Thoracic Oncology Program

Lung Cancer

Treatment Overview

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If your tumor is very small and in its early stage, surgery alone may be recommended.
If the cancer has spread to other areas of the body, such as your liver or brain, chemotherapy or radiation therapy alone will likely be recommended
For all others, Multimodality Therapy may be recommended. Multimodality is the use of chemotherapy, radiation therapy and surgery in one of several different combinations. Preoperative chemotherapy and radiation therapy are used to shrink the tumor and decrease the chance of cancer cells surviving after surgery. Postoperative chemotherapy and radiation therapy are used to kill any cancer remaining after surgery in order to decrease the chance of tumor regrowth.

BIOPSY (Surgical)

During a lung biopsy, the surgeon will sample the section of the lung, which is suspicious and send it to pathology for a diagnosis of your lung disease. You will need to go under general anesthesia for this operation.

The two surgical approaches for biopsy are:

Thoracoscopy (closed lung biopsy) - Thoracoscopy is a minimally invasive technique. Three small (approximately 1 inch) incisions are made in your side. A video-scope is placed through one of the incisions. This scope allows the surgeon to see your lungs. A stapler and grasper are inserted in the other incisions. These are used to sample the area of suspicion. The incisions are closed by sutures, which will eventually dissolve.
Thoracotomy (open lung biopsy) - Thoracotomy is used when the tumor is not accessible with the thoracoscope. An incision is made in your side, between your ribs. The incision is approximately 7 to 9 inches long. Your ribs are separated, not broken, and your lung is inspected and a biopsy is taken. Your muscle and skin are closed with sutures or staples.

For more information, please visit Lung Tissue Biopsy

Staging

One of the best indicators of the extent of cancer are the lymph nodes. Lymph nodes are tiny glands that help the body fight infection and tumor. The stage of cancer is determined by the size of the tumor and the number and location of enlarged lymph nodes. Accurate staging helps tailor treatment to your specific needs. Some staging can be done with CT scan, biopsy, and PET scan. Other situations will require surgical staging.

Surgical Staging

Surgical staging involves two procedures - bronchoscopy and mediastinoscopy. These procedures are performed during one operation and provide exact reports of the extent of your tumor and the number and location of lymph nodes that have been affected by cancer. Once you have fully recovered from the anesthesia, you will be discharged. Most patients are able to go home later the same day. Since you may still feel somewhat sleepy and uncomfortable, someone will need to accompany you home.

For more information, please visit Staging

Treatment

Radiation Therapy

Radiation therapy is used to help shrink your tumor with a form of high energy x-rays which are carefully directed at you tumor and the surrounding tissue at highest risk for local spread. The high-energy beams can kill cells and keep them from dividing and spreading. This helps destroy the tumor, because cancer cells divide and grow faster than normal cells. Normal cells usually recover successfully from radiation, but the high-energy beams will be carefully aimed to target your tumor and lymph nodes and minimize the amount of normal tissue affected.

You will not feel the radiation while it is being delivered, and the actual treatment will take less than 5 minutes. Expect to be in the department for 15 to 30 minutes each day, though, so that the machine can be properly set up for your individual needs. Radiation therapy is given as an outpatient for 5 to 6 weeks.

Chemotherapy

Chemotherapy is used to help shrink the tumor and kill any cancer cells in the lymph nodes. There are several chemotherapy medications that work to kill lung cancer and often a combination of 2 of these medications is prescribed. The specific medication or combination of medications you receive will be selected based on your tumor type and your medical history. Exact doses of each medication will be calculated using your weight, height and lab values.

Chemotherapy will be given as an outpatient. A specially trained nurse will remain with your at all times while your chemotherapy is infusing. The chemotherapy will be given through an IV. You will receive other medications before and during your chemotherapy which are designed to minimize and relieve the side effects.

For more information, please visit Chemotherapy and Radiation Therapy

Surgical Resection

Lung surgery for cancer includes the removal of the tumor, lymph nodes and sections of the lung that contain the tumor. It is the treatment of choice in several types and stages of lung cancer, either alone, or in combination with chemotherapy or radiation therapy. It is also used to remove cancerous tumors that have spread to the lungs from other parts of the body. The surgeon will recommend one of several approaches for removal of the tumor.

We understand that there is a lot of information to remember and this is a very stressful time for you and your family. It may help to bring a pen and notebook to your appointments. Write down questions as you think of them, and please feel free to contact us.

For more information, please visit Lung Surgery for Cancer

This page was last updated on: May 15, 2009.