The Benefits of Minimally Invasive Surgical Options for Lung Cancer

A diagnosis of lung cancer can leave you and your loved ones with a lot of questions, as well as fears. What treatment options are available? How will you recover? What will your quality of life be like?

For lung cancer patients, there is good news on the horizon. Recent innovations in minimally invasive surgical approaches are presenting more positive outcomes than what has been available in the past.

How is a minimally invasive approach different from traditional lung cancer surgery? And what benefits are patients seeing, as a result?

Traditional Approach to Lung Cancer Surgery

Unfortunately, this approach, known as a thoracotomy for lobectomy of the lung –in which the cancerous anatomical portion of the lung is removed – puts pressure on the ribs, as well as the underlying nerves causing significant pain for patients during recovery and for some patients, the pain is permanent. Moreover, this pain puts patients at increased risk for post-surgical health issues, including pneumonia.

How the Minimally Invasive Approach Works

Instead of relying upon one large incision and spreading the ribs, a minimally invasive approach only requires a few small incisions in which a camera and small surgical instruments are inserted.

Benefits for Lung Cancer Patients

Minimally invasive surgery translates into less pain for patients, as well as shorter recovery/healing time. This not only allows patients to return home within a day or two of their procedure, they are also able to return to their normal lives and routines with greater speed. This decreased recovery window enables doctors to administer follow-up treatments sooner.

Patients that might otherwise have been considered ineligible for surgery now have a new minimally invasive treatment option available to them. For example, patients with diminished lung function or emphysema – who might not have been eligible for more traditional surgical approaches – now can be considered for minimally invasive surgery.

Start by Having a Conversation

Don’t write off surgery. Given the advancements for lung cancer patients available today, talk to your doctor, you may have more options than you realize.

As a surgeon, I find it very rewarding to see a patient after surgery. They often look like they haven't had an operation and in a few cases, patients say they feel like they haven't even had an operation at all. With the minimally invasive approaches, they have a minimal amount of pain and recovery. What could be better than that?

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.

Targeted Therapies for Specific Types of Lung Cancer

For some people who have lung cancer, immunotherapy can be an effective tool because it relies on the body's immune system to eliminate cancer cells. Targeted therapies, on the other hand, do not directly affect the immune system; instead, they directly attack specific cancerous cells. Targeted therapy is meant for a small, defined population of lung cancer patients.

Targeted therapy acknowledges that lung cancer is not one diseaseThere are dozens of types of lung cancer, and each behaves differently. These different types of cancers require individualized types of treatment.

As medicine has come to understand those differences more completely, targeted therapies have been developed to address and treat the various types of lung cancer.

What You Should Know About Targeted Therapy

When it comes to targeted therapy, most of the questions people have are about the testing itself. Since targeted therapy uses medication that attacks specific components of a tumor's DNA, the first step is to determine whether a tumor will react to the regimen. This requires testing of the tumor through a biopsy. The biopsy may be tested on-site or may be sent out to another institution, but results are generally available in a matter of days.

When the biopsy reveals a mutation, an oncologist will work with you to determine which type of targeted therapy will be most effective against that particular mutation.

You should know that there are three specific DNA mutations for which the FDA has approved drugs for advanced lung cancer. These drugs are superior to chemotherapy and can begin working immediately. They typically come in the form of a pill taken once or twice a day and offer better responses than chemotherapy.

Even if the mutations that doctors expect are not present, your doctor can work with you to search for other mutations that can be treated with targeted therapies. Otherwise, you may move on to chemotherapy, an appropriate treatment approach.

Keep in mind that there may also be clinical trials that are available to patients with certain types of mutations.

How Targeted Therapies Influence Patient Care

Today, standard DNA and biopsy tests should be done on virtually everyone with lung cancer in the United States. Be aware that insurance may not cover more advanced tests, and that out-of-pocket expenses can be high. Don't despair, there are many assistance programs designed to help people afford advanced testing.

While advanced targeted therapies can work very well, they are not a "cure," and it is important for patients to temper their expectations accordingly. If a particular drug stops working, doctors will determine how the target has changed, and address the new reality accordingly.

While targeted therapies are effective for only a small percentage of lung cancer patients, they can be a well-tolerated and efficient form of medication that is intended for long-term administration. While they do not "cure" cancer, they can offer a durable solution that opens up a whole new cabinet of potential treatments for lung cancer patients.

As time goes on, doctors hope to identify more mutations and to offer more specific, targeted therapies to help improve the prognosis for other lung cancer patients.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.

Immunotherapy and Its Evolving Role with Lung Cancer Treatment

Immunotherapy is a promising treatment for lung cancer. The concept isn’t new. Since the 1970s, doctors have turned to medicine as a tool to stimulate the immune system’s defensive response to cancer. In the past, immunotherapy was used to treat kidney cancer and melanoma.

It is only recently that researchers have found ways to apply the same principles to treating certain types of lung cancer.

Changing the Treatment Outlook for Lung Cancer

Although there are several treatment options doctors can use to treat lung cancer, it isn’t unusual for these cancers to stop responding to chemotherapy after a few months. Fortunately, medical research indicates that immunotherapy might be an option when other methods of treatment prove ineffective.

In 2012, researchers reported encouraging results in a small percentage of people who used immunotherapy to treat non-small cell lung cancer. Other studies involved subsets of patients who lived for many years after receiving immunotherapy when their cancer did not respond to chemotherapy.

Whereas most developments in cancer care produce marginal improvements, immunotherapy has proven to offer dramatic, durable benefits to a limited group of patients. In fact, some patients have lived for several years beyond what would have been possible with conventional treatments.

Some patients in these groups tolerate immunotherapy medicines better than chemotherapy drugs, with fewer side effects, which means they can fight their cancer while enjoying a better quality of life.

Limitations of Immunotherapy

The challenge with immunotherapy is that it seems to work only for a minority of cancer patients. Doctors don’t always know which patients will respond to immunotherapy, although several medical studies are underway to identify which cancers and which patients respond to different immunotherapies.

Research has shown that some cancers express a particular protein called PD-L1 that predicts response to certain immunotherapy drugs. This test can be ordered by your physician.

Who Does Immunotherapy Work For?

For patients whose lung cancer expresses PD-L1, a recent study has shown immunotherapy with a drug called pembrolizumab was superior to chemotherapy as the first treatment for advanced lung cancer.

For other patients, chemotherapy may be the preferred treatment but when chemotherapy stops working, immunotherapy, with drugs like pembrolizumab, nivolumab, or atezolizumab, may be a good option. In this setting, immunotherapy would be expected to work for about 20 percent of patients. Doctors are not sure if the other 80 percent of patients will respond to other types of immunotherapy.

Clinical trials are currently studying the effects of new immunotherapy drugs and new combinations, which could become available soon.

Is Immunotherapy Right for You?

Immunotherapy isn’t right for everyone with lung cancer. If you have a serious autoimmune condition, it’s less likely to be a suitable treatment option for you. In fact, it could make your condition worse. Depending on the type of lung cancer you have, there might be other treatments that your oncologist would prefer to use instead.

Don’t rule out asking your oncologist if immunotherapy is an option for you. Most doctors are happy to discuss all available treatments with their patients and explain why they are or are not suitable. You might even be a candidate to join a clinical trial for a new immunotherapy drug.

Final Thought

If you have nonsmall-cell lung cancer, talk to your oncologist about immunotherapy. This treatment may be a good option if other treatments aren’t working for you. With new immunotherapy drugs in development, there may be an emerging medicine - or combinations of medicines - that could help control your cancer or send it into remission.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.