Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Adenocarcinoma Of The Lung

Treatment

Surgery is the main treatment for all NSCL cancers if the cancer is contained in the chest and has no evidence of having spread to areas outside the chest. Three types of surgery can be used:

• Wedge resection — Removal of only a small part of the lung

• Lobectomy — Removal of one lobe of the lung

• Pneumonectomy — Removal of the entire lung

• VATS (Video-assisted thoracoscopy) — In this procedure, which can be both diagnostic and therapeutic, the surgeon places a flexible tube into an incision in the chest and can visually inspect the surrounding surfaces of the inner and outer linings of the lung area and even do surgery to remove abnormal areas. It is a less-invasive procedure compared to a larger operation, called a thoracotomy.

Since all of these surgical procedures require removal of a portion or the entire lung, and since many of the patients will have diminished lung function to begin with due to years of smoking, it is very important that a full evaluation of the existing lung function and the predicted lung function after an expected surgical removal be done. This is especially important for those with non cancerous abnormalities of their lungs, such as emphysema and chronic obstructive pulmonary diseases.

Depending on how far the cancer has spread (the stage), treatments can include chemotherapy and radiation therapy before and/or after surgery. Stages are defined by the size of the tumor and how far it has spread. Stages I through III are further divided into two "A" and "B" categories. Stage I tumors are small and have not invaded the surrounding tissue or organs. Stage II and III tumors have invaded surrounding tissue and/or organs and have spread to lymph nodes. Stage IV tumors have spread outside the chest area.

People with serious medical problems that make it difficult for them to withstand surgery may receive radiation therapy to shrink the tumor, or a combination of radiation and chemotherapy.

When the tumor has spread significantly, chemotherapy drugs may be recommended to slow the growth of the cancer even if it cannot cure the disease. Chemotherapy has been shown to decrease symptoms and prolong life in advanced cases of lung cancer.

Over the past decade, a series of new treatments has been developed specifically as a result of better understanding of the genetics of lung cancer and the specific abnormalities of the lung cancer cell. These agents are called targeted therapies, since they specifically target the abnormal biochemical pathways that are crucial in the development and growth of the cancer. In specialized centers, the lung cancer tissue that is removed may be tested for specific genetic (DNA) abnormalities and then treated accordingly.

Radiation therapy also may be recommended to relieve symptoms. The use of radiation is especially important in the treatment of lung cancer that has spread to the brain or that has spread to the bone and is causing pain. As mentioned above, it is also used alone or in combination with chemotherapy to treat the lung cancer that is located in the chest area as well.