When Chemotherapy Is Necessary As An Adjunct To Lung Cancer Surgery

When a patient suffers from lung cancer (LC), diagnosing and treating the disease as soon as possible improves the prognosis. As long as the tumor remains localized, a surgeon can remove the affected tissue. Once the tumor metastasizes, however, surgery alone is no longer sufficient. Other forms of treatment – usually as an adjunct method to surgery – are necessary.

For most patients in whom lung cancer has reached an advanced stage, chemotherapy is recommended. This treatment strategy uses medications that are designed to kill cancerous cells that have spread into other areas of the body. It is a systemic approach. In this article, we’ll begin by briefly describing the types of surgery that are done to remove localized tumors. Then, we’ll clarify the reasons the disease may be inoperable, and explain how chemotherapy poses a solution.

Types Of Lung Cancer Surgery

If the tumor is contained within a small portion of the lung, a surgeon can perform a wedge resection. During this procedure, the diseased tissue, along with a ring of surrounding healthy tissue, is cut away and removed. Because the likelihood of the cancer returning is higher than with a lobectomy, the latter option is often recommended.

The left lung is comprised of two lobes while the right lung has three. During a lobectomy, your doctor will remove an entire lobe from the affected lung. If the tumor is located within two adjacent lobes, both are removed with a procedure known as a bilobectomy.

If the cancer has spread throughout the entire lung, and a lobectomy or bilobectomy are insufficient for removing the diseased tissue, a pneumonectomy can be performed. This is a procedure during which the entire organ is removed.

Each of the surgeries described above can be performed with minimally invasive techniques. That said, most hospitals and surgical centers continue to use thoracotomy to perform pneumonectomies.

Reasons Lung Cancer May Be Inoperable

The term “inoperable” is often misunderstood by patients. Many mistakenly believe it means the lung cancer cannot be cured. In reality, when LC is considered inoperable, it merely means that surgery is not the most appropriate treatment method. This may be due to many factors.

For example, small cell lung cancer is often diagnosed after the disease has already metastasized. Hence, surgery as the primary treatment path is ineffective. With non-small cell lung cancer, the disease becomes inoperable once it reaches stages 3B or 4. At that point, it has spread outside the lung. Another reason involves the location of the tumor. If it is located near the heart, many surgeons will be reluctant to proceed.

If the illness is deemed inoperable, alternative forms of treatment can be administered. As already noted, one of them is chemotherapy.

The Role Of Chemotherapy

The chemicals used during chemotherapy seek out and kill cancerous cells. Unfortunately, many healthy cells are also affected, which is the reason patients experience side effects. Because each drug focuses on cells that are active within a specific stage, multiple drugs are often administered simultaneously. This helps ensure the broadest possible coverage.

Chemotherapy may be given for a number of reasons, including the spread of cancerous cells beyond the lungs. This is often done in addition to a lobectomy or pneumonectomy. In many cases, chemotherapy can also be administered to shrink a tumor. Doing so can potentially turn a case of LC that was previously considered “inoperable” into one in which surgery offers a viable cure.

The downside to this form of treatment are the side effects. There are various medications that can be used (e.g. carboplatin, gemcitabine, vincristine, etc.) and each may cause a different set of symptoms. You might experience hair loss, nausea, digestive problems, fatigue, or a loss of appetite. However, given that chemotherapy can help cure lung cancer, these side effects represent an acceptable tradeoff for most patients.

Your physician can recommend an appropriate treatment plan based on the staging of the disease, location of the tumor, and your overall health. Even if a lung cancer is considered inoperable, it can still be cured.

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