Australia’s National Lung Cancer Screening Program represents a significant milestone. From a thoracic surgeon’s perspective, what impact is early detection having on patient care and treatment pathways?

The National Lung Cancer Screening Program is already changing how we diagnose and treat lung cancer by detecting more cancers at an earlier, more curable stage. Since its introduction a year ago, about 100,000 Aussie patients have undergone screening. In my own practice, I've seen a steady increase in referrals for screen-detected lung cancers. Last year, I treated one of the first patients in Australia who was diagnosed with lung cancer from a screening scan. From the time of the scan to the time of discharge home after robotic lobectomy resection was only 10 days! This earlier intervention has the potential to improve long-term outcomes and save lives.

As screening programs identify more patients who require further investigation or treatment, how important is access to minimally invasive surgical approaches in modern thoracic care?

Minimally invasive surgery has become increasingly important as we diagnose more patients with early-stage lung cancer through screening. Robotic-assisted surgery offers greater precision, improved visualisation, and enhanced dexterity, helping surgeons perform complex procedures while reducing complications and supporting faster recovery. It has also become valuable when operating after chemo-immunotherapy, where tissues can be more technically challenging to dissect. This has been particularly relevant to Australian patients since the Federal Government has enabled the use of immunotherapy for locally-advanced cases of lung cancers. Ultimately, these advances help us deliver better outcomes for our patients.

We continue to see rapid advances in operating room technology across Australia. How have these innovations changed the way thoracic procedures are performed today?

Advances in surgical technology have enabled us to perform more lung-sparing operations, such as segmentectomies, for appropriately selected patients with early-stage lung cancer. Technologies including preoperative lesion localisation and indocyanine green (ICG) fluorescence imaging have improved the precision and safety of these procedures. It's exciting to see these innovations become available in Australia and to be able to offer patients access to world-class surgical care.

Looking ahead, what major changes do you foresee in the future of thoracic healthcare in Australia?

Traditionally, Australian cardiothoracic surgeons perform a mix of heart and lung operations, with excellent outcomes by international standards. However, I do believe there is potential value in performing subspecialty operations in higher volumes to achieve optimal outcomes for patients. With sub-specialty training and increased experience with minimally invasive robotic platforms, I expect more patients will benefit from increasingly precise and less invasive procedures. Combined with earlier diagnosis through screening, these advances should continue to improve outcomes and quality of care for patients across Australia.