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Bronchoscopy: A procedure using a thin, flexible tube with a light on the end to examine the inside of the lungs and/or take a sample of fluid or tissue. Chemotherapy: The use of drugs to destroy cancer cells. Immunotherapy: A type of cancer treatment designed to boost the body’s natural defenses to fight cancer. Malignant: A tumor that is cancerous. Metastasis: The spread of cancer from where it began to another part of the body. Oncologist: A doctor who specializes in treating cancer. Prognosis: Chance of recovery. Radiation therapy: The use of high-energy x-rays to destroy cancer cells. Targeted therapy: Treatment that targets specific genes or proteins that contribute to cancer growth and survival. Thoracotomy: Removal of a lung tumor through a cut in the chest. This fact sheet was developed by and is © 2019 American Society of Clinical Oncology, Inc. (ASCO). All rights reserved worldwide. No sponsor was involved. Lung Cancer Treatment Lung cancer overview More than one in four of all diagnosed cancers involve the lung, and lung cancer remains the most common cancer-related cause of death among American men and women. At the same time, it may well be that a great many lung cancers are preventable. Inhaling cancer-causing substances such as tobacco smoke may lead to changes in the lung tissue shortly after exposure — so-called precancerous changes. Nevertheless, cancer itself typically develops over a period of many years, and if detected at an early enough stage can often be treated successfully using a variety of treatments. What are my treatment options? Pre-treatment evaluation Before treatment, a biopsy is usually performed to determine whether a patient has cancer, and if so, what type. Tests are recommended to determine the stage of the tumor. These tests usually include blood tests and imaging. The imaging usually includes computed tomography (CT) scanning of the chest, and may include a PET/CT scan and MRI of the brain. The treatment options and expected results of treatment depend on the stage of the tumor. Treatment options overview About one-third of lung cancer patients are diagnosed with localized disease that may be treated by either surgical resection or, if the patient is not a candidate for full surgical resection, with definitive radiotherapy. Another third of patients have disease that has already spread to the lymph Lung Cancer Treatment Page 1 of 8 Copyright© 2019, RadiologyInfo.org Reviewed: Jul-17-2019 nodes. In these cases, radiation therapy along with chemotherapy and occasionally surgery is used. The last third of patients may have tumors that have already spread to other parts of the body via the blood stream and are typically treated with chemotherapy and sometimes with radiation therapy for the relief of symptoms. Surgery with removal of the entire lobe in which the tumor is located, is the primary treatment for patients with early-stage cancer who are in good general health. The goal of surgery is to totally remove all the tumor cells and thereby provide a cure. Unfortunately, lung cancers tend to develop in smokers more than 50 years of age, who very often have other lung disease or serious medical conditions that magnify the risk of surgery. The location and size of a lung tumor dictate how extensive the operation must be. Open thoracotomy or less invasive video-assisted thoracic surgery, or robotic assisted thoracic surgery using smaller incisions, may be recommended for appropriately selected patients. Lobectomy, the removal of an entire lobe of the lung, is an accepted procedure for removing lung cancer when the lungs are functioning well. The mortality risk is less than three percent to four percent and tends to be highest in older patients. There are three lobes on the right (upper, middle and lower) and two on the left (upper and lower). Sublobar resection may be referred to as either a "wedge resection" or a "segmentectomy." If lung function prohibits lobectomy, or a tumor is very small, sublobar resection may be performed in which a small cancer confined to a limited area may be removed with a small portion of surrounding lung tissue. Sublobar resection may carry a higher risk for recurrence than lobectomy. Sublobar
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