Many patients with stage 1A lung adenocarcinoma often struggle with a question after surgery: the tumor has been completely removed through surgery, and the stage is so early, so do I still need to undergo genetic testing?
In this issue, we have invited Professor Yang Nong, a specially-appointed expert from Hainan Cancer Hospital/Affiliated Cancer Hospital of Hainan Medical University, to provide a detailed analysis of this issue that patients are concerned about, based on clinical diagnosis and treatment, to help everyone cope with it scientifically.
Q1: After undergoing surgery for stage 1A lung adenocarcinoma, is genetic testing necessary?
A: Professor Yang Nong
Many people have heard others say that there is no need for medication or adjuvant therapy in stage 1A, so there is no point in undergoing genetic testing. However, according to current clinical guidelines and expert consensus, genetic testing can be considered after surgery for stage 1A lung adenocarcinoma, especially for patients with high-risk factors, and doctors may recommend it. The decision to undergo testing should be based on a comprehensive assessment of pathological results, recurrence risk, and patient preferences.
We must distinguish between two things: one is whether to take medication after surgery, and the other is whether to undergo genotyping. These are completely different matters.
Stage 1A lung cancer is small and has no metastasis. After surgical resection, the cure rate is high, and most patients do not require chemotherapy or targeted drugs post-surgery. This is correct. However, not treating does not mean not testing.
Q2: What is the significance of genetic testing for patients with stage 1A lung adenocarcinoma?
A: Professor Yang Nong
The greatest significance of genetic testing lies not only in taking medication at the moment, but also in predicting risks and preparing for contingencies.
Firstly, it helps to assess the risk of recurrence and develop individualized follow-up strategies.
Even in the same stage 1A, the prognosis can vary greatly. Through genetic testing, combined with indicators such as high-risk pathological subtypes, vascular invasion, and pleural invasion, doctors can more comprehensively assess the risk of recurrence and develop more personalized follow-up and review strategies. High-risk groups can be monitored closely to minimize the risk of missed diagnosis.
Secondly, it provides a treatment basis for potential recurrences in the future.
A more crucial point is to prepare for potential future recurrences. Although the cure rate for stage 1A is high, there is still a small risk of recurrence. Once recurrence or metastasis occurs, the disease often enters a stage requiring systemic treatment, and the choice of treatment plan may need to refer to the results of genetic testing. The results of genetic testing are one of the crucial references for determining whether targeted drugs can be used subsequently and which targeted drug is suitable.
If genetic testing results are not retained after surgery, in the event of future recurrence, it may be necessary to re-obtain tumor tissue or perform liquid biopsy to confirm gene typing, which will incur additional examination and time costs.
Expert Introduction
Yang Nong
Chief Physician, Doctoral Supervisor
Hainan Cancer Hospital/Affiliated Cancer Hospital of Hainan Medical University
Long-term employed expert of Hainan Chengmei Hospital
He currently serves as Vice President of the Second People's Hospital of Hunan Province, head of the oncology department, and the person in charge of the "Yang Nong Famous Doctor Clinic" / "Yang Nong Famous Doctor Expert Team Clinic". He is also the chief expert of the National Major Scientific and Technological Special Project, a member of the Lung Cancer Special Committee of the National Tumor Quality Control Center, the director of the Hunan Provincial Key Laboratory of Precision Diagnosis and Treatment of Lung Cancer, and the director of the Hunan Provincial Respiratory Tumor Clinical Medical Research Center.
With nearly 30 years of experience, I have been dedicated to precision targeted therapy for lung cancer and gastrointestinal tumors, as well as clinical research and teaching on complex, recurrent, and drug-resistant cases.
He has been honored with titles such as the "National Famous Doctor - Excellent Demeanor" at the 6th session, the "Annual Good Doctor" for eight consecutive years, and the "First Brain Doctor - Famous Doctor". He has authored national guidelines and has long been engaged in the popularization of cancer health knowledge.
Specialization
Precision treatment for lung cancer, diagnosis and treatment of difficult, recurrent, and drug-resistant cases, as well as brain metastasis; individualized precision treatment for brain metastases of lung cancer; early diagnosis of pulmonary nodules and lung cancer; personalized comprehensive diagnosis and treatment for pan-solid tumors; clinical trials of the latest immunotherapy/targeted therapy drugs.
With nearly 30 years of experience in precision immunotherapy for lung cancer, I have led nearly 400 phase I-III clinical trials of new anticancer drugs (including national Class 1 new drugs).
We have been providing comprehensive, individualized, and interdisciplinary diagnosis and treatment for multiple cancer types for a long time.
Visit information
Clinic Hours
On the afternoon of October 17th
Outpatient visit location
The sixth consultation area of Hainan Cancer Hospital
appointment registration
Follow the official account of Hainan Cancer Hospital for "appointment registration"
Friendly Reminder
To facilitate the experts in understanding your condition as soon as possible, please bring along:
●ID card, medical insurance card, mobile phone
●Accompany immediate family members (with decision-making authority)
● Arrange the relevant examinations you have undergone in chronological order
● Paper medical records of previous visits
●Surgical case biopsy: paraffin block or 20-30 white slides
● Pathological diagnosis report
● Inpatient medical records and notes
● Recent relevant examinations
● Patient's current treatment plan
●The most urgent questions to consult
[Friendly reminder: This article is for health education purposes and cannot replace professional medical advice. Specific decisions regarding whether to undergo genetic testing and subsequent treatment plans should be made based on the patient's pathological results, physical condition, and doctor's recommendations.]