Treatment & Diagnosis
Treatment for lung cancer is based on several factors including a patient’s overall health and medical history, the extent of the disease, and other individual factors. Generally, treatment for patients with lung cancer includes surgery, chemotherapy, radiation therapy, laser therapy, or a combination of treatments. Video-assisted thoracic surgery is also available at Sylvester.
Depending on the type and stage of a lung cancer, surgery may be used to remove the cancer along with some surrounding lung tissue.
- If a section (lobe) of the lung is removed, it is called a lobectomy
- If the entire lung is removed, the surgery is called a pneumonectomy
- Removing part of a lobe is known as a segmentectomy or wedge resection
These operations require general anesthesia (you are “asleep”) and a surgical incision in the chest (called thoracotomy). You will generally spend one to two weeks in the hospital. Possible complications include excessive bleeding, wound infections, and pneumonia. Because the surgeon must cut through ribs to get to the lung, these will hurt for some time after surgery. Your activity will be limited for at least a month or two.
If your lungs are in good condition (other than the presence of the cancer) you can usually return to normal activities after a lobe or even an entire lung has been removed. However, if your lungs have been damaged and you have noncancerous diseases such as emphysema or chronic bronchitis (which are common among heavy smokers), you may become short of breath after surgery. Pulmonary function tests are done before surgery to determine whether you will have enough healthy lung tissue remaining after surgery.
If you can’t undergo a thoracotomy (opening the pleural cavity by incision) because of lung disease or other serious medical problems, or if the cancer is widespread, other types of surgery can be used to relieve some symptoms. For example, laser surgery can be used to relieve blockage of airways that may be causing pneumonia or shortness of breath.
If the lung cancer has spread to your brain, you may benefit from removal of the brain metastasis. This is done by surgery through a hole in the skull (craniotomy). It should only be done if the tumor can be removed without damage to vital areas of the brain that control movement, sensation, and speech.
Video-Assisted Thoracic Surgery
Recently, a less invasive procedure for treating early stage lung cancer has been developed. This is called video-assisted thoracic surgery. A tiny video camera can be placed inside the chest cavity to help the surgeon see the tumor. Only small incisions are needed, so there is a little less pain after the surgery. Most experts recommend that only tumors smaller than four to five cm (about two inches) be treated this way. The cure rate after this surgery seems to be the same as with older techniques. It is important, though, that the surgeon performing this procedure be experienced since it requires more technical skill than the standard surgery.
Chemotherapy is the use of anticancer drugs given into a vein or by mouth, in tablet form, to kill cancer cells. Chemotherapy may be given before other treatments, after other treatments, or alone for lung cancer.
Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. Radiation therapy may also be used with chemotherapy to treat lung cancer. Radiation may be delivered externally through a beam, or internally, through drugs or implants directly into the tumor.
Photodynamic therapy (PDT) is a type of laser treatment that involves injecting chemicals into the bloodstream. The chemicals collect and stay longer in the cancer cells than in the healthy cells. At the right time, the light of a laser can be focused directly on the tumor. As the cells absorb the light, a chemical reaction destroys the cancer cells.