Atrium Health Navicent Specialty Center

Thoracic Cancer Surgery

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Essential Facts About Thoracic Cancer Surgery

Thoracic cancer surgery is a catchall phrase that refers to any type of operation performed to remove cancer from any organs in the chest cavity, such as the esophagus, lungs or heart. An oncologist surgeon who specializes in the removal of cancerous tissue completes such surgery. Thoracic surgery is also frequently used to repair or assess organs damaged by cancer. There are numerous types of thoracic cancers which require surgery, including those listed below:

Lung Cancer

Lung cancer is one of the leading causes of death in the United States and throughout the world. Although primarily caused by cigarette smoking, approximately 13 percent of lung cancer patients are non-smokers. Cancer of this type often advances rapidly. This makes its treatment challenging. However, a skilled surgeon can sometimes take out the affected tissue without harming the lung or interfere with its function. When this is the case, the prognosis is usually much better than it is for patients who are not good candidates for thoracic surgery. Taking out the malignant cancerous part of the lung is usually referred to as a lobectomy. If it is successful, the person may go on to live a normal life and reach old age. If the cancer is caught early, the chances of this are excellent.

Esophageal Cancer

Esophageal cancer is also smoking-related cancer, although there are other causes of the disease. These include genetic and dietary factors. For example, studies are now underway that have shown a possible link between acid reflux disease and esophageal cancer. An oncology specialist can perform various procedures to remove any esophageal tumors and cut away some of the surrounding tissue. The latter is done to ensure that all of the malignant cells have been removed.

Mediastinal Tumors

Mediastinal tumors are growths that form in the part of the chest that separates the chest wall from the lungs. Such tumors can be benign or malignant, but because of the area where they form, they must be removed or the person's life is at stake. The spine in back and the breastbone in front surround this area, which is referred to by doctors as the mediastinum. On either side of this area is a lung. However, the mediastinum contains other organs as well as the lungs, such as the trachea, thymus, esophagus, and heart.

Tumors of this kind are typically comprised of germ reproductive cells that often develop in the soft tissue or nerves. Although sometimes fatal, if a diagnosis is sought early and a skilled oncologist surgeon successfully completes treatment, the prognosis is often quite good.


Mesothelioma is a type of lung cancer that is directly related to asbestos exposure. Many individuals who worked in shipyards, car-manufacturing plants or at construction sites for long periods of time developed this disease later in life. In its latency period, this refers to the time between the initial exposures to asbestos and when the disease first manifests, is quite long. In certain cases, the latency period may be as long as 40 years. For quite some time, this made it difficult for oncology specialists to gather statistics.

Surgery for mesothelioma typically involves removing all or part of the affected lung. If tumors are present in both lungs, the surgeon usually removes as much tissue as possible without destroying lung function. As with all types of lung cancer, surgery is generally completed in conjunction with chemotherapy to ensure the best possible outcome.

Chest Wall Tumors

Chest wall tumors, as their name implies, are tumors that grow in the smooth muscle or in the nerve bundles located in the chest cavity. Unlike most cancers, pain is often an early symptom, as the tumors press on surrounding tissues or blood vessels. A skilled oncologist can perform surgery to remove the tumors, after which further tests are usually ordered. These tests help the doctor to determine if any cancer cells have spread to other areas of the body.

Stent Insertion or Tracheal Resection

Tracheal resection or stent insertion is two types of thoracic surgeries that are performed to enlarge a narrow airway. With stent insertion, a small coil or piece of metal is inserted into the person's airway trachea to keep the area opened and unobstructed. Tracheal resection is somewhat different, and this involves "rerouting" part of the tracheal tube to a different area of the lung. Regardless of which procedure the surgeon recommends, the goal is the same: to remove obstructions and increase oxygen levels by freeing up the patient's airway.

Types of Thoracic Cancer Surgeries

A surgeon who specializes in cancer operations can perform thoracic cancer surgery in one of the several ways. One of the newest options is Video-Assisted Thoracic Surgery, also simply referred to as VATS. During this procedure, the surgeon inserts a thin, long tube through a small incision in the patient's chest. The tube is attached to a camera, which is called a thoracoscope. The surgeon completes the operation while watching the thoracoscope on a high-resolution monitor.

Robotic thoracic cancer surgery is also an option and is somewhat similar to VATS. During this type of procedure, the surgeon can see the site of the operation through a camera inserted into the chest. He or she then proceeds to operate at a console using controls that translate the movements of the surgeon's fingers, wrists, and hands to the instrument inserted in the chest. Therefore, a "robot" is essentially completing the surgery, but it is guided 100 percent by the actual surgeon's hands.

Open surgery methods include traditional surgical procedures where an incision is made in the skin and layers of fat and muscle are held with retractors while the surgeon operates. This type of surgery is the most common of all thoracic cancer surgeries, but the newer approaches are gaining popularity among many oncologists. A patient's surgeon is the best person to determine which technique is best for his or her individual situation and long-term health goals.