapy, radiotherapy and targeted drugs form the basis of modern lung cancer treatment. These methods can be prescribed alone or in combination, depending on the type of tumor and the stage of the disease.

Surgery

The only way to completely cure the disease is to surgically remove the tumor. Unfortunately, this is only possible in a small percentage of cases.

Surgical intervention depends on the degree and location of the lung tumor, lung function, heart condition, and other factors. In the past few years, Korean surgeons have adopted unique methods to ensure the best outcomes in each case and to minimize complications.

Surgery is the most effective treatment for non-small cell lung cancer.

The cost of surgical removal of a lung tumor in South Korea starts at $ 15,000. Complex surgeries involving the complete removal of a lung (pneumonectomy) can cost more than $ 23,000. It should be understood that the cost of the same procedure can vary significantly depending on the hospital.

The most common types of surgery:

• Wedge resection: if the tumor is very small or if the patient’s lung function does not allow for lobectomy, surgeons try to remove the tumor with a minimal amount of healthy tissue.

• Lobectomy: lung lobe removal procedure. For example, if lung cancer is present in the upper lobe of the right lung, a right upper lobectomy is performed. It is recognized as the gold standard; it can be performed with bronchial resection.
• Pneumonectomy: complete removal of one lung. If the cancer penetrates the central or mediastinal structures, this may be the only chance. With pneumonectomy, there is a much higher risk of complications and mortality than with lobectomy.

Minimally invasive surgery

In recent years, thoracoscopic resection of a lung tumor has opened up new opportunities for some patients. Recently introduced surgical robots allow for more complex operations. Thoracoscopic resection is a method of removing a tumor through small incisions in the skin. The advantage is that the pain after surgery is significantly reduced, and the recovery time is reduced.

Minimally invasive surgery is mainly performed in patients with early lung cancer. Among other advantages, the procedure has a great aesthetic result. Scars on the chest will be almost invisible. Robotic-assisted thoracic surgery in Korea costs $ 17,000-25,000, depending on the clinical case. RATS is available at leading clinics in the country, such as Samsung Medical Center and Gangnam Severance Hospital.

Chemotherapy and targeted therapy

Systemic chemotherapy is required for the treatment of advanced lung cancer.



New drugs and combined chemotherapy regimens significantly minimized side effects and improved therapeutic results. In addition, even if the tumor is completely removed, antitumor chemotherapy may reduce the risk of recurrence. In small cell lung cancer, chemotherapy has become the standard treatment.

The cost of systemic chemotherapy in South Korea is significantly lower compared to most Western European and American clinics, starting at $ 600– $ 1,000 per course. A variety of medications are being studied to treat lung cancer and to prevent recurrence. The most interesting are targeted drugs, highly selective pharmacological agents aimed at unique tumor cell molecules. These drugs are actively used by Korean oncologists, achieving impressive results in the later stages of cancer.

For non-small cell lung cancer, drugs such as cisplatin, taxol, taxotere, gemcitabine + targeted agents like Iressa and Tarceva are usually prescribed. Current regimens for small cell lung cancer include cisplatin, etoposide, vincristine, isophosphamide and cyclophosphamide.

Radiation therapy

If surgical removal is not possible or is not the best option, radiation therapy can reduce the size of the tumor. There are several methods of radiation therapy, including 3D conformal radiation therapy and intensity-modulated radiation therapy.

High-precision computer-aided irradiation techniques allow high doses of radiation to be delivered to the tumor, while minimizing damage to normal tissues. Thanks to these technologies, significantly better treatment results are achieved with fewer complications. When planning radiation therapy, doctors take into account such factors as the size of the tumor, the stage of the disease, histological type and degree of tissue differentiation, as well as the sensitivity of the tumor to radiation.

Therefore, qualified medical personnel, modern diagnostic and therapeutic equipment is necessary for effective and safe radiation therapy. Today it is an extremely complex method, demanding of the professional and technical level of the clinic.

The cost of radiation therapy in South Korea ranges from $ 3,000 to $ 25,000, depending on the technology used and the characteristics of the clinical case.

© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator