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Cancer Care Center

Diseases and Conditions

Lung Cancer – Treatment

With their depth and range of expertise, our specialists apply a wide array of state-of-the-art techniques to cure patients by removing and killing cancerous tissue. Our surgeons also use the most advanced techniques to relieve the symptoms of patients with advanced disease so they may improve their quality of life.

Surgery and Minimally Invasive Surgical Procedures

Lung resection is the surgical removal of all or part of the lung. The lung has three parts (called lobes) on the right side and two on the left. Often, an operation for lung cancer involves removing part or all of a lobe.

Thoracic surgeons at BMC offer patients a variety of minimally invasive and robotic surgical procedures to treat lung cancer. The use of these state-of-the-art surgical techniques results in fewer side effects than traditional methods. The following are the principle surgical options used to treat lung cancer:

Wedge resection
Also known as segmentectomy, this treatment for early-stage cancer removes an area of lung smaller than a lobe—usually the tumor and a small area of healthy lung tissue around it.

The removal of a lobe, this operation is usually effective at taking out all of the cancerous tissue and decreasing the chance of the cancer coming back. BMC was the first hospital in New England to perform robotic lobectomies, which require only small incisions. Robotic surgery is less painful and offers faster recovery times than more standard operations for lung cancer.

This option, the removal of an entire lung, is considered if a tumor is large or located in a difficult-to-reach or central position in the lung. Although pneumonectomy can result in significant loss of function, many people live quite well with only one lung.

Video-assisted thoracoscopic surgery (VATS) lobectomy
Depending on the size and location of your cancer, it may be possible to use this minimally invasive approach to perform a resection.

The BMC thoracic surgery team was the first group of surgeons in New England with the expertise and technology to perform lung resections using video-assisted thoracoscopic surgery (VATS). This minimally invasive alternative to open chest surgery greatly reduces the patient’s pain, recovery time and risk for infection.

When using VATS, the physician makes tiny incisions in the patient’s chest and inserts a thorascope (a fiber-optic camera) as well as surgical instruments. As the physician turns the thorascope, its views are displayed on a video monitor to guide surgery. The surgeon has no need to stress or cut ribs because all movements are performed at the tip of the instrument, at the point of contact with the cancerous tissue. 

Further enhancing the precision of this process, BMC’s VATS technology is also unique in its use of multiple robot-powered cameras that yield 3D views inside the chest.

Laser resection
Some tumors defy standard surgical techniques because of their location. However, a laser can strike small tumors in delicate or hard-to-reach areas. When conducting a laser resection, the surgeon inserts an endoscope into the lung, directs the laser at the tumor and transmits the high-energy beam, which destroys cancerous tissue by vaporizing it.
Photodynamic therapy
The emerging technique of photodynamic therapy is generally used to minimize a patient’s pain and discomfort, but it is being investigated as a treatment for early-stage cancer. The patient is injected with a light-sensitive anticancer drug that is absorbed by cancer cells. Laser light is then used to activate the cancer-killing drug.

Tumor ablation
BMC physicians may use tumor ablation to destroy or shrink a tumor or to relieve the symptoms of a patient who is not a candidate for surgery. When using the minimally invasive technique of tumor ablation, the physician employs catheters to ablate (destroy) cancerous tissue. Guided by computed tomography (CT), the physician inserts a specially equipped needle (probe) into the tumor that transmits cancer-killing energy into the malignant cells. Forms of ablation include

  • Radiofrequency ablation, which burns the tumor with a high-frequency electric current
  • Cryoablation, which sends liquid nitrogen through the probe to freeze cancer cells
  • Microwave ablation, which transmits heat from radio waves to kill the cancer cells

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Used alone or in combination with other treatments, chemotherapy uses drugs to kill cancer cells. These medications are given orally in a pill form or intravenously through a needle or catheter.

Chemotherapy is a systemic treatment that circulates through your entire body. The drugs enter the bloodstream and kill abnormal cells. These powerful agents affect rapidly reproducing cancer cells but can also affect normal, fast-growing cells as well. Healthy cells usually repair themselves after chemotherapy, but during treatment, you may experience a number of side effects. Possible side effects include: hair loss; fatigue; increased risk of bleeding, bruising, low blood counts, or infection; and nausea, diarrhea, or vomiting. Your doctor will prescribe medications that can relieve many of these effects.

The type, stage and location of your cancer, as well as your overall health, will determine the design of your chemotherapy treatment and its frequency—which may vary from daily to once a month.
Bring a list of questions when you visit us, and consider inviting a friend or family member to accompany you to your first few sessions for support.

What to expect
In a typical session, you receive the chemotherapy through an intravenous (IV) needle inserted either in your arm or in your subclavian vein (below your collar bone). During this process, known as infusion, you may sit or lie down, read, watch television, talk with others, sleep or engage in other low-key activities.

While you undergo your treatment and after you conclude it, your care team will use tests and imaging to track the results.

Recovery varies with each patient. Some individuals may regain their strength within days, whereas others may take months to fully resume daily activities. During recovery, get plenty of rest, do low impact exercise and eat a balanced diet. Meditation, yoga and other complimentary therapies are often helpful to patients during recovery. These activities and many others are available to you at BMC.

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Radiation Therapy

Radiation therapy (or radiotherapy) uses high-energy radiation to destroy cancer cells. Administered by a radiation oncologist, the high-energy particles break a portion of the DNA within a cancer cell and prevent it from reproducing itself.
Radiation therapy takes a variety of forms and employs different types of high-energy particles, from X-rays and gamma rays to electron beams and protons.

Radiation may be applied alone or in combination with surgery and/or chemotherapy. In some cases, radiation is given before surgery to reduce the size of tumors. Or it may follow surgery to purge any remaining cancer cells. Some patients may receive dual courses of radiotherapy and chemotherapy at the same time.

At BMC, the radiotherapy techniques we use to treat lung cancer include

The best treatment choice for you will depend on the type of cancer you have and the extent and location of the disease. Your radiation oncologist will discuss your treatment options with you.

External beam radiotherapy (EBRT)
External beam radiotherapy is performed on an outpatient basis. Guided by computer-generated 3D images of the cancer, a linear accelerator administers beams of radiation that match the shape of the patient’s tumor.

Although the radiation is precisely targeted, it can damage normal tissue near cancerous cells. Your radiation oncologist reduces this risk by administering a series of small doses that allow nearby normal tissue time to heal during treatment. A typical course of external radiation therapy may schedule treatments five days a week over five to eight weeks. 

What to expect
External beam radiotherapy is a painless process, much like having a routine X-ray. Although the actual treatment takes only a few minutes, each session may last 10 to 15 minutes, including preparation time.

The side effects of radiation vary from person to person. The most common side effects are fatigue, skin changes and loss of appetite. Your radiation oncologist will meet with you weekly during your treatment and will help you to manage any side effects you experience.

CyberKnife® Robotic Radiosurgery System
One of our advanced technologies is the CyberKnife Robotic Radiosurgery System, a new, noninvasive alternative to surgery for the treatment of benign and cancerous tumors. CyberKnife treatment is a painless process that uses highly focused and precise beams of radiation to treat tumors almost anywhere in the body.  Despite its name, there is no actual "knife" used in the procedure. In fact, no part of the CyberKnife System physically touches the patient during treatment. It is performed on an outpatient basis over a period of one to five days. CyberKnife may be used in the treatment of some lung cancers. For more information about CyberKnife, ask your doctor or visit our CyberKnife website

Seed implantation (brachytherapy)
BMC physicians specialize in the latest and most effective cancer treatments, including such state-of-the-art techniques as seed implantation, also known as brachytherapy.

This internal form of radiotherapy is delivered during a surgical procedure to remove cancerous tissue. When the resection is complete, the surgeon, in collaboration with the radiation oncologist, implants seed-like radioactive pellets near the remaining portion of the lung to prevent new growth of cancer cells. The pellets remain in place for the rest of the patient’s life, although their level of radiation decreases over time.

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Integrative Medicine

Integrative medicine practices have been shown to reduce cancer-related symptoms such as pain, anxiety, nausea and fatigue. The Program for Integrative Medicine and Health Care Disparities in the Department of Family Medicine at BMC combines conventional medical treatments with evidence-based complementary therapies. These treatments include free therapeutic massage to decrease preoperative anxiety and postoperative pain in cancer patients undergoing surgical procedures and free acupuncture administered by a licensed acupuncturist. We also offer consultations that focus on stress management, nutrition and coordination of complementary therapies.

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Follow-Up Care

Periodic follow-up care is very important after treatment for lung cancer to make sure that the patient remains free of tumors. At BMC, your treatment plan will include services that go well beyond the procedures to remove the cancer. Your plan will include:

  • Services and guidance to relieve side effects
  • Procedures to monitor and control pain during and after treatment
  • Guidance and follow-up on the details of home care

Management of your care continues over the weeks, months and years following your treatment. And for out-of-town patients, this care includes collaboration with your local health care providers for follow-up, using our nationwide network of health care institutions.

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