Early stage lung cancer (Stage I & II) is usually treated by surgical intervention and a combination of chemotherapy and radiation treatment. Stage II cancer may treated by surgery in certain instances, though generally later stage cancer is treated by chemotherapy alone or by combination of chemotherapy and radiation treatment – it is possible for tumors to be shrunk in size so a re-staging of the patient is warranted and surgery becomes a viable option.
The process of removing the cancer tumor is known as “resection”, or the cutting away of the cancer mass and suspected diseased tissue. There are a variety of surgical options available but the standard techniques are:
Thoracotomy – an incision is made through the chest wall; and
Median Sternotomy -where the surgeon cuts through the breastbone to access the chest cavity and the lungs.
As both of these techniques involve considerable recovery periods and pain for the patient, alternatives have been devised to provide access to lung cancer tumors and allow for less discomfort for the patient;
Anterior Limited Thoracotomy – known as “ALT” is performed on the front of the chest and involves a much smaller incision than thoracotomy or median sternotomy;
Anterioraxilary Thoracotomy – known as “AAT” involves an incision on the front of the chest close to the underarm; and
Posterolateral Thoracotomy – known as”PLT” involves an incision through the back or side of the chest area of the patient.
ALT in particular provides a less invasive option than a standard thoracotomy, and certainly results in reduced blood loss for the patient with a much reduced recuperation period and pain.
Video-Assisted Thoracoscopy or Video-Assisted Thoracic Surgery (VATS)
VATS is a state-of-the-art surgical technique which allows for resection of tumors without the need for invasive, full-surgery. A video camera allows the surgeon to see the interior of the patient’s chest and the location of cancer tumors using a high-powered television screen. This provides a skilled surgeon with the ability to operate without actually opening up the patient and involves a much smaller set of incisions.
As the incisions and surgical-invasion is significantly reduced, the patient experiences far less pain and enjoys a much reduced recuperation period post-operation. The technique is not universally employed for two main reasons – firstly, the level of surgical skill required is very high and only highly skilled surgeons can utilize the technique successfully. In addition, as the surgeon is not provided with a full view of the area where the diseased tissue is located, it is possible to miss other cancer tumors or evidence of diseased tissue which a standard operation may uncover.
VATS is usually most appropriate for early stage lung cancer where there is no evidence that the disease has metastasized to other parts of the body or lungs themselves.
The Use of Other Therapies
Depending on the nature of the disease and the overall health of the patient, it is common for patients to undergo treatment pre and post-operation with chemotherapy and radiation treatment. In certain instances, where surgery is not advisable, a patient may undergo such alternative therapies in combination or as stand-alone treatments, but the exact treatment regime which is advised for a patient depends on individual circumstances and the findings of the oncology team providing treatment.