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Lung Cancer

Cancer is a disease that results from abnormal growth and division of cells. Lung cancer refers to cancer that originates in the airways or lung tissue. According to the CDC, cancer is the second leading cause of death in the United States and lung cancer is the number one cause of cancer death in both men and women. It is also the second most common cancer in the US, after skin cancer. There are two types of lung cancer: small cell lung cancer (SCLC) or non small cell lung cancer (NSCLC).

Smoking is the leading risk factor causing most lung cancers, but other risks include previous radiation therapy, exposure to environmental toxins, and genetic factors. 

Signs and Symptoms can include:

  • Cough
  • Hemoptysis (bloody sputum)
  • Chest pain
  • Shortness of breath
  • Hoarseness
  • Pleural effusion(s)
  • Or a patient may be asymptomatic


Once there is concern that a patient may have lung cancer, there are multiple interventions we offer to either diagnose, stage, and/or resect the cancer.

Diagnostic Interventions include:

  • Endobronchial ultrasound (EBUS)

    An endobronchial ultrasound (EBUS) is a bronchoscopic technique that uses ultrasound to view structures within the airway, lung, and mediastinum. This approach can be used in the diagnosis and staging of lung cancer, in diagnosing mediastinal lymphadenopathy of unclear etiology, in sampling/biopsying certain pulmonary nodules and endobronchial or peribronchial lesions, and in sampling mediastinal masses. We will often perform an EBUS with fine needle aspiration (FNA) in order to sample the tissue in question. The advantage in performing an EBUS versus another form of diagnostic testing is that this procedure is minimally invasive and is usually performed under moderate sedation (not general anesthesia).

  • Electromagnetic navigational bronchoscopy (ENB)

    An electromagnetic navigational bronchoscopy (ENB) uses virtual technology and an electromagnetic field to target a distant lesion in the lung in order to obtain a biopsy. Similar to other bronchoscopies, the advantage of this procedure is that it is minimally invasive and is usually performed under moderate sedation.

  • Esophageal endoscopic ultrasound (EUS)

    An esophageal endoscopic ultrasound is a procedure where the surgeon enters the esophagus with an endoscope to view and/or biopsy esophageal masses, certain lung masses, and abnormal lymph nodes.

  • Lymph node biopsy

    A lymph node biopsy can be performed by a minimally invasive or open surgical approach. We can perform lymph node biopsies via EBUS, EUS, mediastinoscopy, or VATS. A lymph node biopsy may be indicated in order to diagnose abnormal or large lymph nodes, or for cancer staging.

  • Pleural biopsy

    A pleural biopsy is performed via a VATS. This may be indicated if a patient has a recurrent pleural effusion, irregular pleural thickening, or if other tests have not given definitive answers.

Surgical Interventions include:

  • Wedge resection

    This is a limited resection of the lung and may be done to remove early stage lung cancer or lung metastasis in patients with inadequate lung function and who have a more peripheral lesion. Think of this as cutting and removing a pie slice portion of the lung that has the lesion or area of disease. We also use this technique to remove lung blebs or bullae that have burst and caused a pneumothorax.

  • Segmentectomy

    One or more segments of the lung are removed. This may be an option for patients who have certain kinds of low grade cancers, metastases, or who have inadequate lung function and are not candidates for a lobectomy.

  • Lobectomy

    This is the standard operation for surgical treatment of lung cancer and involves removing an entire lobe of the lung. Other indications for lobectomy include tuberculosis, chronic lung abscess, bronchiectasis, benign tumors, fungal infection, and congenital anomalies.

  • Pneumonectomy

    This is the surgical removal of an entire lung. This is typically performed on patients who have large or centrally located lung cancers, or chronic infections that lead to the destruction of lung tissue.

Surgical approaches include:

  • Video assisted thoracoscopy (VATS)

    A video assisted surgery is a minimally invasive lung surgery where the surgeon creates multiple small incisions in the chest and uses a video camera that sees into the chest in order to perform the procedure. Performing a VATS procedure will accomplish the same anatomic dissection as an open thoracotomy approach.

  • Robot assisted thoracoscopy

    Robot assisted thoracic surgery is a minimally invasive lung surgery similar to a VATS, but uses a unit (or “robot”) with multiple moveable arms that are controlled by the surgeon at a separate console.

  • Open thoracotomy

    An open thoracotomy is an invasive surgical approach where the surgeon may make one or more large incisions through the chest wall to access the area(s) of concern.