What is the classical surgical approach to treating lung cancer?

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jkirkwoo's profile pic

jkirkwoo | (Level 1) Adjunct Educator

Posted on

It can depend on the type of lung cancer.  Small cell lung cancer is often not treated with surgery due to the fact that most times when it is first diagnosed it has already spread beyond the lung and therefore surgery would normally not be beneficial and the other modalities of radiation and chemotherapy would be used.

Non small cell lung cancer is the one most often treated with surgery although it is also treated with other modalities as well.  It is a decision made between you and your Doctor.  There are three common ways to utilize surgery for lung cancer and these are removing a section of the lung, a lobe of the lung or removing a whole lung.

Removing a section of the lung is called either a wedge resection or a segmentectomy.  A wedge resection is the removal of part of one or more lobes.  A segmentectomy is the removal of part of the lung along with the veins, arteries, and airways of that part.

Removing a lobe of the lung is called a lobectomy.  This is the most common type of surgery on the lung.  Removing two lobes is called a Bilobectomy.

Removing a whole lung is called a Pneumonectomy.

This should not be taken as medical or surgical advice and is a decision made with your own physician or cancer specialist.

ophelious's profile pic

ophelious | High School Teacher | (Level 1) Educator

Posted on

Okay...first I need to begin with my classic disclaimer: I am not a medical professional so please do not construe anything I say as medical advice.  For a more detailed answer that takes into account individual circumstances one must see a doctor.  In light of this, I will do my best to answer you question : )

I am not exactly sure what you mean by the "classical" surgical approach, so I will describe the three most common.

  1. Wedge Resection: This is where the cancerous tissue is removed, along with a bit of healthy lung tissue (for good measure.)  Though the risk of the cancer returning is higher for this method, it is also the one that has the lowest impact on your overall breathing capacity.
  2. Lobectomy: The right lung consists of three "lobes" and the left two (or maybe it's the other way around...i don't recall); a lobectomy consists of removing the entire lobe.  This reduces your breathing capacity but is more likely to "get" the cancer.
  3. Pneumonectomy: This involves removing the entire left or right lung.

HERE is an picture that will give you an idea of the above terms.  In surgery the cuts are made almost on you side...this way the doctor avoids going through the chest and getting near the heart.

giorgiana1976's profile pic

giorgiana1976 | College Teacher | (Level 3) Valedictorian

Posted on

Decision of lung tumor resection is not based solely on pathologoanatomic type of cancer or its degree of expansion, but also the overall health of the patient. Lung cancer is a neoplasia that occurs on land predisposing more than 80 - 90% of patients who have such a cancer are older smokers. Smokers' body is already suffering, and many have other chronic health problems: circulatory disorders, cardiovascular disease, obstructive pulmonary disease (pulmonary obstructive), which are conditions that influence greatly the risk of anesthesia in each patient and significantly reduce the chances of success of surgery.

It should be noted that if in the past, the cancer spread to lymph nodes located between the two lungs, was thought to be surpassed, in terms of surgery, some experts now consider it operable, resection being followed by chemotherapy treatment to strengthen the results obtained by surgery. Sometimes it can be can add short course of radiotherapy to improve even more the overall health and to extend patient survival. But the adjuvant therapies depend on cancer individual patient specifics, but also the personal experience of the doctor who treats the patient.

When possible, it is recommended that therapeutic option chosen to be the surgery. Resection remains the main option in cancer therapy of stage I and II than in the case of non-microcellular carcinoma, so in patients who have no signs and suggestive symptoms  of mediastinal invasion or invasion of neighboring organs. The role of surgery in stage III remains quite controversial, and patients in stage IV are almost never candidates for such a therapy.

Classic surgical approach consists in removing lobe where the tumor is found, this procedure keeping the functionality of the remaining lung. If the tumor is  hilarious located , surgical procedure may be extended, with a greater risk to the patient. Resection of a segment of lung is an option in patients with reduced pulmonary reserve. Studies which have set out to demonstrate the superiority of one procedure have concluded that the survival rate is similar for both.

A therapeutic procedure,minimally invasive, is video assisted Thorax-scopy, it can be used both for therapeutic purposes, and in curative intent. Its associated morbidity is low and the period of hospitalization of patient and discomfort associated are also lower.  Such a procedure is preferred in elderly patients.

Treatment involves surgical removal of the tumor  itself ,also a part of the surrounding parenchyma, to reach the healthy tissue (this resection must take into account the oncological safety margin), and regional lymph node stations. After surgery, the patient will be kept under medical supervision and will receive specific treatment against pain.

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