Abstract
The diagnosis of lung cancer was significantly enhanced by the development of the fiberoptic bronchoscope in 1965. Since then, advances in photosensitizers and light sources have brought photodynamic medicine into the light. This article offers an historic overview of the emergence of photodynamic medicine through the perspective of a pioneer with more than 30 years’ experience. Along with a discussion of photodynamic diagnosis of lung cancers via optical coherence tomography, the curative, palliative, and neoadjuvant roles of photodynamic therapy for early and advanced lung cancers are explored. An emerging strategy of using PDM to treat peripheral early-stage lung tumors is briefly discussed.
The Birth of Fluorescence Bronchoscopy for Diagnosing Lung Cancer
The diagnosis of lung cancer was significantly enhanced by the development of the fiberoptic bronchoscope in 1965. “However, as superficial carcinomas in the extremely early stage could not be recognized by an ordinary bronchoscope, we tried to develop a fluorescent bronchoscope in 1978,” revealed Dr. Kato. Joining colleagues in the United States, Professor Profio and Dr. Doiron of the University of Southern California and Professor Dougherty of Roswell Park Memorial Institute, Dr. Kato researched the use of photodynamic diagnosis (PDD) for lung tumors.
Conclusions
PDT represents a promising yet currently underused alternative treatment modality for patients with lung cancer. Based on more than 30 years of experience with PDT, Dr. Kato considers it a definitive monotherapy for early-stage, centrally located non–small cell lung cancer. PDT also appears to be an effective palliative measure for improving many of the symptoms of advanced lung cancer, and may prove to be of use as a neoadjuvant component of multidisciplinary therapy for patients with locally advanced disease. Finally, emerging strategies for using PDT to treat earlystage peripheral lung cancer appear promising but require further study
