Non-Small-Cell Lung Cancer (cont.)
Koyamangalath Krishnan, MD, FRCP
Surgical removal of the tumor provides the best chance of long-term, disease-free survival and the possibility of a cure. In stages I and II NSCLC, removal of the tumor by surgery is almost always possible unless the person is ineligible for surgery because of other medical conditions or complications of the tumor. (These patients usually receive radiation therapy.) Generally, only some stage IIIA cancers are operable. Persons with stage IIIB or IV tumors are generally not candidates for surgery.
Only 30-35% of people with NSCLC have operable tumors. Approximately 50% of people who undergo surgery have a relapse after surgery.
Before a patient can undergo surgery for lung cancer, he undergoes pulmonary function tests to make sure his lungs are strong enough.
The standard operations for lung cancer include lobectomy (removal of one lobe of the lung) or pneumonectomy (removal of the whole lung). Attempts to remove a smaller part of the lung (wedge resections) carry a higher risk of recurrence and poor outcome.
Like all operations, these procedures have benefits and risks. All operations carry a risk of complications, both from the operation itself and from the anesthesia. The surgeon discusses these benefits and risks with the patient. Together, they decide whether the patient is a candidate for surgery.
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