Lung Cancer

Treatment

A team of medical professionals from various specialties provides innovative treatment strategies and supportive care for Mayo patients. This multidisciplinary approach combines the knowledge and wisdom of many experienced specialists to treat the patient.

Treatment for lung cancer is based on the type and stage of tumor and the patient's general medical condition. Options include surgery, radiation, chemotherapy, or a combination of these treatments. For some people, participation in a clinical trial is another option.

Surgery

Chest surgeons — also called thoracic surgeons — perform lung cancer surgery, along with a specialized, skilled surgical team. Non-small cell lung cancer, when it has not spread outside the chest, can usually be treated successfully by surgery.

Surgery for non-small cell lung cancer can take several forms:

• Mediastinoscopy — a minimally invasive way of sampling the lymph nodes along the main airway in order to assess for spread of the main tumor.
• Thoracoscopy — a minimally invasive way of accessing the chest through small incision(s) to diagnose and treat lung cancer. It is also called video-assisted thoracic surgery (VATS).
• Wedge resection — removing a small section of one lung.
• Segmentectomy — removing a segment (part of a lobe) of one lung.
• Lobectomy — removing an entire lobe of one lung. The right lung has three lobes, and the left lung has two. Lobectomy is the most common type of lung cancer surgery.
• Sleeve resection — removing a part of the airway with or without adjoining lung and reattaching the remaining ends to preserve lung tissue and avoid a larger resection such as a pneumonectomy.
• Pneumonectomy — removing a lung.

Surgeons also sample lymph nodes from the center of the chest (mediastinum). This is done even if an earlier biopsy of the lymph nodes was negative for cancer in the lymph nodes.

After surgery, it's common for patients to stay in the hospital for a week and avoid strenuous activity for a month or more. If the patient has other chronic lung conditions, such as emphysema or bronchitis, the hospital stay might be longer. Because surgeons must cut between the ribs to access the lungs, patients may experience rib pain until they fully heal. Occasionally, part of a rib is removed during surgery, and a rib fracture is not uncommon.

Radiation Therapy

Radiation treatments for lung cancer are primarily given with external beam radiation. Patients who receive this type of radiation are not radioactive. Radiation therapy is prescribed by a radiation oncologist — a doctor who specializes in giving radiation for cancer. These doctors work with patients to design a radiation plan based on their stage of cancer and general medical condition.

Other things to keep in mind about radiation therapy:

• Radiation can destroy cancer cells without surgery.
• Radiation is sometimes given before or after surgery.
• Radiation treatments may be done before, during, or after chemotherapy.
• Advances in computed tomography (CT) imaging techniques give radiation oncologists a more precise way to locate tumors. This helps them to administer a maximum dose of radiation to the tumor(s) from several angles with less damage to surrounding tissues.

An innovative form of radiation therapy called radiofrequency ablation uses electrical energy delivered through a needle to destroy tumor cells by heat. This treatment is available at Mayo Clinic in Florida and Minnesota for patients with certain cases of lung cancer.

Chemotherapy

Chemotherapy can include a variety of drugs. How these medications are given (e.g., by mouth, by intravenous solution) and where they are given vary, depending on which drugs are given. Chemotherapy is prescribed by a medical oncologist — a doctor who specializes in treating cancer with medication. Chemotherapy may help radiation to be more effective. The doctor will work with patients to decide the best approach. An experimental drug given in a clinical trial may also be an option.

Photodynamic Therapy

Photodynamic therapy is effective in treating lung cancer that involves the bronchial tubes. In cases of very early cancers, the treatment can eliminate the cancer. In more advanced cases, photodynamic therapy is used to palliate symptoms that result from blockage of the bronchial tubes. This therapy is available at Mayo Clinic in Minnesota. See more on photodynamic therapy.