Jason M. Wallen, MD, MBA, FACS, FCCP, associate professor of surgery, division chief of thoracic surgery, director of gastric and esophageal cancer program, medical director of the thoracic oncology program, Upstate University Hospital, discusses the role of surgery in patients with advanced-stage lung cancer.

The role of surgery beyond early-stage disease is mostly palliative, Wallen says. Surgery tends to drop off the treatment radar as patients transition into stage III and IV disease, although there are some cases where this type of therapy is an option in stage III disease. With that being said, patients with stage III lung cancer who undergo surgery should not expect dramatic benefit. In these settings, chemotherapies, targeted therapies, and immunotherapies have become the standards of care.

As lung cancer becomes more advanced, symptoms may arise that are difficult to control with chemotherapy alone, or patients may progress despite systemic therapy, Wallen adds. In these cases, surgeons can be called upon to help, especially with regard to pleural effusions, which occur when fluid builds up around the lung causing it to collapse.

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Dr. Wallen on Surgery in Patients With Advanced Lung Cancer

Jason M. Wallen, MD, MBA, FACS, FCCP, associate professor of surgery, division chief of thoracic surgery, director of gastric and esophageal cancer program, medical director of the thoracic oncology program, Upstate University Hospital, discusses technological advances made in non—small cell lung cancer (NSCLC).

Endobronchial ultrasounds and bronchoscopies can be used to stage patients. In terms of more recent advances, electromagnetic navigation can be used for bronchoscopy and percutaneous needle biopsy with portable, user-friendly equipment, allowing for several procedures to be performed with a single set of equipment, says Wallen. Previously, several procedures were necessary to appropriately diagnose and stage a patient. Now, these assessments can be done on a single day in a single setting.

Regarding surgery, minimally invasive techniques are now standard of care. Robotic surgery, explains Wallen, is newer to the field, and allows for more complex surgeries. In terms of palliation, technologies have remained fairly consistent, although emerging techniques with laser therapy have been shown to have a positive impact on patients’ quality of life, concludes Wallen.

Jason M. Wallen, MD, MBA, FACS, FCCP, associate professor of surgery, division chief of thoracic surgery, director of gastric and esophageal cancer program, medical director of the thoracic oncology program, Upstate University Hospital, discusses technological advances made in non–small cell lung cancer (NSCLC).

Jason M. Wallen, MD, MBA, FACS, FCCP

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Dr. Wallen on Surgery in Patients With Advanced Lung Cancer

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