At MD Anderson, some of the nation’s top lung specialists focus their extraordinary expertise on you. We customize your treatment to deliver the most advanced, effective and least invasive treatments available for lung cancer. And because your peace of mind is important to us, we specialize in techniques and therapies than can help preserve lung function and quality of life
We’re constantly researching safer and more effective treatments for lung cancer with fewer side effects. We are proud to be one of the few cancer centers in the nation to house a prestigious federally funded lung cancer SPORE (Specialized Program of Research Excellence) program. This leads to a large number of active clinical trials at MD Anderson and ensures that our patients have access to some of the most cutting-edge therapy anywhere in the world.
If you are diagnosed with lung cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the stage and type of lung cancer; other lung problems, such as emphysema or chronic bronchitis; other prior or current medical conditions; and possible side effects of treatment.
Your treatment for lung cancer will be customized to your particular needs. It may include one or more of the following therapies to treat the cancer and help relieve symptoms.
Lung Cancer Surgery
Statistically speaking, the more experienced the surgeon, the better the outcomes for lung cancer patients. MD Anderson’s Thoracic Center is home to many of the field’s most highly trained, experienced and respected thoracic surgeons. They operate only on cancers involving the chest and use the most advanced surgical techniques to treat a wide variety of lung cancers, including highly complex cases.
All patients with lung cancer who undergo surgery at the Thoracic Center enroll in a program of enhanced recovery, which aims to minimize pain, surgical stress and downtime. This leads to faster recovery, fewer side effects and better quality of life following surgery.
The most common types of surgery for lung cancer, in order of the amount of lung tissue removed, are:
- Wedge resection: Removal of the tumor and a pie- or wedge-shaped piece of the lung around the tumor. This procedure is typically used to perform a biopsy of a lung nodule.
- Segmentectomy or segmental resection: Removal of a segment, or part, of the lobe where the cancer is located. Both the segmentectomy and wedge resection are typically performed on patients who have limited lung capacity and can’t tolerate the removal of a larger section of the lung. They are also a good option for patients with small early-stage tumors generally measuring less than two centimeters. Both preserve lung capacity and the patient’s quality of life.
- Lobectomy: Removal of the lung lobe where the cancer is located. This is considered the “standard of care” for most lung cancer patients who undergo surgery.
- Sleeve lobectomy: A more complex form of lobectomy that is typically used for centrally located tumors. Though not always possible, sleeve lobectomies are preferable to pneumonectomy (complete removal of the lung) in order to preserve more functioning lung tissue.
- Pneumonectomy: Removal of the entire lung. This surgery is occasionally required due to the location of the tumor. In people with lungs that are otherwise healthy and function normally, pneumonectomy is well tolerated.
During most of these procedures, the surgeon will also remove lymph nodes from the chest. Since cancer often spreads through these nodes, doctors will examine them under a microscope to find out if the lung cancer has moved outside the lungs. This will help doctors decide if you need further treatment after surgery, such as chemotherapy, radiation therapy or targeted therapy. Treatment following surgery is called adjuvant therapy.
Occasionally, patients may receive chemotherapy or radiation before surgery in order to shrink the tumor. This is called neoadjuvant therapy.
For some lung cancer surgeries, there are different ways to perform the same procedure. Your surgeon will work with you to choose the best option. These methods include:
- Open surgery: The traditional surgical method. Surgeons perform the procedure through a four- to eight-inch incision between the ribs.
- Minimally invasive surgery: These procedures require several smaller incisions, typically between ¼ and ½ inch, and usually have a shorter recovery time and less pain for the patient. There are two primary methods of minimally invasive surgery for lung cancer patients.
- Video-assisted thoracic surgery (VATS) or thoracoscopy: This technique uses a small camera and instruments that are inserted into the chest allowing the surgeon to perform the surgery through small incisions. It is typically performed on patients with small, early stage lung cancers.
- Robotic-assisted Surgery: This newer method of minimally invasive surgery uses robotic arms remotely controlled by the surgeon. Better images of the surgical site and greater instrument dexterity allow the surgeon to perform more complex surgery than is possible with VATS.
Lung Cancer Radiation Therapy
At most hospitals, radiation oncologists are expected to treat several different types of cancer. MD Anderson’s Thoracic Center has radiation oncologists dedicated exclusively to caring for patients with lung cancer. This gives them incredibly deep experience in designing treatment plans.
Working with these radiation oncologists is a team of radiation therapy specialists, including dosimetrists and medical physicists, that helps MD Anderson deliver the maximum amount of radiation with the least damage to healthy cells. The radiation therapy treatments used for lung cancer patients include:
- 3D-conformal radiation therapy: Several radiation beams are given in the exact shape of the tumor. This is primarily used as a palliative treatment and not to cure the disease.
- Brachytherapy: Tiny radioactive seeds are placed in the body close to the tumor. Brachytherapy is primarily used to treat metastatic growths in the airway. Since most of these growths can be treated with external beam radiation, brachytherapy is rarely used on lung cancer patients.
- Intensity-modulate radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor. This type of radiation is commonly used to treat cancers that have invaded nearby lymph nodes.
- Volumetric-modulate Arc therapy (VMAT): A type of IMRT, in VMAT therapy, the part of the machine that shoots out the beam of radiation rotates around the patient in an arc. This can irradiate the tumor more precisely and shorten procedure times.
- Stereotactic body radiation therapy (SBRT): High doses of radiation delivered with several beams at various intensities and angles to precisely target the tumor. Learn more about SBRT.
All radiation therapies are used with all lung cancer subtypes. MD Anderson’s lung radiation oncology team develops models for several different treatment types and determines which is best for each patient. Read more about radiation therapy.
Lung cancer proton therapy
A type of radiation therapy, proton therapy delivers a high dose of radiation directly to the tumor, sparing nearby healthy tissue and organs. MD Anderson operates one of the world’s largest and most advanced proton therapy centers. Read more about proton therapy.
Systemic Therapy for Lung Cancer
There have been significant advances in the treatment of lung cancer through the last decades. The medical oncologists at MD Anderson’s Thoracic Center are world renowned in the care of lung cancer patients and have participated in the clinical trials that have led to the development of important new treatments, including targeted and immune therapies.
Targeted therapy for lung cancer
Cancer cells use specific molecules (often in the form of proteins) to survive, multiply and spread. Targeted therapies stop or slow the growth of cancer by interfering with, or targeting, these molecules. Currently there are targeted therapies for many subtypes of adenocarcinoma. Read more about targeted therapies.
Immunotherapy for lung cancer
Immunotherapies recruit the body’s own immune system in the fight against cancer. The current standard of care for non-small cell lung cancer includes the use of checkpoint inhibitor immunotherapies, which take the natural “brakes” off the immune system, allowing it to attack cancer cells. This treatment can lead to durable responses and has revolutionized care for lung cancer patients. Read more about immunotherapy.
Chemotherapy for lung cancer
Chemotherapy uses drugs to directly kill cancer cells by stopping their growth. This form of treatment is commonly combined with immunotherapy. In combination, both drugs become more effective. Learn more about chemotherapy.
Angiogenesis is the process of creating new blood vessels. Some cancerous tumors are very efficient at creating new blood vessels, which increases blood supply to the tumor and allows it to grow rapidly.
Researchers developed drugs called angiogenesis inhibitors, or anti-angiogenic therapy, to disrupt the growth process. These drugs search out and bind themselves to VEGF molecules, which prohibits them from activating receptors on endothelial cells inside blood vessels. Other angiogenesis inhibitor drugs work on a different part of the process, by stopping VEGF receptors from sending signals to blood vessel cells.
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