Should you have surgery? Can I have surgery?
This question is important and sometimes can be complicated. The discussions about you and what should be done are an important part of the work of the lung cancer team. If you have a cancer which can be safely completely removed, surgery should be considered. But in order to decide whether surgery is an option for you, several questions need to be answered:
- The first question we ask is, “What type of cancer do you have?” Did the cancer originate in the lung, or did it start somewhere else and spread to the lung? If it started somewhere else, then it is not a lung cancer and treatment would be different. If it is a lung cancer, there are 3 major types – adenocarcinoma, squamous cell carcinoma, and small cell lung cancer. Each of these has different treatment pathways. For example, if you have small cell cancer, surgery almost never helps and is very unlikely to be recommended.
- The second question we ask is, “What is the stage of your cancer?” Stage involves how big the cancer is, exactly where it is located, and the extent to which it has spread. Staging affects treatment options. For example, a stage 1 squamous cell cancer can usually be treated surgically, whereas chemotherapy and radiation combined might be the best choice for a stage 4 adenocarcinoma.If you would benefit from surgery, you may be a candidate for “VATS,” or video-assisted thoracoscopic surgery. This is a minimally invasive approach to the chest for which Dr. Steliga has special training. It is not available in most of Arkansas.
- The third question is about your overall health and lung function. This also affects your treatment choices. For example if you have a stage 1 cancer but your lung function is very poor then we may offer you a different specialized treatment option, ablation, in which the cells in the area of the cancer are frozen or heated in order to kill them.
What about chemotherapy and radiation therapy?
These two treatments are listed together because they are often used together to get the best possible outcome. When an operation is not what is best for you (or sometimes even when it is), a team of dedicated experts will discuss the possibility of treatment with chemotherapy and/or radiation. All of our team members use state-of-the-art approaches to lung cancer.
I need something not mentioned here. What should I do?
You should ask. There are other possible treatments available at UAMS.
What about clinical trials?
At UAMS, clinical research is just another way we are working toward improving the health of patients throughout Arkansas and the world. Our lung cancer team has access to more clinical trials than any other clinic in the state.
For both patients and doctors, trials offer a chance to gain access to new experimental drugs or procedures and devices before they are commonly available. If you are eligible for a clinical trial, your team will discuss options with you as part of your personalized treatment plan.
What about second opinions?
Our multidisciplinary team of experts welcomes patients with lung cancer who may be seeking a second opinion. This is an important role of an academic lung cancer center. Our team includes pulmonary, surgery, oncology, pathology, radiology, radiation therapy and palliative care physicians.
Cancer therapy is not working for my family member. Can you help?
Yes we can help. In two ways. First, we can offer a second opinion, as mentioned above. If there is more that we can do, we can offer that. Second, if our team agrees aggressive treatment options are no longer effective, we can ask our Palliative Care team to talk with your family member. Palliative care doctors relieve pain, improve function, and improve the quality of life for patients regardless of diagnosis and stage.
In conclusion, if you think you might have lung cancer or know that you do, the UAMS lung cancer team can work with you to form a personalized diagnostic or treatment plan. Because we are the only cancer center and academic hospital in the state of Arkansas, we have advanced therapies not available elsewhere in the state. A member of our lung cancer team can be reached through the number listed above.