Diseases & Conditions
Lung Cancer - Treatments
Lung Cancer Staging
Based on the evaluation of the cancer—and its staging to determine its severity—your physician will recommend the appropriate treatments.
How is Lung Cancer Treated?
With their depth and range of expertise, our specialists apply a wide array of state-of-the-art techniques to cure patients by removing and killing cancerous tissue. Our surgeons also use the most advanced techniques to relieve the symptoms of patients with advanced disease so they may improve their quality of life.
Lung resection is the surgical removal of all or part of the lung. The lung has three parts (called lobes) on the right side; and two on the left. Often, an operation for lung cancer involves removing part or all of a lobe.
Thoracic surgeons at BMC offer patients a variety of minimally invasive and robotic surgical procedures to treat lung cancer. The use of these state-of-the-art surgical techniques results in fewer side effects than traditional methods.
Following are the principle surgical options used to treat lung cancer:
Also called segmentectomy, a small part or pie-shaped wedge of the lung is removed
The removal of an entire lobe, this operation is usually effective at taking out all the cancerous tissue and decreasing the chance of cancer coming back. BMC was the first hospital in New England to perform robotic lobectomies, which require only small incisions. Robotic surgery is less painful and offers faster recovery times than more standard operations for lung cancer.
This option, removal of an entire lung, is considered if a tumor is large or located in a difficult-to-reach or central position in the lung. Although pneumonectomy can result in significant loss of function, many people live quite well with only one lung.
Video-Assisted Thoracoscopic Surgery (VATS) Lobectomy
Depending on the size and location of your cancer, it may be possible to use this minimally invasive approach to perform a resection. With VATS, several tiny incisions are made in the chest through which the surgeon inserts instruments as well as a small video camera that projects images onto a computer monitor. Your surgeon uses the images from the computer monitor as a guide during surgery. It may be possible to perform any of the resections (wedge, segmentectomy, lobectomy, pneumonectomy) described above.
Some tumors defy standard surgical techniques because of their location. However, a laser can strike small tumors in delicate or hard-to-reach areas. When conducting a laser resection, the surgeon inserts an endoscope into the lung, directs the laser at the tumor, and transmits the high-energy beam, which destroys cancerous tissue by vaporizing it.
The emerging technique of photodynamic therapy is generally used to minimize a patient’s pain and discomfort; but it is being investigated as a treatment for early-stage cancer. The patient is injected with a light-sensitive anticancer drug that is absorbed by cancer cells. Laser light is then used to activate the cancer-killing drug.
BMC physicians may use tumor ablation to destroy or shrink a tumor or to relieve the symptoms of a patient who is not a candidate for surgery. When using the minimally invasive technique of tumor ablation, the physician employs catheters to ablate (destroy) cancerous tissue. Guided by computed tomography (CT), the physician inserts a specially equipped needle (probe) into the tumor that transmits cancer-killing energy into the malignant cells. Forms of ablation include:
- Radiofrequency ablation (RFA) burns the tumor with a high-frequency electric current.
- Cryoablation sends liquid nitrogen through the probe to freeze cancer cells.
- Microwave ablation transmits heat from radio waves to kill the cancer cells.
Non-Surgical Cancer Treatments
Surgery or minimally invasive treatments for lung cancer are typically used in combination with other treatments, including:
Using chemotherapeutic drugs to kill cancer cells is often used after surgery, alone, or in combination with other treatments. These medications are given orally in pill form or intravenously, through a needle or catheter in your arm or a long-term catheter called a port put under the skin on your chest.
Radiation (or radiotherapy) may be given prior to or after surgery and in combination with chemotherapy. High-energy waves are applied to the chest area to kill cancer cells. Other forms of radiation therapy include:
- Cyberknife radiosurgery, which enables your surgeon to perform computer-aided noninvasive radio surgery. The Cyberknife uses image-guided robotic technology to precisely focus high-dose radiation directly at the tumor.
- Seed implantation (also called brachytherapy), which is a form of internal radiation. Your oncologist implants small radioactive pellets, or "seeds," on the lung. The seeds emit radiation, which destroys cancer cells.
- External beam radiotherapy (EBRT) is performed on an outpatient basis. Guided by computer-generated 3-D images of the cancer, a linear accelerator administers beams of radiation that match the shape of the patient’s tumor.
Although the radiation is precisely targeted, it can damage normal tissue near cancerous cells. Your radiation oncologist reduces this risk by administering a series of small doses that allow nearby normal tissue time to heal during treatment. A typical course of external radiation therapy may schedule treatments five days a week over five to eight weeks.
In addition to procedures that treat cancer directly, BMC's thoracic surgeons perform procedures that can alleviate conditions or symptoms that arise in connection with lung cancer. These treatments include:
- Pleurodesis, which is used to alleviate the effects of pleural effusion. Pleural effusion is the abnormal accumulation of fluid in the pleural space, which is the area between the two layers of tissue that cover your lungs. The build-up of this fluid can constrict the lungs, limiting the amount of air that they take in. This can lead to shortness of breath, a fast heart rate (tachycardia), and difficulty breathing, especially when you are lying flat. The treatment options include chemical pleurodesis, in which your surgeon injects a chemical agent into the pleural space. The chemical irritates the two layers, which eliminates the space.
- PleurX Catheter, a thin, flexible tube that your surgeon will place in the pleural space to drain the fluid accumulation associated with pleural effusion. For this minimally invasive procedure, your surgeon will apply a local anesthetic to the area of the chest in which the catheter will be placed. Your surgeon will make a small incision in your chest and place the catheter. The catheter is then connected to a small bottle that uses gentle suction to drain the fluid.