Surgery
Occasionally, surgery may be used to help
determine exactly which type of
lung cancer you have.
Surgery to remove
the cancer may be an option when your cancer is in only one lung or present in
one lung and in nearby lymph nodes. Surgery usually is done only if your doctor
thinks all the cancer can be removed and your general health is good enough for
you to handle the surgery.21 Surgery is the most
effective
treatment for the early-stage non–small cell lung
cancers (stage I through stage IIIA). Often in stages IB through IIIA,
surgery will be combined with radiation and/or chemotherapy.
Surgery Choices
The type of surgery performed depends on the location and
size of your lung cancer.
Lung function studies and a
lung scan are often done before surgery to predict
whether you will have enough remaining lung function after surgery to live a
fairly normal life.
Lung surgery
- Lung surgery
(thoracotomy)
Surgery to remove
lymph nodes in the center of the chest is usually
recommended at the time of lung surgery to determine whether the cancer has
spread.
Radiofrequency ablation
Radiofrequency ablation
uses a small needle inserted through the skin and into the tumor. Energy passes
through the needle into the tumor. This heats and kills cancer cells. It also
closes up the little blood vessels in the area so there is less
bleeding.
Cryosurgery
Cryosurgery (also called
cryoablation) freezes the tumor and kills it. Cryosurgery for lung cancer is
experimental and is being used only in certain
clinical trials.
Laser therapy
Laser therapy uses a narrow beam
of very intense light to destroy cancer cells. Laser therapy usually is used as
a
palliative care to remove tumors that block the
airway; it does not cure lung cancer.
Photodynamic therapy
Photodynamic therapy (PDT)
uses laser light and a special light-activated substance (Photofrin) to kill
cancer cells. It is approved for palliative treatment to destroy tumors that
block the airway but it does not cure the lung cancer. Few lung cancers are
treated with this therapy. Surgery is still the standard treatment for
early-stage lung cancer.
In clinical trials, PDT appears to help
relieve coughing, shortness of breath, and coughing up bloody mucus. Additional
research is being done.
Cautery
Cautery is used to burn (cauterize) and
remove tumors that block the airway.
What To Think About
You may have
side
effects from your surgery.
Chemotherapy may be given before
(neoadjuvant) or after (adjuvant) surgery to destroy any cancer cells.
Adjuvant chemotherapy for non–small cell lung cancer has been shown to
improve long-term survival for stages I, II, and III that have been completely
removed with surgery.15
Adjuvant radiation
therapy does not seem to improve long-term survival but may reduce tumor
recurrence in the lungs.3