Lung Cancer Surgery: An Important Treatment Option

 

Lung Cancer Surgery:

Lung cancer is one of the most commonly diagnosed cancers around the world. It is estimated that over 230,000 new cases of lung cancer are diagnosed each year in the United States alone. While lung cancer survival rates remain low compared to other cancers, surgery offers one of the best chances for cure, especially if the cancer is caught in its early stages. This article explores the different types of lung cancer surgeries that may be recommended based on the stage and location of the cancer.

Types of Lung Cancer Surgery

There are a few main types of lung cancer surgery that surgeons may recommend based on how far the cancer has spread in the lungs and surrounding areas.

Wedge resection: For small, localized tumors near the edge of the lung, surgeons may remove a wedge or section of the lung around the tumor. This surgery aims to remove the cancer with some healthy tissue surrounding it while sparing as much normal lung tissue as possible.

Lobectomy: For larger tumors within one of the five lobes of the lungs, a lobectomy involves removing the entire lobe of the lung. This is one of the most common lung cancer surgeries and aims to fully remove any cancer cells within that section of the lung.

Pneumonectomy: In cases where the tumor involves an entire lung or is too large to be removed by lobectomy, surgeons may perform a pneumonectomy. This complex surgery removes the entire lung. It is challenging to recover from but offers the best chance of cure if the entire lung needs to be removed.

Sleeve Resection: For select centrally located tumors near major airways, surgeons may perform a sleeve resection where they remove the cancer with some surrounding lung and healthy tissue while reconstructing and rejoining the airways. This aims to remove the cancer while preserving as much lung function as possible.

Lung Cancer Surgery Preparation and Risks

Prior to lung cancer surgery, patients will undergo thorough medical testing and screening to determine if they are healthy enough for the operation. Tests like CAT scans, PET scans, biopsy, cardiac testing and pulmonary function tests help evaluate the extent of cancer and lung/heart function.

Those with medical risks from issues like smoking-related lung disease, heart disease or other illnesses may not be candidates for potentially high-risk lung surgery. Risks of lung cancer surgery include bleeding, infection, collapsed lungs and heart issues. Risk also increases with procedures removing larger portions of lung tissue since less lung remains after surgery. However, with experienced surgeons at high volume cancer centers, risks can be well managed.

Outcomes of Lung Cancer Surgery

When performed by expert thoracic surgeons, lung cancer surgery offers the possibility of a cure if the cancer is caught early before it has spread beyond the lungs. Studies have shown:

- Stage 1 Non-Small Cell Lung Cancer: Surgery alone can achieve 5-year survival rates of 70-90% depending on tumor size and lymph node involvement.

- Stage 2 Non-Small Cell Lung Cancer: Surgery plus adjuvant chemotherapy or radiation can achieve 5-year survival rates of 50-70%.

- Locally Advanced Stage 3a Non-Small Cell Lung Cancer: Surgery plus neoadjuvant or adjuvant chemotherapy and radiation offers 5-year survival rates of 30-50% depending on lymph node spread.

Even for more advanced Stage 3b cancers in select patients, aggressive multimodality treatment including surgery can still provide some long-term survivors. Outcomes are best if lung cancer is detected early through screening at specialized cancer centers.

Recovery from Lung Cancer Surgery

Recovery from lung surgery depends on the procedure type but typically requires a hospital stay of 3-7 days. Patients are monitored closely for bleeding or other complications before being discharged home.

The first 6 weeks focus on rest, wound healing and gradually increasing activity levels as approved by doctors. Pulmonary rehabilitation including breathing exercises helps regain/improve lung function after less tissue remains. Over several months, most patients report getting back to normal daily routines within limitations. But full recovery from lobectomies or more complex procedures takes 6-12 months in many cases. Long-term yearly follow-up CT scans also monitor for cancer recurrence.

In summary, lung cancer surgery offers the best hope for cure when the cancer is localized to the lungs. Care at high volume centers by experienced thoracic surgeons leads to improved outcomes. While recovery requires time, research shows that early-stage lung cancer survivors who undergo complete tumor resection by surgery have length and quality of life comparable to individuals without cancer. Lung cancer screening also aims to diagnose more cancers surgically in early stages that are potentially curable. Overall, lung surgery should be considered as a key treatment option for local or regional lung cancers where it can provide the most chance for long-term survival.

 

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