Your team of specialists in medical oncology, thoracic surgery, radiation oncology, radiology and pathology will work together to assess your best course of lung cancer treatment. That will involve the creation of a coordinated plan, staging the disease and designing a personalized treatment plan consistent with the highest standards of care. Your treatment will be tailored to your specific type of lung cancer, and it may involve a combination of surgery, radiation and chemotherapy.
As part of this commitment to care, WellStar offers the STAT Thoracic Consultation Center - Atlanta’s only true multidisciplinary clinic. Patients with chest or lung cancer are seen in one afternoon by four specialists - pulmonary, thoracic surgery, medical oncology and radiation oncology. Prior to STAT, the time spent from an abnormal finding to treatment was about two months. Now, it’s 13 days. The STAT Thoracic Consultation Center is available at WellStar Kennestone Hospital.
It might also involve some of WellStar’s cutting edge technologies such as the CyberKnife or Intensity Modulated Radiation Therapy (IMRT), both offered as radiation treatments for lung cancer.
In addition, WellStar physicians hold weekly lung tumor conferences, designed to discuss difficult cases and new technologies for lung cancer patients.
Lung Cancer Surgery
Surgery is the most effective treatment for the early stages of lung cancer, and can be useful in the later stages in terms of diagnosis or relieving pain.
At WellStar, operations for lung cancer are almost exclusively performed with a minimally invasive technique known as VATS (video assisted thoracic surgery.)
VATS surgery uses a small camera to see inside the chest, while the surgery is done inside the chest through two small “band-aid” incisions. Advantages of this minimally invasive technique include:
- Less pain
- Shorter hospital stay
- Faster recovery and return to normal function
- Lower infection rate
- Lower complication rate including irregular heartbeats and pneumonia
The types of VATS lung resections:
- Wedge resection: The surgeon removes a small wedge-shaped piece of lung that contains the lung cancer and a margin of healthy tissue around the cancer. This is likely to be done when your lung function would be decreased too much by removing a lobe of lung (lobectomy).
- Lobectomy: The right lung has three lobes and the left lung has two lobes. A lobectomy removes the entire lobe of your lung that contains the cancer. Your lungs can function with the lobes that remain.
- Pneumonectomy: A pneumonectomy removes your entire lung that contains the lung cancer. A pneumonectomy is done only when necessary because it will greatly reduce your overall lung function.
Thoracic surgeons at WellStar also work closely with its pulmonologists, medical oncologists, and radiation oncologists to determine the type and stage of lung cancer. If surgery is indicated, then specific tests are done to determine the patient’s lung function. The combination of the cancer’s stage and these tests will be used to make decisions regarding the extent of surgery to be done.
Other operations can be done for diagnosis, including:
- Mediastinoscopy, which can indicate whether the cancer has spread to the lymph nodes in the chest. During a mediastinoscopy, a surgeon inserts a mediastinoscope (lighted tube) through a small incision in the neck while a patient is under general anesthesia. This mediastinoscope allows the surgeon to examine the center of the chest and nearby lymph nodes, as well as remove a tissue sample.
- Bronchoscopy which is used to look inside the lungs' airways, called the bronchi and bronchioles. The airways carry air from the trachea, or windpipe, to the lungs. In this procedure, your doctor passes a thin, flexible tube called a bronchoscope through your nose (or sometimes your mouth), down your throat, and into your airways. The bronchoscope has a light and small camera that allows your doctor to see your windpipe and airways and take pictures. You’ll be given medicine to make you relaxed and sleepy during the procedure.
Other operations are done for pain relief of advanced lung cancer:
- VATS pleural biopsy: A surgery to remove a sample of the tissue lining the lungs.
- VATS pleurodesis: A procedure that causes the membranes around the lung to stick together and prevents the buildup of fluid in the space between the membranes.
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Adjuvant chemotherapy is administered after surgery in certain circumstances when the patient is at high risk for recurrence. Chemotherapy can also be utilized concurrently with radiation for a cure in Stage 3 lung cancer patients. Stage 4 patients are often treated with chemotherapy or targeted therapies to prolong survival and control symptoms.
Medical oncologists at WellStar believe in a personalized approach to lung cancer therapy - often guided by the genetics of the cancer and the condition of the patient.
Radiation or more commonly, CyberKnife, can be used to cure some early stage patients who are not candidates for surgery. It is also used in both small cell and non-small cell concurrently with chemotherapy, and can be effective for controlling symptoms when the cancer has spread to the brain or to bones.
At WellStar, radiation administered by radiation oncologists in consultation with medical oncologists and surgeons. And several innovative radiation therapies are offered, including two found to be extremely effective against difficult cases of lung cancer:
- Intensity Modulated Radiation Therapy (IMRT) - allows modulation of radiation across the tumor, while sparing healthy surrounding tissue.
- The CyberKnife - a highly-advanced form of non-invasive radiation therapy that allows treatment of cancer that previously was inoperable or complex. WellStar is the first health system in Georgia to offer the CyberKnife.
- Brachytherapy - where radiation is delivered directly to the tumor, minimizing damage to healthy cells. Radioactive material is implanted directly into (or next to) the tumor. The implants emit radiation for up to a year, exposing the cancer cells to higher levels of radiation than would be possible using traditional external beam techniques.