Surgical Procedures for Lung Cancer
If lung cancer is localized and has not spread beyond the original site, surgical removal of the cancer is the most common treatment. The goal is to remove as much of the cancer as possible while keeping as much lung tissue and function as possible. Chemo- and/or radiation therapy may be used before the surgery to shrink the tumor or after to try to kill off any remaining cancer cells after surgery.
Surgical removal is not always an option since most lung cancers are found in advanced stages. In this case, surgery may be done to relieve symptoms.
Surgery for Early Stage Lung Cancer
Surgery can be a cure for stage 0 and other early stages of lung cancer, depending on the specific type.
A thoracotomy is a surgical method for opening the chest wall. This give access to the lungs and other structures, including lymph nodes, which can be removed if needed during a procedure.
Options for lung cancer surgery are based on type, stage, size, and locations of tumor, include:
- Wedge resection —A section in the shape of a triangle is cut from lung tissue. A margin of healthy tissue around the tumor will also be removed.
- Segmental resection —Similar to a wedge resection, but a larger section of lung tissue is removed.
- Lobectomy —The lung is sectioned into lobes that connect to one another. If cancer is contained to one of these sections, the entire lobe can be removed.
- Sleeve resection —Part of the airway is removed. After removal, the lung is reattached.
- Pneumonectomy —Removal of the entire lung. This may be an option if cancer is in more than one lobe and in contained one lung.
Palliative Procedures for Advanced Lung Cancer
A number of minor procedures can help relieve symptoms and improve quality of life. As cancer grows, it affects the body's ability to function properly. In the case of lung cancer, tumors cause problems that can can interfere with breathing.
Surgery may also be used to remove tumors that spread to other areas, such as the brain or an adrenal gland and are causing problems
Procedures to relieve symptoms may include:
- Thoracentesis —A needle is inserted into the pleural space outside of the lungs to draw out excess fluid.
- Pleurodesis —A substance is placed in the pleural space that surrounds the lungs. The substance causes the two pleural layers to stick together, eliminating the space between them.
- Pericardiocentesis —A needle is inserted into the pericardium, the protective sac that surrounds the heart. Excess fluid is drawn out and removed.
- Pericardial window —A piece of the pericardium is take out. The fluid drains into the chest or abdomen.
- Chest catheter —A catheter can be placed into the chest. The tube attaches to a device and fluid drains into it. These can also be placed during one of the surgical procedures mentioned in the previous section.
- Photodynamic therapy —Light-sensitive molecules are injected into the bloodstream. These molecules are absorbed by cells throughout the body, but tend to remain longest in cancer cells. When these molecules are exposed to a special light, they cause cell damage and death. The light will be directed to the tumor using an bronchoscope . It is useful for lung cancer in its earliest stages. PDT can also be helpful when tumors affect breathing. In this case, it will help ease breathing.
- Laser therapy —A special light source is use to core out an area where tumors are blocking the airway. This can be done when other treatment methods are not an option.
- Stent —If a tumor is blocking the airway, a metal stent can be placed during surgery or a bronchoscopy to keep it open.
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- Michael Woods, MD, FAAP
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