Lung Cancer Treatments

Surgery for Lung Cancer

• Thoracotomy: Surgery to remove all or part of a lung might be performed by making an incision on one side of your chest (thorax) during a procedure called a thoracotomy. After the incision is made between the ribs, all or part of the lung is removed depending on the location, size, and type of lung cancer that is present.

Video-Assisted Thoracic (Vats) Surgery for Lung Cancer

Video-Assisted Thoracic Surgery (VATS) is performed using a small video camera attached to a thoracoscope, which is introduced into the patient’s chest through one of four small incisions. The video camera then transmits magnified images of the chest cavity onto strategically positioned monitors in the operating room—providing the surgeons with an unparalleled view inside the entire chest. The images are of the same quality as high definition television. Concurrently, the three remaining incisions serve as entry ports for the surgical instruments necessary to carry out the procedure.

CentraState thoracic surgeons Robert Caccavale, M.D. and Jean-Philippe Bocage, M.D. helped to pioneer this minimally invasive surgery and together they have successfully performed thousands of these procedures.

Benefits of VATS include:

• Just four one-inch incisions. A traditional thoracotomy requires an incision of 10-14 inches as well as unavoidable injury to one or more ribs and damage to muscles.
• A one- to two-day hospital stay. Patients of typical thoracotomy require stays of 7-10 days
• A marked reduction in recovery time as compared to the traditional thoracotomy
• A significantly reduced complication rate. Less than five percent of VATS patients experience post-surgical complications compared to 30 percent of thoracotomy patients.

Radiation Therapy for Lung Cancer

Radiation therapy is administered at CentraState’s Karen Olbis Radiation Oncology Center. Our Radiation Oncology Center has earned full accreditation by the American College of Radiology for expertise in Radiation Therapy. The center is fully equipped with state of the art equipment, plus highly trained and experienced physicians, physicists, dosimetrists, therapists and oncology certified nurses. Therapeutic radiation for lung cancer includes:

• External beam radiotherapy (EBR): Uses a machine called a linear accelerator to deliver high doses of radiation to the site while limiting exposure to healthy tissues and organs and minimizing side effects. This includes 3D conformal radiotherapy, Intensity-modulated radiation therapy (IMRT), Image-guided radiation therapy (IGRT), Stereotactic ablative radiation therapy (SART)

Interventional Oncology for Lung Cancer

Interventional oncology uses image-based techniques such as x-rays, CT scans, and MRIs to guide this minimally invasive procedure. These can include:

• Radiofrequency ablation, which uses a CT scan, ultrasound, or MRI to guide a needle-like probe into a tumor generating radiofrequency waves that create heat around an electrode at the tip of the needle, destroying the cancer cells.
• Cryoablation: Similar to radiofrequency ablation, cryoablation involves inserting a probe into a tumor using a CT scan, ultrasound, or MRI. Cancer cells are destroyed by freezing them with liquid nitrogen or argon gas.

Both of these techniques generally involve one appointment, and following the procedure, the dead cancer cells are slowly absorbed by the body.

CentraState is one of the few hospitals in the region to offer these interventional oncology techniques.

Chemotherapy for Lung Cancer

Chemotherapy is provided at CentraState’s Jean Mehr Infusion Therapy Center and administered by Magnet-designated nurses credentialed in chemotherapy and certified in cancer care. Depending on the stage of the lung cancer, chemotherapy may be used in different situations:

• Before surgery (sometimes along with radiation therapy) to shrink a tumor. This is known as neoadjuvant therapy.
• After surgery (sometimes along with radiation therapy) to kill any cancer cells that may have been left behind. This is known as adjuvant therapy.
• As the main treatment (sometimes along with radiation therapy) for more advanced cancers or for some people who aren’t healthy enough for surgery.

Targeted Therapies for Lung Cancer

Cancer care is evolving from standardized treatment regimens to more personalized, targeted therapies. These newer treatments take advantage of individual differences at the cellular level as well as the body’s natural ability to fight disease. For each patient, the challenge of targeted therapy is to find the underlying process that’s driving his or her cancer and find ways to stop it. Targeted treatments may be used alone or in combination with standard treatments such as chemotherapy, radiation, and surgery, and can include:

• Immunotherapy: Targeted immunotherapy helps eliminate cancer’s ability to hide from your immune system so your body can find cancer cells and destroy them.
• Genomic medicine: Many cancers are caused by mutations in our DNA, the building block chemicals in the body that instruct cells on how to work. In the case of cancer, a mutation causes cells to grow too quickly and harm nearby, healthy cells. By identifying these genetic mutations, researchers are developing new medications that effectively reverse the DNA instructions that cause cancer cells to grow.
• Checkpoint inhibitors: Checkpoint inhibitors are proteins that keep the immune system from attacking normal cells. Some cancers contain many of these proteins, offering cancer cells similar protection from the immune system. Checkpoint inhibitors stop these proteins from doing their job, allowing the immune system to eliminate cancer cells.

Clinical Trials for Lung Cancer

Some patients may be eligible to participate in clinical trials for lung cancer in which they receive an emerging lung cancer treatment before it becomes publicly available. Talk to your oncologist or surgeon to learn more. You may also want to speak with your cancer navigator.