Editor’s Note: From October 18 to 19, 2024, the CACA Gastric Cancer Integration Conference was held in Wuhan, bringing together multidisciplinary experts from both domestic and international fields to focus on the frontiers, standards, and progress in gastric cancer diagnosis and treatment. During the conference, Oncology Frontier had the opportunity to interview the conference chairman, Dr. Han Liang, from Tianjin Medical University Cancer Institute and Hospital. Dr. Liang shared insights into his journey to becoming a surgeon, the professional qualities required of surgeons, and the future trends in surgical oncology. His extensive clinical experience and unique perspectives revealed the challenges and honors behind the career of a surgeon, as well as the limitless possibilities of medical advancements.

Medicine Was a Predestined Path: A Lifelong Commitment to Growth with the Cancer Hospital

“Some things are like destiny,” Dr. Liang reflected on his journey in medicine with deep emotion. He took the national entrance exam in 1980 and graduated after five years of university in 1985, marking a 39-year career in medicine. Dr. Liang considers himself fortunate to have grown alongside the Chinese Anti-Cancer Association (CACA). Founded in Tianjin in 1984, CACA’s development coincided with his arrival at Tianjin Cancer Hospital, where he has witnessed the association’s 40-year journey and grown together with it.

Dr. Liang’s decision to specialize in oncology is rooted in his early experiences. He vividly recalls being around six or seven years old when his grandfather came to Tianjin from their hometown in Shandong for liver cancer treatment. However, with limited medical resources at the time, there were no effective diagnostic or treatment options, and his grandfather unfortunately passed away. This experience gave Dr. Liang a profound understanding of cancer and fueled his determination to pursue cancer treatment. Later, while in university, he encountered two more relatives seeking treatment at Tianjin Cancer Hospital, solidifying his conviction to specialize in oncologic surgery.

However, when Dr. Liang first started working at the hospital in 1985, he faced significant challenges. Cancer treatment options were limited, and late-stage patients often had no viable treatments. The hospital’s senior director even questioned their choices, suggesting that the young graduates were entering a field with few treatment possibilities, mostly dealing with late-stage cases. Despite this, Dr. Liang felt fortunate to find a platform full of challenges and opportunities where he could dedicate himself to his passion for medicine.

A Good Surgeon Needs Diverse Professional Qualities

The journey to becoming a successful surgeon is filled with a doctor’s courage and effort, and often, the blood and tears of patients and their families. Dr. Liang believes that strong foundational skills are essential, but he also emphasizes the importance of natural talent in surgical practice. A sign of a mature surgeon, he notes, is the ability to avoid or minimize repeating the same mistakes. In Dr. Liang’s view, becoming an outstanding surgeon requires the following key qualities:

1. Passion: A genuine interest in medicine is the first requirement for becoming a successful surgeon. Without passion, it’s difficult to achieve excellence in this field.

2. Manual Dexterity: Surgery demands a high level of technical skill. Whether in traditional open surgery or modern laparoscopic and robotic procedures, surgeons need solid hands-on capabilities. Aspiring surgeons should assess their own manual skills.

3. Professional Ethics: In addition to surgical skills, medical ethics are indispensable. Dr. Liang recalled a line from Zuo Zhuan, an ancient Chinese text: “The greatest virtue is establishing moral character, followed by achievements and scholarly contributions.” As the “Father of Chinese Surgery” Qiu Fazu once said, “A doctor without virtue is unfit to practice medicine,” indicating that doctors must have a spirit of dedication and willingness to give their all for patients. Dr. Liang frequently reflects on how to be a good person, do good work, and pursue knowledge.

4. Lifelong Learning: Choosing medicine as a career means committing to lifelong learning. Dr. Liang often motivates himself with the words of Professor Zhongtian Yi: “Dare not relax for even a day; dare not be careless with any task.” In today’s fast-paced society, it is crucial to stay grounded and continuously study.

5. Specialized Focus: As medical disciplines become increasingly specialized, surgeons need to choose an area of interest and delve deeply into it. The “10,000-hour rule” applies here—achieving success requires at least 10 years or even 20 years of dedicated exploration in a particular field.

6. The Right Platform: A good platform can provide more opportunities and resources, helping surgeons realize their aspirations. Dr. Liang also pointed out that being a doctor isn’t as glamorous as many imagine. In clinical practice, doctors face numerous challenges, including health insurance issues and communication with patients’ families. Thus, good doctors, particularly surgeons, need to handle doctor-patient relationships effectively and have strong communication skills. They must also possess unwavering perseverance and a spirit of dedication to excel in the medical field.

The Future of Surgical Oncology: Towards Intelligence and Precision

Regarding the future trends in surgical oncology, Dr. Liang is highly optimistic about the application of artificial intelligence (AI) in medicine. He mentioned that recent news about AI developments has left him astonished. Predictions suggest that by 2056, robots could completely replace surgeons. We are living in an era of unprecedented change, one that could mark a historic transformation in human history.

Dr. Liang believes that medicine will undergo revolutionary changes. For example, drug development, particularly immunotherapy, has seen explosive growth in recent years. Innovations such as dual-immunotherapy, bispecific antibodies, antibody-drug conjugates (ADCs), and anti-CLDN therapies have all shown promising results. In gastric cancer treatment, some experts predict that in the near future, 80% of gastric cancer cases will have identified targets and corresponding treatments. Traditional chemotherapy-based approaches may only remain relevant for the next 10 years in gastric cancer. This indicates that in the next decade, significant changes in gastric cancer treatment will occur, encompassing both drug therapies and AI-assisted surgeries.

Signs of AI integration in surgery are already visible. Techniques like indocyanine green navigation for lymph node dissection, intelligent laparoscopes, robotic surgery with 4D reconstruction, and vascular reconstruction have been applied in gastric cancer surgeries. These advancements are making surgeries increasingly minimally invasive, refined, and precise, while gradually reducing the scope of resections and lymph node dissections. Dr. Liang foresees unlimited potential in the future of gastric cancer treatment.

Dr. Liang also mentioned China’s Healthy China 2030 strategy, which aims to improve the long-term survival rate of all solid tumors by 10%. He is confident that this goal will be achieved for gastric cancer. As medical technology continues to advance, the future of surgical oncology promises to be brighter than ever. Let us look forward to the arrival of that day together!

Dr. Han Liang

• Director of the Gastric Cancer Center, Tianjin Medical University Cancer Institute and Hospital
• Council Member, Chinese Anti-Cancer Association (CACA)
• Former Chairperson, Gastric Cancer Committee of CACA
• Chair-Elect, Surgical Oncology Committee of the Chinese Medical Doctor Association
• Vice-Chairperson, Gastric Cancer Expert Committee of the Chinese Society of Clinical Oncology (CSCO)
• Vice-Chairperson, Gastrointestinal Stromal Tumor Committee of CACA
• Deputy Leader, Gastrointestinal Group of the Enhanced Recovery After Surgery Committee of the Chinese Research Hospital Association
• Deputy Leader, Gastrointestinal Group of the Chinese Society of Oncology
• Standing Committee Member, Integrative Medicine Committee of CACA
• Member, National Standardized Diagnosis and Treatment Expert Committee for Cancer
• Member, Executive Committee of the National Quality Control Committee for Gastric Cancer
• Chairperson, Gastric Cancer Committee of the Tianjin Anti-Cancer Association
• Executive Deputy Editor-in-Chief, Chinese Journal of Clinical Oncology
• Principal investigator of more than 10 national and provincial-level projects
• Recipient of numerous awards, including the National Science and Technology Progress Award (Second Prize), the First Prize for Science and Technology Progress from the Chinese Medical Association and Ministry of Education, the Hubei Provincial Science and Technology Progress Award (First Prize), and the Tianjin Science and Technology Progress Award (Third Prize).
• Listed as one of China’s “Highly Cited Researchers” for 2021–2022 and recipient of the 2021 Oncology Research Expert Nomination Award.
• Author of 10 published monographs and over 460 papers, including more than 150 SCI-indexed papers.