“Is there a cure for lung cancer?” That is a very common question for me. We all know the statistics. Lung cancer has around a 15% five year survival rate. But the truth is in the details. The majority of patients diagnosed with lung cancer are diagnosed at an advance stage, i.e. stages III and IV (there are four stages). Only 25% of people diagnosed with lung cancer are diagnosed at the earliest stages, stages I and II. The standard of care treatment for the physically fit person with stage I and II lung cancer is surgery, or removal of part of the lung where the cancer is located. The five year survival for someone treated with surgery for Stage I lung cancer is around 80%. That means 80% of those individuals are effectively cured of their lung cancer.
This is great news right? What’s the hesitation? We all know that the information bin on lung cancer is a black box. Public awareness about lung cancer and the treatment modalities to fight it is minimal…though improving. Forums like #LCSM Chat, the American Lung Association and Addario Lung Cancer Foundation, are leading the charge to disseminate evidence-based information. But the bottom line is: people are afraid of surgery. Patients view thoracic surgery (surgery on the contents of the chest, in this case the lungs) as high risk, with potentially prohibitive complication rates. “Are you going to crack my chest open?” another common question I receive. I usually reply “You are not a walnut.”
Just as the treatment of advanced stage lung cancer has evolved (such as molecular testing, personalized therapy, immunotherapy, etc.) so has the surgical treatment for early stage lung cancer. In most cases of stage I lung cancer, surgery can be performed minimally invasively with small incisions and a high definition camera. If you had a friend who had their gall bladder removed in the past 10 years, most likely it was removed in a similar manner. With the gall bladder, it is called laparoscopic surgery. With lung cancer it is called thorascopic surgery (scopic meaning camera, thora or thorax meaning chest: chest surgery with a camera. As I tell my students, 90% of surgery is common sense; the other 10% is finding a pair of scrubs that actually fit.) Thorascopic surgery, also called video-assisted thoracic surgery or VATS, results in smaller incisions, shorter stay in the hospital, less need for pain medicine and faster return to work and activities of daily living. Moreover, VATS has the same cancer survivor results as traditional open surgery, where we have to make a larger cut and spread the ribs (again, we’re not “crackin’” anything).
On March 19th, around 10AM PT, At UC Davis we will be performing a Live Lung Cancer Surgery on Twitter (Don’t worry, we won’t be tweeting while operating, our public relations people will!). One of our patients who has a keen interest in education was excited to volunteer and share her story. She will undergo a right VATS lower lobectomy (removal of the bottom third of the right lung) for early stage lung cancer. Now the focus of this Twitter project is not the surgery itself. There are plenty of videos on YouTube that can show you how to do a VATS lobectomy (when I say “you” I mean your board certified thoracic surgeon…please leave your neighbors pets alone.). The focus of this project is of course our patient, her story, her experiences on this important day, and the clinical care processes that will support her recovery.
Our patient’s case highlights some very important issues:
1) Surgery for lung cancer has evolved. Now with minimally invasive approaches, small incisions, and state of the art treatment during and after surgery, we are able to “stack the deck” in our patients favor to ensure their successful results.
2) You only need lungs to get lung cancer. She is a never smoker, and has no appreciable risk factors.
3) Lung cancer is the number one cancer killer of women, yet only 1% of women when polled identify this fact (source: Lung Force Women’s Lung Health Barometer),
4) Up to 80% of patients with stage I of lung cancer such as hers (early stage) are cured after treatment, and that is not the public perception.
The event will follow her day through the preoperative check in process, the operation, postoperative recovery, and follow her tumor through pathology processing, and whisking the tumor off to our research folks and tissue banking group.
The surgery is March 19th around 10am PT. Please follow with the #LCSM hashtag or #UCDVATS.