When it comes to lung cancer, people sometimes think “inoperable” means “incurable.” If lung cancer is inoperable, it means that the cancer can’t be removed with surgery. Even if surgery isn’t possible or recommended, there are still other treatment options available that can shrink the cancer, slow its growth, treat the symptoms, or even cure it outright.
The factors that impact whether lung cancer may be treated with surgery include:
- the type of lung cancer
- the stage of the cancer at diagnosis
- the location of the primary tumor
- if cancer has spread (metastasized) outside of the chest
- overall health
Surgical intervention — and patient survival — is dependent on determining the type and stage of the cancer as early as possible. Surgery is usually only recommended if the lung cancer hasn’t progressed outside of the lung. Early-stage lung cancer is very difficult to detect. Around 40 percent of those with lung cancer receive a diagnosis in an advanced stage when surgery isn’t recommended.
There are two types of lung cancer:
- small cell lung cancer, which makes up about 10 to 15 percent of lung cancer patients
- non-small cell lung cancer, which makes up about 80 to 85 percent of lung cancer patients
Since small cell lung cancer tends to spread very quickly, surgery usually isn’t recommended unless the cancer is discovered very early. This type of cancer tends to respond better to chemotherapy and radiation therapy.
Surgery for non-small cell lung cancer is more common. However, surgery is dependent on the stage of the cancer when it’s first diagnosed.
The stages of each type of cancer are determined by the location and spread of the cancer.
Stages of small cell lung cancer
- Limited. Cancer is confined to one side of the chest, in one part of the lung, and may include nearby lymph nodes.
- Extended. Cancer has spread to other parts of the chest or metastasized to other organs.
Stages of non-small cell lung cancer
- Stage 1. Cancer is located only in the lungs.
- Stage 2. Cancer is in the lungs and nearby lymph nodes.
- Stage 3. Cancer is in the lungs and lymph nodes in the middle of the chest. Two subtypes of this stage are:
- Stage 3a. Cancer has spread to lymph nodes on the same side of the chest where the cancer started.
- Stage 3b. Cancer has spread to lymph nodes on the opposite side of the chest where the cancer started.
- Stage 4. Cancer has spread to both lungs and may have metastasized to other organs.
The stages with the most likely potential for surgery are the limited stage, and stages 1, 2, and 3a. This is because the cancer hasn’t spread too far from where the cancer originally started. The more it spreads, the more difficult it is to treat.
Survival rates for lung cancer vary greatly depending on type of cancer and stage at diagnosis. Non-small cell lung cancer has a higher survival rate at all stages as compared with small-cell lung cancer, and both have poor prognoses when diagnosed at later stages.
While there’s no cure, the two most common treatment options are:
- Radiation therapy. Also known as radiotherapy, this treatment is used to beam concentrated bursts of radiation directly onto cancerous sites.
- Chemotherapy. This treatment is injected into the blood vessels to travel to the lungs to work throughout the body.
While chemotherapy is less targeted than radiotherapy, treatment for inoperable lung cancer can include both of these treatments at the same time.
Getting a diagnosis of inoperable lung cancer isn’t necessarily a death sentence. With early intervention and the right treatment plan, those with lung cancer can work toward a reasonable quality of life and symptom management to increase their chances for survival.