Surgery for Lung cancer

Overview

In accordance with the International Agency for Research on Cancer GLOBOCAN World Cancer Report, lung cancer affects over one million individuals across the globe each year. By far the most common type of cancer incidence and mortality in men worldwide is lung cancer. In women, the lung tumour is the fourth-most prevalent malignant tumour, following breast cancer, cervical cancer, and colorectal cancer; however, it ranks first when it comes to mortality rates.

The management of lung cancer treatment is handled by a multidisciplinary team of specialists who collaborate to provide the best care possible.
The type of treatment for lung cancer that you receive is determined by several factors, including:

• Tumour histology or type (non-small cell carcinoma versus small cell carcinoma)
• Tumour extent (stage of cancer)
• Tumour position and size
• Factors specific to the patient (for example, comorbidity, age, pulmonary function)

It can be difficult to determine which treatment is most suitable for you. Your cancer treatment team will make appropriate suggestions, but the final call will be yours.
Chemotherapy, radiation therapy, immunotherapy, and surgery are the common treatment options for lung cancer. The type of therapy used may be determined by the type and stage of the lung cancer. You may also be given combination therapy.

A significant advancement has been seen in surgical techniques for lung surgery in recent years. Surgical therapy is still the mainstay of lung cancer treatment. Following a meticulous selection, it is the sole method of treatment that provides long-term survival, at least in the case of those who have the early-stage disease and others with more advanced stages.

Lung cancer surgery types

Lobectomy
The lungs are made up of five lobes: two on the left and three on the right. Cancer can appear anywhere in the lungs. If you have cancer in any of the lobes, your lung specialist might perform a lobectomy to eliminate the cancerous cells from the lobes. When one or two lobes need to be removed to cure the cancer, this procedure may be considered.

Pneumonectomy
When treating lung cancer, it is sometimes necessary to remove the whole affected lung. If lung cancer impacts two or more lobes of the lung, for example, all three lobes of the right lung or both the left lobes, this procedure may be required. This surgery is performed to remove cancer from the body, preventing it from growing or spreading; however, not all patients are ideal candidates for this surgery. Prior to performing this surgery, one has to undergo pulmonary testing to ensure sufficient healthy lung tissue will remain after the surgery for adequate breathing.

During this surgical procedure, the surgeon will make a cut (incision) on the side. They then remove the lung following the separation of the tissue and ribs.
Although a pneumonectomy can help cure lung cancer, it is a difficult procedure. Only with a good chance of remission will the doctor recommend this procedure. If your cancer is advanced or has already spread, eliminating the lung may not be beneficial.

Removing a segment of the lung

Another option is to remove just a segment of the cancerous tissue from the lungs. When tumours are small and have not spread beyond the lungs, the doctor might suggest this procedure. Options include:

• Segmentectomy: This approach is used to eliminate a large segment of lung tissue but not to eliminate an entire lobe.
• Wedge resection: This procedure involves removing a small portion of the lung from one or maybe more lobes.
• Sleeve resection: This surgical procedure is an alternative method to eliminating the whole lung. It saves a portion of the lung by just removing cancerous areas such as parts of the air passage or bronchus.

Lung cancer surgery may serve as an effective treatment. Even so, the doctor may also advise radiation or chemotherapy after surgery. This treatment is a preventative measure that helps kill microscopic cancerous cells that may spread to the lymph nodes.

How is lung tumour surgery performed?

The hospital’s medical team administers general anaesthesia to patients through the intravenous means prior to the operation. It induces sleep and aids in performing a painless procedure.

Once the patient is unconscious, the surgeon will most likely use one of two methods mentioned below to reach the lung:

Thoracotomy (open surgery)

The surgeon performs a thoracotomy by creating a cut just below the nipple and then around the back beneath the shoulder blade, following the curve of the ribs. It usually involves dividing certain chest wall muscles and gently spreading between two ribs, allowing the surgeon to access the lung. This procedure is performed when the entire lung needs to be removed.

Minimally invasive surgical procedures
Minimally invasive surgical procedures involve removing the lung tumour without opening the chest.

• Thoracoscopy (video-assisted thoracic surgery)
This is also known as keyhole surgery or laparoscopic lung cancer surgery. To gain access to the interior of the chest, up to four small incisions are typically made by the surgeon. The surgeon uses these incisions to advance instruments and a camera to visualise the lung, and then, performs the surgery with special instruments.
• Robotic surgery for lung cancer
It is also known as robotic-assisted thoracic surgery and is used to eliminate diseased lung tissue, sometimes along with surrounding lymph nodes. A surgeon will control the surgical equipment on the robotic surgical system while sitting at a console adjacent to the patient in the surgery room.

A small video camera is inserted into one of the small incisions by the surgical team. During the procedure, surgical instruments are attached to a robot arm. The robotic hand is guided by the surgeon from the control unit. This procedure can help with tumours that are difficult to access.

What to expect after the lung tumour surgery?

• The patient may feel weak and groggy once the anaesthesia effects have worn off.
• The patient may be administered pain relievers to relieve any pain.
• It is not unusual to have drains and tubes placed in the chest. These tubes are placed during the surgical procedure to drain any blood and fluid. These are usually removed within a few days following the surgery.
• If the patient has to go back home with a tube still placed, the doctor or nurse will explain how to care for it.
• During the patient’s stay in the hospital, a respiratory therapist may help them improve the functioning of their lungs. They may use certain medications and devices (such as a spirometer) to know how well the lungs are functioning.
• Before the patient is discharged from the hospital, they will be given instructions for wound care and home recovery.

What are the risks associated with lung cancer surgery?

Lung cancer surgery is a major procedure that can require either weeks or months to recoup from, based on the procedure. Despite its effectiveness, surgery has some risks, including:

• Infection
• Pneumonia
• Anaesthesia-related allergic reaction
• Bleeding
• Blood clots

It is critical to discuss these risks with the doctor. Another long-term potential complication is shortness of breath when participating in certain activities. This is particularly true if a lung disease is also associated with lung cancer (for example, chronic bronchitis or emphysema).

What is the lung cancer surgery cost in India?

Even though there are a lot of treatment options available for lung cancer treatment, lung cancer surgery still remains the cornerstone of treatment.

The lung cancer surgery cost in India varies depending on a number of factors, including:

• Cancer type and stage
• Location of the cancer
• Type of surgery performed
• Hospital or clinic where the surgery is performed and their location in India

In general, depending on the factors mentioned above, the cost of lung cancer surgery in India can fluctuate roughly between INR 4,00,000 and INR 8,00,000 or more; however, it is important to note that these are only estimates, and the actual cost of surgery can vary greatly depending on the specific circumstances of each case. To get an accurate estimate of the cost of lung surgery in India, it is best to speak with healthcare providers or hospitals directly.

Takeaway
Lung cancer surgery is a major procedure that can be used to treat certain stages of lung cancer. Keyhole surgery and robotic surgery techniques have improved surgical options for treatment with minimal invasion. While the cost of lung cancer surgery in India varies, it is generally less expensive than that in other countries. It is important to note, however, that surgery is not always the best choice for lung cancer treatment, and other options like radiation therapy and chemotherapy may be considered. Seeking treatment from a specialist for lungs is critical to ensure proper diagnosis and treatment. Finally, early detection and maintenance of lung health are critical in lowering the risk of lung cancer and increasing the chances of a lung cancer cure.