Local Treatment of Lung Cancer
Local therapy treats cancer in a limited region. It cannot fully treat cancer that is widespread. Local therapies for lung cancers include surgery, radiation therapy, and ablation.
Surgery is a treatment that removes tumors or entire organs with cancer. It is a very common treatment for stages I, II, and III. The type of surgery done depends on where and how much the cancer has grown. Common lung surgeries are:
- Wedge resection – A small part of a lobe is removed,
- Segmentectomy – A large part of a lobe is removed,
- Lobectomy – An entire lobe is removed,
- Sleeve lobectomy – An entire lobe and part of the bronchus is removed, and
- Pneumonectomy – The entire lung is removed.
Removal of a lung tumor can sometimes be done with one of two methods. The classic method is thoracotomy. This surgery removes tissue through a large cut. Thoracoscopy is a newer method. It removes tissue through small cuts. It can be done with or without help from a robot.
Radiation therapy most often uses high-energy x-rays to treat lung cancer. The x-rays damage DNA in cancer cells. This either kills the cancer cells or stops new cancer cells from being made.
For lung cancers, the most common radiation method is EBRT (external beam radiation therapy).
A large machine makes the high energy x-rays used for treatment. Conformal techniques are used. These techniques shape the radiation dose to the cancer site to spare healthy tissue. Common techniques for lung cancer are:
- 3D-CRT (three-dimensional conformal radiation therapy) delivers a photon beam that matches the shape of the target. Treatment is completed in about 6 weeks.
- IMRT (intensity-modulated radiation therapy) is a form of 3D-CRT. It further modifies the beam’s intensity during treatment.
- SABR (stereotactic ablative radiotherapy) treats cancer with very precise, high-dose photon beams. It is also called SBRT (stereotactic body radiation therapy). Receiving SABR is much like other conformal techniques except treatment is finished in about 1 to 2 weeks.
- Proton therapy treats cancer with proton beams that deliver radiation mostly within the tumor. Treatment is completed in about 6 weeks.
A lung tumor is harder to target than some other tumors in the body. This is because breathing causes the tumor to move. IGRT (image-guided radiation therapy) can improve how well the radiation beam targets the tumor. It uses a machine that delivers radiation and also takes pictures of the tumor.
Ablation destroys small tumors with little harm to nearby tissue. It isn’t used often for lung cancer.
It may be used for small tumors. Radiofrequency ablation kills cancer cells using heat or cold from electrodes that are passed through a bronchoscope. This treatment is done by an interventional radiologist.
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