Advances in Lung Cancer Care

World Lung Cancer Day is on August 1st to Raise Awareness of Lung Cancer

Medical experts at Montefiore Medical Center are trying to raise awareness to the detection and treatment for lung cancer. -File Photo

By Neel P. Chudgar, M.D., associate director, Clinical & Translational Research, Thoracic Surgery at Montefiore Einstein Cancer Center & Assistant Professor of Cardiothoracic and Vascular Surgery at Albert Einstein College of Medicine 

Bronx Voice 

July 27, 2023 

HEALTH - World Lung Cancer Day is observed every year on August 1 to raise awareness of lung cancer and, for us, to reflect on where we are when it comes to both research and treatment of this disease. Of all cancers, lung cancer is the leading cause of death both in our country and New York. Lung cancer is also a leading cause of disability among cancers, which makes finding new ways to treat this disease of the utmost importance. 

Though reports of lung cancer date back to more than 100 years ago, in the last few years, treatment of the disease is getting markedly better. With the ability to detect cancers at earlier stages, more people are getting access to surgical therapies, and for some people, this treatment can curative. While undergoing surgery can understandably be frightening, surgical management of this disease has dramatically evolved over the past decade.

The Evolution of Surgery for Lung Cancer

Evaluation of a national database of people treated for lung cancer has demonstrated a shift in how cancers are removed. Prior to 2010, more than two-thirds of patients would undergo lung removal surgically by thoracotomy, an operation where a large incision across the chest is made, and the ribs are spread to access the chest cavity. In contrast to these more painful procedures, the majority of cases are currently performed with small incisions, either robotically or using video-assisted thoracoscopic surgery (VATS), meaning with a camera and telescopic instruments. 

Neel P. Chudgar, M.D., associate director, Clinical & Translational Research, Thoracic Surgery at Montefiore Einstein Cancer Center & Assistant Professor of Cardiothoracic and Vascular Surgery at Albert Einstein College of Medicine 

While minimally-invasive surgery has been long supported and practiced, recent data has found that people who undergo lung surgery using VATS, had quicker recovery after surgery when compared to people undergoing traditional open procedures. Similarly, no differences in survival have been noted in individuals who have been appropriately selected to have surgery by minimally-invasive techniques.

These types of “small incision” surgeries have gained great popularity in recent times, and there has been a surge in the robotics over the last decade. 

While robotic surgery and VATS are both types of minimally-invasive operations, the robotic platform is a newer technology that has gained great popularity amongst surgeons. With improved three-dimensional visualization along with specialized instruments that allow for incredibly precise movements, the robotic system, which has surged in popularity, will almost certainly become the most used form of minimally-invasive thoracic surgery. 

‘Why Less-is-More’

In addition to updates in how operations are performed, there has also been more data to support a “less-is-more” approach regarding the amount of lung needing to be removed. While removing a full lobe of the lung, or lobectomy, has been seen as the gold standard for lung cancer surgery in the past, we are seeing that certain individuals can be treated with smaller resections. Two recent trials have demonstrated that some patients with small tumors, less than two-centimeters in size and located in the outer portion of the lung, can have a sublobar or partial lung resection, which allows more of the lung to be preserved. This advance may enable surgery to be offered to more people with reduced lung function who would not otherwise tolerate lobectomy, a surgical procedure where an entire lobe/section of the lung is removed. 

At Montefiore Einstein Cancer Center, we offer the most evidence-based lung cancer care to our community. In just two years, our thoracic surgery team has completed 200 robotic-assisted operations. Moreover, the vast majority of surgeries performed for lung cancer are minimally-invasive, allowing our community members to return to their normal lives sooner. 

As we approach World Lung Cancer Day, we couldn’t be prouder to announce that our fast-growing program will soon perform its 100^th robotic anatomic lung resection, whereby a portion of the lung with its corresponding vascular and airway anatomy is removed. These operations provide technically demanding and high-quality cancer care, and our institution is thrilled to provide high volume, world class care. Equally exciting is that nearly half of these procedures are sublobar resections, meaning we can save more lung.

I have no doubt that the future of lung cancer care will undoubtedly bring more hope to the horizon. We look forward to sharing more details about new milestones in lung cancer treatment. In the meanwhile, if you are 50 or older and currently smoke or have smoked in the past, talk to your doctor about lung cancer screening today.