A cardiothoracic surgeon is well-versed to treat lung cancer patients. Thoracic surgery is part and parcel of cardiothoracic surgeon treatment.
Thoracic surgery also referred to as chest surgery, can be used to diagnose or even repair lungs affected by cancer, trauma, or pulmonary disease. For lung cancer, the surgeon may remove nodules, tumors, and lymph nodes to diagnose stage and treat the disease. The cardiothoracic surgeon treats the patient with care and concern.
Cardiothoracic surgery happens to be the field of medicine involved in the surgical treatment of organs inside the thoracic cavity, usually, the treatment of conditions of the heart, lungs, and other pleural or even media. For lung cancer as a chronic disease, surgery happens to be the need of the hour as it requires the anticipation of future disease evolution by sparing lung tissue and also preserving lung function, while an oncologic complete resection must be performed. Cardiothoracic surgeon treatment is the need of the hour.
Lung cancer happens to be a disease that is usually identified too late for treatment with curative intent. Lung cancer evolutions, innovative systemic treatments, minimally invasive thoracic surgery approaches as well as peri-operative medical care have changed the role of surgery in the treatment of lung cancer.
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Why is surgery required for early lung cancer? This is so as it is usually low-risk, cost-effective with excellent patient-related outcomes, and can be performed with minimal morbidity. Several innovations are being introduced, aimed at changing the paradigm of late presentation, high morbidity as well as low cure rates. A multi-pronged approach is taken to tackle lung cancer.
Patients diagnosed with lung cancer are of course more managed by specialist multidisciplinary teams, to ensure that they do receive appropriate treatment.
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The impact of enhanced recovery
The focus is on shorter discharge and other benefits by mobilizing the patient on the day of surgery and changing their expectations to one of very early discharge that need not be underestimated. Part of this has emerged from the availability of ambulatory chest drain systems which incidentally do deliver controlled suction and can safely discharge patients with their chest drain in place.
Minimally invasive surgery
When it comes to surgical practice for early lung cancer as well as selected cases of more advanced disease, there has been indeed a major shift towards minimally invasive surgery. Video-assisted thoracoscopic surgery for lung cancer is more in demand nowadays.
There are no contemporary high-quality trials that indicate one surgical approach is better than the other. The pace of development is so, that new techniques are being promoted and also popularized via the Internet and social media.
Surgery for more advanced disease
As the number of dedicated thoracic surgeons has increased over some time, resection rates have risen. There is increased confidence among thoracic surgeons to offer surgery for locally advanced diseases (such as Pancoast tumors, invasion of the chest wall, and sleeve resections) and also after induction treatment or after relapsed disease. This does include treatment by less invasive techniques.
In experienced centers, advanced surgical techniques are being performed for more locally advanced lung cancer, with the aid of adjuncts like extracorporeal membrane oxygenation and cardiopulmonary bypass. These techniques do provide a controlled environment for advanced tracheal resections and also resections involving the great vessels.
Surgical advances combined with no doubt more thoracic surgeons, enhanced recovery, and also advanced thoracic anesthesia have rather extended the profile of patients deemed ‘operable’. Older as well as frailer patients, with poorer lung function and more co-morbidity are now being offered surgery with excellent outcomes.
Demonstration of just how far thoracic surgery with enhanced recovery has come can be evidenced by examining the successful outcomes of modern lung volume reduction surgery. Such patients, previously considered inoperable, are now a group who see some of the greatest benefits of thoracic surgery.
Conclusions
The cardiothoracic surgeon has a major responsibility in treating patients with lung cancer.