Lung cancer

Nurse with chemotherapy

Treatment options

A team of specialists will recommend the treatment they think is best for you. This will depend on the type of lung cancer you have, the size and position of the cancer, how advanced it is and your overall health. Find out how DNA testing may also help to determine the best treatment for you. 

Surgery

This is not an option for all patients with lung cancer, as for some, the risks of the procedure may outweigh the benefits.  You may be concerned about being able to breathe if all or some of your lung is removed, but it is possible to breathe with only one lung. All surgery is conducted at St. George’s Hospital in London. However, your initial consultation and follow-up will be at Royal Surrey.

  

There are three main types of lung surgery:

 

  • Lobectomy –   A lobectomy is a surgery to remove one of the lobes of the lungs. The lungs have sections called lobes. The right lung has 3 lobes. The left lung has 2 lobes. A lobectomy may be done when a problem is found in just part of a lung.

 

  • Wedge resection or segmentectomy –  where a small piece of the lung is removed. This is only used when the cancer is small and limited to one area of the lung.

 

  • Pneumonectomy –  where the entire lung is removed. This is used when the cancer is located in the middle of the lung or has spread throughout.

 

Other surgical procedures

Thymectomy  - is the removal of the thymus gland. You can read more about this procedure on the Macmillan website (opens in new tab).

 

Pleurodesis  – This is treatment for fluid on the lung and involves putting a mild irritant drug into the space between your lung and chest wall. This is done to try and stick your lung to the wall of your chest and prevent a further collection of fluid or air in this space.

 

Mediastinoscopy – This is an operation carried out under general anaesthetic, where the surgeon makes a small cut in the skin at the front of your neck to allow them to have a look at the space between your lungs. They can also take biopsies from your lymph nodes. You can read more about this procedure on  the Macmillan website (opens in new tab).

How is surgery performed?

Surgery is carried out in two ways and will be determined by the location, size and stage of the tumour.

 

  • Thoracotomy -  This usually involves making a cut in your chest or side and removing a section of the infected lung.

 

  • Video assisted thoracoscopic surgery –  This is a type of keyhole surgery that can be performed using a surgical robot. It will see a number of small incisions made in your chest and a camera inserted into your chest to monitor the removal of the affected section of lung.

 

Find our more about the surgical procedures for lung cancer on the Macmillan website (opens in a new tab).

Preparing for surgery

Prehabilitation will prepare your body and mind for surgery.  You can take simple steps to improve your physical and mental health.  This will reduce your risk of complications, improve your wellbeing and aid your recovery.

 

Nutrition - Eat a healthy diet. If you are overweight, reducing your weight will reduce many of the risks of having an anaesthetic and surgery. Aim for a normal body weight.  Visit the NHS website and calculate your BMI (opens in a new tab). You can also find advice from our dietitians on our eating well pages.

 

Physical activity - This will help you to eat better, sleep better and improve your general wellbeing. In addition, this will ensure your heart and lungs are fitter for anaesthesia and surgery. Learn more from our physiotherapists on our keeping active pages.

 

Breathing exercises - With the help of breathing exercises, you can maximise your lung capacity to get you ready for your surgery, and also for faster recovery.

 

Smoking and alcohol - If you smoke, giving up for several weeks before the operation will reduce the risk of experiencing breathing problems. The longer you can give up beforehand, the better. If you cannot stop smoking completely, cutting down will help.

We recommend that you reduce or stop drinking alcohol in the lead-up to your surgery. The earlier you do this the better. If you choose not to stop completely then cutting down will help.

 

As with all surgery, there is always a risk of complications. These will be discussed with you during your consultation and can usually be treated using medicine or more surgery, but they may increase your hospital stay.

Oncological treatments

 

Chemotherapy - This uses medicine to kill cancer cells. When used to treat lung cancer, chemotherapy can be given straight into your vein through an intravenous drip or orally as a tablet. You may receive a combination of chemotherapy and radiotherapy.

Find out more about receving chemotherapy at Royal Surrey Cancer Centre.

 

Immunotherapy – Works by helping the immune system recognise and attack cancer cells. The type of immunotherapy given to lung cancer patients is known as checkpoint inhibitors, which work by blocking proteins that prevent the immune system from fighting the cancer cells. This treatment is given directly into your vein through an intravenous drip.

Read more about receiving immunotherapy at Royal Surrey Cancer Centre.

 

Targeted therapies – Targeted cancer drugs work by directly targeting the mutations within the cells. Targeted therapies are mainly used for patients with non-small cell cancers that have moved outside of the lung or to other parts of the body.

 

Radiotherapy - This involves using a low dose of radiation to destroy the cancer. Radiotherapy may be given to some patients whose tumour is unsuitable for surgery or have chosen not to have surgery. It can also be given to help relieve the symptoms arising from cancer.

Discover more about radiotherapy and how it is delivered at Royal Surrey Cancer Centre.

 

Stereotactic Ablative Body Radiotherapy (SABR) – This is a way of giving radiotherapy to precisely target certain cancers, whilst avoiding as much surrounding healthy tissue as possible.

 

Radiotherapy to the brain – This is sometimes given to patients with small cell lung cancer as a preventative measure after completing a course of chemotherapy. This type of cancer is known to have a tendency to spread to the brain and your consultant may feel this will minimise the risk.