Lung cancer is the leading cancer killer in both men and women in the United States. In fact, it causes more deaths than colorectal, breast, and prostate cancers combined. Lung cancer, however, can come in many different forms — and because of that, a combination of various treatment types may be necessary.
One type of lung cancer treatment that may not be as well known to the general public is the minimally invasive pneumonectomy. This cutting-edge surgical procedure has been shown to be an effective option for some lung cancer patients.
An article published in the September 2015 issue of the Annals of Thoracic Surgery reviewed a new study and statistical model that may help predict which malignant pleural mesothelioma (a rare, deadly form of lung cancer) patients are most likely to extend their lives with surgical treatment. The researchers studied mesothelioma patients who had undergone an aggressive type of pneumonectomy. They were able to build a scoring system that could help doctors identify which patients may be the best candidates for not only undergoing a pneumonectomy, but successfully extending their lives.
What Is a Minimally Invasive Pneumonectomy Procedure?
A pneumonectomy is a type of surgical procedure in which an entire lung is removed. Though the concept may seem scary, it is completely possible to live a fairly normal life with 1 lung — respiratory function becomes reduced and physical tasks will be more difficult, but otherwise-healthy post-pneumonectomy patients still have about 70 to 80% of their pre-surgical respiratory function. As an example, Pope Francis has led quite a successful life and he has been living with 1 lung since he suffered an infection as a teenager that caused him to have his lung removed.
By getting rid of the cancerous lung, the goal is to prevent the cancer from growing or spreading to other parts of the body. With a traditional pneumonectomy, the chest is cut open and the lung is removed. It is a very invasive procedure and recovery can be quite painful.
With a minimally invasive pneumonectomy, however, surgeons perform Video-Assisted Thoracic Surgery (VATS). Small incisions are made to provide access to the chest cavity without spreading a patient’s ribs, allowing the surgeon to easily see inside using a tiny camera. By leaving the ribs alone, most patients are able to experience a quicker recovery with less pain.
In a 2013 study called “Maximizing the benefit of minimally invasive surgery,” researchers noted that the benefits generally included “less postoperative pain, fewer operative and post-operative major complications, shortened hospital stay, faster recovery times, less scarring, less stress on the immune system, and smaller incision.”
In an online video, speaking on behalf of the Global Resource for Advancing Cancer Education (GRACE), thoracic surgeon, Dr. Eric Vallières, provides his perspective on who seems to benefit the most from minimally invasive surgery. And his answer is: the older population. Dr. Vallières said:
“…the advantages of that [minimally invasive surgery] are dominant in the older patients. The main reason is they don’t hurt as much, and because they don’t hurt as much, they don’t need as much pain medication, and as a result, they don’t run into the complications that some older folks will run into when they take narcotics – confusion, and everything else that comes in. So, minimally invasive surgery — big asset for the older crowd, no doubt in my mind about that.”
Who May Qualify for a Pneumonectomy?
Surgery is generally considered to be an option for patients who have non-small cell lung cancer, which is also the most common type of lung cancer. About 85% of lung cancers are non-small cell lung cancers. A doctor may recommend a pneumonectomy if the tumor is in a central area of the lung and involves either the 2 lobes on the left, or the 3 lobes on the right. With mesothelioma patients, doctors may recommend a more aggressive extrapleural pneumonectomy, which not only removes a lung, but the affected chest lining, the diaphragm, and the heart lining as well.
What Are the Possible Disadvantages of a Minimally Invasive Pneumonectomy?
The main disadvantages of a minimally invasive pneumonectomy revolve around the fact that the procedure is still fairly new and there may be a bit of a learning curve for doctors. Additionally, because the procedure is not completely common yet, researchers are still learning what the actual disadvantages are surrounding the surgery. However, with the recent study of pneumonectomy procedures in mesothelioma patients, it is promising to know doctors may eventually have a better way to determine which individuals with lung cancer may benefit most from a pneumonectomy.
If you or someone you love was diagnosed with mesothelioma or another type of lung cancer, don’t be afraid to ask your doctor questions. As they outline your treatment options, consider inquiring about the minimally invasive pneumonectomy and find out whether it may be a good choice in your specific situation.