How Lung Cancer is Treated?

Surgery offers the best chance of cure when the lung cancer is localized and all evidence of the cancer can be removed at the time of surgery (i.e. stages I and II). Sometimes surgery is performed for more advanced stages after treatment with radiation or chemotherapy.

The basis behind all different types of lung surgery is that surgery can be beneficial if it is possible to remove all of the tumor with no adverse effects on breathing or nearby structures. For some patients, it is possible and necessary to have one lung removed entirely to remove all traces of the cancer. However, it is preferable to take out the smallest amount of lung possible that will still remove all traces of the cancer, including nearby lymph nodes.

  • A wedge procedure is similar to a pie wedge. It involves the removal of a small piece of lung and is most often performed for small peripheral tumors or as a biopsy to determine the diagnosis.
  • Lobectomy: Considered the “gold standard” for treatment contained within an isolated portion of the lung, a lobectomy involves the removal of one lobe (a separate, independent part of the lung) of the lung.
  • Pneumonectomy: This involves the removal of an entire lung and is sometimes required if the cancer is confined to a single lung but is not confined within a single lobe.
  • VATS: (Video-Assisted Thoracoscopic Surgery): VATS is used to diagnose problems as well as to remove small parts of the lung for biopsies and for patients with poor lung function. One major advantage of VATS is that it allows for much smaller incisions than were previously needed for this type of surgery.
  • Radiofrequency Ablation (RFA): RFA is a minimally invasive treatment involving the heating and destroying of cancer cells in a specific area. A probe is inserted into the tumor, usually by CT guidance in a CT scanner. Sedation or general anesthesia is usually required. It is considered for patients who cannot tolerate surgery due to poor lung function, as the recurrence rate after therapy is generally higher than with surgery.

Medical Therapies such as Radiation or Chemotherapy are commonly utilized in combination with surgery or when surgery is not an option.

Surgery is not an option when…

  • Cancer has spread (metastasized) to other regions of the body. Surgery in the lung would not be effective in eradicating the cancer since cancer would be left behind in other places.
  • Removing the amount of lung required to remove the tumor will leave the patient too short of breath for a reasonable quality of life.

In both of these cases, broader, systemic medical therapies are required, such as radiation or chemotherapy.