Lung Disease

Accounting for approximately 25% of cancer related deaths, lung cancer causes more deaths than breast, colon, and prostate cancer combined.  It is the most common cause of cancer related deaths in both men and women.  With 170,000 new cases of lung cancer developing each year in the United States alone, it is a serious medical problem.  Fortunately, new, safer therapies continue to be developed in this field.  This enables us to treat patients who, in the past, were not candidates for certain types of therapy.  In addition, with diagnostic improvements, lung cancer may be detected earlier, leading to better chances for optimal outcomes.

Lung cancer can be broadly separated into two groups: small cell cancer and non-small cell lung cancers.  Small cell cancer is generally treated with chemotherapy.  Non-small cell lung cancers are treated with surgery when the tumor is localized.  The three main types of non-small cell lung cancer are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

Therapy for non-small cell lung cancer is based on a number of conditions related to the tumor and patient factors.  When a patient is first evaluated for a lung cancer the first step after establishing a diagnosis is to confirm the stage of the cancer.  There are 4 basic stages of lung cancer.  Stage I and II are smaller tumors without central lymph node involvement.  Stage III has central lymph node involved in cancer, and Stage IV has spread to other parts of the body. General treatment strategies for the various stages are outlined below.


Initial Therapy

Surgical Therapy


Stage I . Surgery Radiation
Stage II . Surgery Radiation

Stage III

+/- Radiation
If good response to therapy, surgery indicated Radiation
Stage IV Chemotherapy
No role for surgery Radiation

Types of Surgery

Diagnostic/Staging Procedures
Designed to help diagnose the type of tumor or to accurately stage the tumor.  This allows the clinician and patient to determine an appropriate course of therapy. Common examples include: bronchoscopy, mediastinoscopy, and Chamberlain procedure.

Palliative Procedures
Designed to improve or relieve symptoms related to cancer. Common examples include: laser bronchoscopy, airway stenting, and pleural drainage catheters.

Curative Produres
Designed in hopes of curing the patient of cancer. These include pneumonectomy, lobectomy and segmentectomy or wedge resection.

  • Pneumonectomy
    Removal of the left or the right lung, which is occasionally necessary due to location of tumor.
  • Lobectomy
    Removal of only the section or lobe of lung with the tumor.  In the human body, the right lung is divided into three lobes and the left the lung is divided into two lobes.  If the tumor was located on the right and isolated to the right upper lobe, then a right upper lobectomy would generally be performed. This procedure may be performed through limited thoracotomy or thoracoscopically.
  • Segmentectomy or Wedge Resection
    Removes less lung tissue than a lobectomy.  It is generally selected for patients who have more medical problems, difficulty breathing, or extremely small tumors.