This article will provide an overview of the process leading up to your lung cancer surgery. Whether you’re planning to undergo a wedge resection, lobectomy, or pneumonectomy, knowing what lies ahead will relieve your anxiety, and help you prepare.

Tests To Monitor Your Condition And Health

The outcome of the procedure will depend largely on your health. The healthier you are, the better your body will able to tolerate the operation. Your physician will examine your medical history to look for preconditions or past complications that may make surgery impossible. These include postoperative clotting, problems tolerating anesthesia, and breathing issues following procedures in the past. Your doctor will also need to be informed regarding any medications you’re taking since they can increase the chances of bleeding.

A physical examination will be done as well as tests to monitor the strength of your body’s pulmonary system. If your pulmonary function is severely hampered, lung cancer surgery – especially in the case of a pneumonectomy – may not be an option.

Improving Your Chances For A Successful Recovery

If you’re currently a habitual smoker, your doctor will strongly suggest you quit. Doing so can improve your ability to heal properly following lung cancer surgery. You should also take the time to work with your doctor toward creating an exercise routine you can follow after the operation. A regular workout consisting of mild exercises will help your pulmonary and circulatory systems recover.

Lastly, plan in advance to have others help you with specific tasks after you are released from the hospital. For example, you’ll need someone to either prepare or bring meals to you; you’ll require help with vacuuming, dusting, yard work, and other chores; and you may need a friend or neighbor to check in on you daily just in case you experience complications stemming from your surgery.

Important Questions For Your Doctor

Prior to the operation, it’s important to clarify any details about which you have questions. For example, ask your doctor about the type of anesthesia you’ll receive. Ask about the possible side effects, and any changes you’ll need to make to your lifestyle due to impaired lung function. You’ll also want to ask the medications you’ll be given to take at home. Ask about potential signs that indicate there may be a problem during your recovery, and whom you should call if you notice them. Also, find out when you can expect to resume your normal activities, including returning to work.

Other Considerations Prior To Surgery

Even though minimally invasive lung cancer surgery poses fewer complications than open thoracotomy, they can still occur. It’s worth preparing in advance. For example, many people choose to donate their blood for use in the event they require a transfusion during the procedure. That way, they can avoid relying upon the hospital’s supply. This can be especially useful if you have a rare blood type (e.g. AB Rh negative).

You may also want to designate someone who can make medical decisions for you in the event you are unable to do so. The person you designate can decide which medical treatments you should – and should not – receive.

Nearly all minimally invasive lung cancer surgeries are performed without problems. If you’re planning to undergo such a procedure, however, it’s worth preparing ahead as much as possible.

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The operation has traditionally been done through invasive thoracotomy – that is, cutting through the chest to access the lungs. In recent years, surgeons have begun using a minimally-invasive approach known as video-assisted thoracic surgery (VATS). Below, we’ll describe the differences between VATS and conventional thoracotomy. We’ll then take a look at how patients are chosen for the former. Lastly, we’ll explain what you can expect during recovery following a VATS lobectomy.

VATS Lobectomy Versus Invasive Thoracotomy

During thoracotomy, a surgeon makes a long incision into the middle of your chest. He or she must also cut through your sternum and spread your ribs in order to gain access to your lungs. In some cases, a portion of one or more ribs is removed.

Because this approach is highly invasive, the risk of complications is high. The operation may result in infection, respiratory failure, or pleural effusion. Moreover, there is typically significant pain during the postoperative recovery period.

In contrast, a VATS lobectomy is done with two to four small incisions into the sides of the chest, with each measuring less than an inch. A thoracoscope (i.e. instrument with a video camera) is inserted through one of the incisions. It sends images of the area back to a monitor that your surgeon uses to guide other surgical instruments. By studying the area displayed on the monitor, your surgeon can cut away and remove the affected lobe.

Note that the surgery is completed without cutting through the sternum and separating the ribs. Consequently, there are fewer complications and less pain during recovery.

Determining Candidacy For Minimally-Invasive Lung Cancer Surgery

Not all patients are suitable candidates for minimally invasive lung cancer surgery. As a general rule, those with small tumors near the outer edge of the lung make better candidates. Also, a VATS lobectomy is only possible if the disease can be detected while it is in its early stages. Once it spreads beyond the lungs (i.e. it metastasizes), other treatment measures become necessary.

As long as a medical center offers this approach to lung cancer surgery, it is considered for all patients. Your doctor – and an oncologist – will ultimately decide whether your condition makes you a suitable candidate.

Recovering From The Operation

With invasive thoracotomy, you can expect to stay in the hospital for up to ten days. That said, many patients are released as early as five or six days following surgery. With a VATS lobectomy, you may be released after two days, assuming your condition is stable. The recovery time following minimally invasive lung cancer surgery is much shorter than that required after undergoing traditional thoracotomy. Many patients are able to return to their normal activities within three to six weeks.

Reasons Few Surgeons Perform VATS Lobectomy

Not all medical centers offer minimally invasive lung surgery. While the approach has become more widespread over the last decade, many surgeons still lack the necessary skills and training. Relying upon images displayed on a video monitor to perform the removal of a lobe poses a steep learning curve.

If you have been diagnosed with early-stage lung cancer, ask your physician whether a VATS lobectomy represents a viable treatment option. If it does, check whether your doctor’s facility can perform the operation. You’ll benefit from a faster recovery, less postoperative pain, and a lower risk of complications during the procedure.

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A person who smokes more than one pack of cigarettes per day has a risk of developing lung cancer 20-25 times greater than someone who has never smoked.

Once a person quits smoking, his or her risk for lung cancer gradually decreases. About 15 years after quitting, the risk for lung cancer decreases to the level of someone who never smoked. Cigar and pipe smoking increases the risk of lung cancer, but not as much as smoking cigarettes.
Other causes of lung cancer include the following:

Passive smoking presents another risk for lung cancer. An estimated 3,000 lung cancer deaths occur each year in the U.S. that are attributable to passive smoking.

Air pollution from motor vehicles, factories, and other sources probably increase the risk for lung cancer, and many experts believe that prolonged exposure to polluted air is similar to prolonged exposure to passive smoking in terms of risk for developing lung cancer.

Asbestos exposure increases the risk of lung cancer by nine times. A combination of asbestos exposure and cigarette smoking raises the risk to as much as 50 times.

Lung diseases, such as tuberculosis (TB) and chronic obstructive pulmonary disease (COPD), also create a risk for lung cancer. A person with COPD has a four to six times greater risk of lung cancer even when the effect of cigarette smoking is excluded.

Radon exposure poses another risk. Radon is a by-product of naturally occurring radium, which is a product of uranium. Radon is present in indoor and outdoor air.

The risk for lung cancer increases with significant long-term exposure to radon, although no one knows the exact risk. An estimated 12% of lung cancer deaths are attributable to radon gas, or 15,000 to 22,000 lung cancer-related deaths annually in the U.S. Radon gas is the second leading cause of lung cancer in the U.S. As with asbestos exposure, smoking greatly increases the risk of lung cancer with radon exposure.

Certain occupations where exposure to arsenic, chromium, nickel, aromatic hydrocarbons, and ethers occurs may increase the risk of lung cancer.

Lung Cancer Survival Rates

Several factors influence lung cancer survival rates. The type of cancer, the stage it is at when diagnosed, and the overall condition of the patient all play a role in determining survival. Cancer survival is usually expressed in terms of a five-year survival rate, which is the percentage of patients with cancer who survive at least five years after their cancer is diagnosed.

Studies have shown that five-year survival rates among non-small cell lung cancer patients vary by stage. Stage 0 patients have the best survival, of close to 50% at five years. Approximately one-quarter of stage II patients survive to five years, as compared to 8% of stage III patients and only 2% of stage IV patients. In general, small cell lung cancer tends to proceed more rapidly to terminal disease. Ten to fifteen percent of patients with limited-stage small cell lung cancer, and between one and two percent of those with extensive-stage cancer, survive to five years.

Estimates of cancer survival do not reflect current treatment advances that may lead to better chances of survival, because they are typically calculated for a five-year period that does not include the previous year. Further, each patient responds to treatment in a unique way; aggregate estimates do not account for individual factors that may improve or worsen the likelihood of survival.

The overall number of deaths in the United States from lung cancer rose throughout the 1980s, and began to drop for men in the 1990s. However, a similar decrease has not been observed among women. Over fifty thousand current and former smokers have been enrolled in the National Lung Screening Trial to find out if chest x-rays and CT scans taken before the onset of lung cancer symptoms may improve early diagnosis and therefore survival.

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A gene controls a cell and informs it as to what to do. This will include growing and reproducing and usually the cells follow the order. Sometimes instructions become confused and cells start growing and multiplying where they shouldn’t. These groups of cells can form into tumors or lumps and may spread through the bloodstream and lymphatic system (this is known as known as metastases).

The lumps or tumors fall into two categories; benign (non-cancerous) or malignant (cancerous). The difference being that benign tumor cells remain in one place and are not usually a concern.
Malignant tumor cells invade nearby tissues and spread to other parts of the body.
A swollen lymph node often provides the first sign that a malignant tumour has spread (metastasized). Quite often this occurs when a cancerous tumor is close by but cancer may metastasize to practically any part of the body and hence it is important that these type of tumors are found quickly.

The name of a particular cancer is basically defined by the part of the body where they grow. As an example a growth in the lung that spreads to the bladder is known as lung cancer with bladder metastases.

In lung cancer the cells of the lung are first involved.

The two main types of lung cancer are:

Non-small cell lung cancer (NSCLC). This is the most common type of lung cancer. It growth is slower than small cell lung cancer. Approximately 80% of lung cancers diagnosed are this type.

Small cell lung cancer (SCLC). This type invades quickly and will spread to other parts of the body.

NSCLC are groups of different cells and there are three types

Squamous cell carcinoma, this is often found in the central part of the lung.

Adenocarcinoma,this generally occurs in the outer part of the lung.

Large cell carcinoma, this can occur almost anywhere in the lung.
Although people with adenocarcinoma have a more favorable outlook, any non-small cell cancers can increase in size quickly and the prognosis can therefore be poor.

Treatment differs for each type of cancer as they do behave very differently. The treatment will depend on the staging of the disease.

Advanced stages of NSCLC may be treated by removal of the affected lung tissue to remove all or part of the tumour. While it may be possible to completely remove the tumor, this may not always be possible.

Chemotherapy and radiation treatment is common and administered after an operation or where the tumor is small enough for surgery not to be necessary. The patients general state of health also plays a part as treatments can be debilitating.

Chemotherapy and radiation are the only real options for those with SCLC and the results generally don’t provide remission but they are successful at extending the patient’s life.

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CT Scan
PET Scan
Bronchoscopy
Needle biopsy
Surgical biopsy

Once a diagnosis of lung cancer has been established, your doctor will need to assess the stage of the disease. Staging is the process by which the cancer is assessed and categorized; this is essential for determining an effective treatment regime which will depend on a number of detailed factors. Factors include the size of the tumor, location, whether it is primary (originated in the lungs) or metastasized (spread to the lungs from another tumor elsewhere in the body), whether it has spread to the lymph nodes and many other factors.

Staging is frequently referred to as TNM – Tumor, Lymph Nodes, Metastasized.

Treatment regimes will be determined by the type of lung cancer a patient has acquired. Metastasized cancer is treated differently from primary cancer – in the latter case, the tumor originates in the lung and can be treated by surgery in the early stages backed up by chemotherapy or radiation treatment. Metastasized cancer cannot be so easily treated by surgery unless the cancer is non-aggressive and the tumor of relatively small size.

Your doctor will probably recommend minimally invasive surgery for early stage, primary lung cancer and this has distinct advantages in both treatment outcome and for the patient. Minimally invasive techniques do not involve opening the thoracic cavity (the chest) and is not major surgery with the attendant risks that carries. It is usual for a patient to be up and walking within a couple of hours of the procedure and to be home within a day or two of being admitted to hospital. Chemotherapy or radiation treatment may be used to follow up the removal (known as a resection) of the cancerous lung tissue.

Traditional open surgery may be used where the cancer is located in an inaccessible portion of the lungs or is at a stage where minimally invasive techniques are not appropriate. This requires an incision in the side of the chest (the flank) and the spreading of the ribs to gain access to the area where the tumor is located. This involves additional pain and discomfort for the patient and a longer stay in hospital with a longer recovery period, which is why minimally invasive techniques are often preferred. Again, the operation will frequently be followed up by additional chemotherapy or radiation treatment where necessary.

Where the disease has reached a stage at which it is incurable, palliative surgery may be undertaken to help the patient’s quality of life, such as the removal of the tumor which has become of a size where airways are being obstructed.

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This article will describe the ways in which the mitral valve can malfunction. We’ll explain the procedure used to correct the problem as well as its advantages over other forms of treatment.

Ways In Which The Mitral Valve Can Malfunction

Two problems can occur with the mitral valve. First, it can fail to close properly after blood has moved from the left atrium into the left ventricle. If this happens, blood can flow back into the atrium when the ventricle contracts. As a result, you may feel winded or have difficulty catching your breath.

The second problem is that the MV might fail to open properly. That prevents blood from flowing from the atrium into the ventricle. This condition is usually caused by rheumatic fever and is far less common.

Repairing The Problem

There are two strategies to correct a malfunctioning MV: replacement of the valve or surgically repairing it. Replacements can be made from metal or tissue. However, because introducing any foreign object into the body carries risks, many doctors recommend repairing the valve.

Long ago, mitral valve repair required the surgeon to cut through the patient’s breastbone. Today, the procedure is far less invasive. The surgeon makes a small incision (between 2 and 4 inches) and uses robotic assistance to guide his or her approach.

Advantages Of The Procedure

There are several advantages to repairing the MV rather than replacing it. The mortality rate during replacement surgery can climb up to 8%. By contrast, the mortality rate associated with mitral valve repair typically ranges between 1-2%. There’s also less blood loss and a lower chance of infection during – and immediately following – the operation. The recovery time is shorter and patients are usually able to return home more quickly than would be the case if they received a replacement.

Another advantage: patients who undergo mitral valve repair do not need to take blood thinners. Those who receive a replacement valve are forced to take blood thinners for the remainder of their lives. Otherwise, they risk developing blood clots.

While minimally invasive techniques have significantly reduced the risks involved with mitral valve repair, not everyone is a good candidate for the operation. Be sure to discuss your options with your physician.

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During the early part of the last century, the popularity of cigarette smoking underwent explosive growth among men. Two decades later, women joined the ranks of habitual smokers in droves. Today, lung cancer claims nearly 150,000 lives each year; eighty percent of cases are directly attributed to cigarettes. Despite how deadly it is, the condition is largely avoidable.

While smoking is the leading cause of the disease, there are other, less prevalent causes. In this article, we’ll describe a few of them in detail, beginning with habitual smoking and continuing with secondary smoke, and exposure to other elements.

Habitual Smoking

Doctors measure the risk that a patient might develop lung cancer by considering two variables. They want to know how many packs a patient typically smokes per day and how many years the patient has indulged the habit. The higher each number is, the more likely the disease will manifest. Despite what a lot of smokers believe, cigars and pipes also present a risk (albeit much lower).

Cigarette smoke contains thousands of chemicals. Some of them, like nitrosamines, are known to be carcinogenic. Over time, those chemicals infiltrate and damage the cells in the bronchi, leading to the development of malignant tumors. The cancerous cells can eventually affect the heart, causing the right side to enlarge.

Secondary Smoke

Many people mistakenly believe that inhaling secondhand smoke does not represent a risk of developing lung cancer. In fact, it does. Thousands of people in the U.S. die each year from developing the disease after constant exposure to secondhand smoke. For example, patients who do not smoke cigarettes, but live with an habitual smoker are 24% more likely to suffer from the disease.

Exposure To Asbestos

Years ago, asbestos was used liberally within houses, apartments, and office buildings in order to insulate them. Unfortunately, while it provides effective insulation, asbestos also damages the tissue within the lungs. Given time and prolonged exposure, that damage can lead to cancer. Further, asbestos significantly increases the likelihood of a smoker developing the disease. For example, a non-smoker who works with the material is 5 times more likely to be affected than someone who does not work with it. By contrast, a smoker who works with asbestos is up to 90 times more likely.

Other Risk Factors

There are other risk factors besides those mentioned above. For example, people who are exposed to radon gas, arsenic, nickel, and chloromethyl ethers on a regular basis run the risk of developing lung cancer. Genetics also plays an important role. A patient may be more susceptible to the disease if someone in his or her immediate family has had it.

Once diagnosed, a doctor will recommend a number of possible treatments, including chemotherapy, radiation therapy, or surgery. If the disease is identified early enough, it is possible for the doctor to treat it successfully and for the patient to enjoy a long, healthy life.