In a groundbreaking moment for the future of surgical oncology and cancer treatment, Dr. Yuman Fong, Chair of the Department of Surgery at City of Hope, recently delivered the prestigious Lister Legacy Lecture at The Royal College of Surgeons of Edinburgh’s triennial conference. Dr. Fong’s address, titled “The Surgeon in the 21st Century,” embodied a forward-thinking vision of surgical innovation that intersects with cutting-edge technology, gene therapy, and artificial intelligence, marking a transformative era for cancer care globally.
The Royal College of Surgeons of Edinburgh, steeped in history as one of the oldest surgical institutions in the world, commemorates the profound legacy of Baron Joseph Lister, who revolutionized surgery by introducing antiseptic protocols. This foundational work drastically reduced surgical infections and mortality rates, paving the way for the sterile techniques now universally practiced. Inspired by such innovations, Dr. Fong has embarked on a mission to push surgical boundaries further by integrating AI and robotics into medical practice, advancing not just the technique but the very infrastructure for future surgical interventions.
Dr. Fong’s pioneering work in liver surgery has rewritten the prognosis for metastatic colorectal cancer, particularly Stage 4 cancer that has spread to the liver. Once considered uniformly fatal, this condition can now in some cases be cured through carefully planned liver resection, a surgical approach meticulously refined by Dr. Fong and his team. The introduction of the Fong Score, a system for staging patients based on the extent of cancer spread and other clinical parameters, has become an essential tool for determining surgical candidacy and predicting outcomes, dramatically improving individualized treatment planning.
Advancements in minimally invasive surgical technologies have long fascinated Dr. Fong. Over the years, he has contributed to the design and global dissemination of novel interventional tools aimed at reducing patient trauma and recovery time. Most notably, his leadership in pioneering robotic liver surgery has culminated in recent studies demonstrating its feasibility as a safe outpatient procedure. This paradigm shift toward minimally invasive and outpatient protocols holds enormous promise for healthcare systems burdened by cost and resource limitations, while enhancing patient quality of life.
At the intersection of gene therapy and immuno-oncology, Dr. Fong’s lab has spent more than two decades engineering oncolytic viruses designed to selectively infect and kill cancer cells. The flagship construct, CF33, is a novel chimeric virus that has exhibited potent anticancer activity across multiple tumor types including colon, lung, breast, ovarian, and pancreatic cancers in preclinical models. Beyond direct oncolysis, CF33 activates the immune system to recognize and attack cancer, bolstering long-term therapeutic efficacy through immune-mediated mechanisms.
Clinical translation of CF33 is underway through multisite trials, evaluating its safety and efficacy in patients with diverse solid and hematologic malignancies. These investigations are pivotal in determining the virus’s role both as a monotherapy and in combination with other immunotherapies, representing a new frontier in targeted cancer treatment that may overcome resistance to existing modalities and substantially improve patient outcomes.
Dr. Fong is also at the vanguard of integrating artificial intelligence and augmented reality into surgical practice. Current pilot projects involve deploying AI to enhance intraoperative navigation, improve tissue characterization, and predict the biomechanical behavior of tissues during surgery. By delineating “no-go zones,” AI systems aim to prevent inadvertent damage, potentially reducing complication rates. Augmented reality facilitates real-time collaborative surgeries by overlaying detailed anatomical data and functional information onto the surgical field, thereby enhancing precision and enabling distributed expertise from remote specialists.
Remote surgery, although still experimental, is being actively developed to extend the reach of expert surgical care to underserved or geographically isolated populations. Preclinical studies demonstrate that a network of surgeons can simultaneously operate on a patient with the assistance of robotic systems and AR-guided visualization. This approach not only promises to democratize access to specialized care but also heralds a future where emergencies and complex cases can be addressed regardless of location.
Complementing these technological frontiers is Dr. Fong’s interest in wearable devices and remote patient monitoring to optimize perioperative care. Supported by a $7 million award from the Patient-Centered Outcomes Research Institute (PCORI), City of Hope researchers are investigating how physical activity metrics captured by wearables before and after surgery influence recovery trajectories, particularly in older adults. This patient-centric approach aims to develop tailored intervention strategies that reduce complications, hasten convalescence, and ultimately improve long-term functional status.
City of Hope’s integrated model, combining cutting-edge laboratory research with rapidly initiated clinical trials, serves as a fertile ground for incubating innovations like CF33 and robotic-assisted surgery. The institution’s expansive network across multiple states ensures that these pioneering therapies can be evaluated and disseminated broadly, providing hope to patients who previously had limited treatment options.
Dr. Fong’s work exemplifies the confluence of surgical tradition and technological innovation, a synergy poised to redefine cancer care in the 21st century. By leveraging gene therapy, AI, robotics, and wearable technologies, his multidisciplinary approach is transforming the surgeon’s role from a sole operator in the operating room to a nexus of collaborative expertise, empowered by data-driven decisions and remote connectivity.
As clinical trials progress and AI-assisted surgeries begin to enter routine practice, the promise of accessible, precision cancer treatment becomes ever more tangible. Dr. Fong’s vision of making exceptional cancer surgery universally available—irrespective of geographic or socioeconomic barriers—reflects a bold commitment to democratizing healthcare and advancing patient outcomes on a global scale.
Through continued innovation and collaboration with medical technology companies worldwide, City of Hope is positioned at the forefront of this surgical renaissance. The work championed by Dr. Fong not only honors the legacy of pioneers like Joseph Lister but also accelerates our ability to cure and manage cancers once deemed hopeless, ushering in a new era of hope and healing.
Subject of Research: Surgical innovation in oncology, artificial intelligence integration in surgery, gene therapy using oncolytic viruses, remote surgical collaboration, robotic liver surgery, patient wearables for perioperative monitoring.
Article Title: The Surgeon in the 21st Century: Dr. Yuman Fong’s Visionary Approach to Cancer Care Innovation
News Publication Date: Not specified
Web References:
- https://www.cityofhope.org/yuman-fong
- https://www.cityofhope.org/new-city-of-hope-study-shows-liver-surgery-to-remove-cancer-can-now-be-a-safe-outpatient-procedure
- https://www.cityofhope.org/news/cancer-killing-virus-helps-eliminate-colon-cancer
- https://www.cityofhope.org/city-of-hope-and-imugene-announce-first-patient-dosed-in-phase-1-trial-to-test-cancer-killing
- https://www.cityofhope.org/world-lung-cancer-day-city-of-hope-approved-for-7-million-to-study-interventions-for-lung-cancer-in
Image Credits: City of Hope
Keywords: Cancer, Surgical procedures, Medical specialties, Oncology, Gene therapy, Artificial intelligence, Robotic surgery, Liver surgery, Immunotherapy, Remote surgery, Wearable technology
