Advances in surgery in patients with advanced lung cancer

Lung cancer is the growth of malignant tumor cells in the tracheobronchial tree or lung tissue. In the early stages it usually progresses without symptoms, although the earliest symptoms are usually cough and hemoptotic expectoration (streaks of blood in the sputum).

Repeated or torpid pneumonia requires bronchoscopy to rule out the existence of a tumor obstructing a bronchus. In more advanced stages, other symptoms may appear, such as chest pain when breathing or coughing, shortness of breath, aphonia or voice changes.

However, Dr. Romero Vielva emphasizes that all these symptoms are not specific, so they can appear in other lung diseases and not be associated with lung cancer.

Treatment, an option with guarantees?

Treatment options for lung cancer include surgery, radiation therapy and chemotherapy. Despite advances in medical and radiation oncology, surgery remains the gold standard treatment for lung cancer. Radiotherapy is a radiation treatment that destroys tumor cells and is also considered a radical treatment applicable in cases where surgery is excluded for some reason.

Chemotherapy is a treatment with cytotoxic drugs that prevent tumor cells from dividing and growing. It can be used in combination with surgery and radiotherapy. In patients with advanced stages, chemotherapy is usually the only treatment. When deciding which treatment is most appropriate for the patient, it is important to differentiate between the two types of lung cancer. One is “small cell lung cancer” which has no indication for surgical treatment and is treated with chemotherapy and radiotherapy.

The other type is “non-small cell lung cancer” and in this type the treatment depends on the stage at which the diagnosis is made. In early stages the treatment of choice is surgery, while in patients with advanced stages the treatment will be combined with chemotherapy, radiotherapy and surgery if possible.

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When surgery is the only option

Surgery in advanced lung cancer consists of resection of the tumor and the adjacent structures affected by it. These structures may be the chest wall, mediastinal nodes, great vessels, diaphragm, pericardium or carina. Surgery should be performed after induction treatment with chemotherapy and/or radiotherapy and is assessed according to the extent of each case, the patient’s characteristics and provided that it can guarantee a complete resection of the entire tumor. This decision must always be made by a multidisciplinary committee made up of medical oncologists, radiation oncologists and thoracic surgeons.

The truth is that all studies have shown that the patients with the best survival at any stage are those in whom radical surgery can be performed, which also includes advanced stages.

As for the recovery process, in most cases it is a procedure similar to that of any other open lung resection. The recovery will depend on the patient’s previous condition and whether post-surgical complications occur. Good analgesia, physiotherapy and early mobilization are fundamental to help in the recovery process.

All studies show that the patients with the best survival at any stage are those in whom radical surgery can be performed. This also includes advanced stages.