Lung Cancer Surgery

Lung cancer has now become the number one killer of all cancers. This applies to not only the United States but also is applicable worldwide. In the year 2008, more than 215,000 people will develop lung cancer in this country, with greater than 161,800 persons expected to die from this disease. Smoking is the most common preventable risk factor, including cigarettes, pipe and cigar smoking. Other risk factors include alcohol use, physical inactivity, air pollution and occupational exposure. Recently, certain genetic markers have been found which increase the lung cancer risk by 70 to 80 percent in patients with these markers.

There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC comprises about 75 to 85 percent of all lung cancers and is treated with surgical resection if patients can tolerate lung resection and the cancer appears to be completely resectable (Stage I and II). Some selected stage II and III patients may have both surgical resection along with chemotherapy and/or radiation therapy. Patients with nonoperable or metastatic disease may be offered palliative chemotherapy or radiation therapy. SCLC comprises 20 to 25 percent of lung cancers and is usually treated with chemotherapy and chest radiation therapy with about half of the patients surviving 18 to 24 months.

Most lung cancers do not cause symptoms until they have reached an advanced stage. The most common symptoms are bloody sputum, pneumonia which does not improve with antibiotics, or pain which is usually due to the cancer spreading beyond the lung to distant areas (bone or brain most commonly) or growing into nearby structures. Most early lung cancers are found incidentally on x-rays or other studies done to evaluate other problems. This is usually prior to patients having any symptoms.

Due to the general lack of symptoms with early lung cancers, most are discovered in an advanced stage. Overall, the five-year survival rate for all lung cancer patients is 10 to 12 percent. Only 10 to 15 percent of patients will present with localized disease. Five year survival data from NGMC’s Cancer Registry closely correlates with national survival statistics from 1347 contributing facilities. The Cancer Center participates in many national research trials for lung cancers in hopes of improving the long term survival of lung cancer patients.

Although many improvements in the treatment of lung cancer will continue to be made, the most significant factor in decreasing the number of deaths related to lung cancer will be achieved by preventing this cancer in the first place. The most preventable risk factor is smoking, as 80 to 90 percent of all cancers are related to first or second hand smoking.