Cancer Treatment
When lung cancer is diagnosed without screening, after symptoms develop, it is in an advanced stage in which treatment of chemotherapy, radiation therapy or combination chemotherapy and radiation therapy is given. Surgery is typically done in selected cases following chemotherapy and/or radiation therapy. Such surgery typically requires thoracotomy and in many cases surgical removal of an entire lung or revoval of ribs. Such surgery can result in death or major complications, pain and disability. Recurrence of cancer and death is very common despite these treatments.
Because most lung cancers found by CT screening are of small size and early stage, treatment is most often with surgical resection only, without the need to add radiation therapy or chemotherapy after surgery. In many circumstances, surgical resection of small, early-stage lung cancers can be performed without thoracotomy, using video-assisted (VATS) or robotic minimally invasive techniques that appear to have equivalent survival with smaller surgical incisions, and more rapid recovery. Removal of an entire lung is rarely necessary.
Research is ongoing to determine whether resection of smaller amounts of lung tissue (wedge resection or segmentectomy) will provide similar survival results.
In elderly patients or patients with major heart and lung disease that make surgery risky, cure can be attained without surgery using modern radiation therapy methods or local destruction of cancer with radiofrequency ablation or other physical methods. These methods have not yet been shown to produce cure rates from surgical resection.
Emerging data suggests that screen-detected lung cancer can be routinely managed with less invasive video-assisted surgery (VATS) which can reduce the side effects, length of hospital stay and cost, and also significantly reduce the risk of mortality from the surgery. Some studies indicate that VATS can reduce the risk of surgical mortality to 0.1%.
For more information on VATS surgery and additional information on treatment click here.
