Lung cancer surgery and its staging

Understanding lung cancer
Tumors that start in the lung are divided into two main groups: non-small cell lung cancer and small cell lung cancer, depending on how the cells involved look when observed under a microscope. These two types of lung cancer grow and metastasize in different ways, that is, they behave differently and, as such, are also treated differently.
Non-small cell lung cancer is more common than small cell lung cancer and generally grows and metastasizes more slowly, that is, it is less aggressive. Small cell lung cancer is less common than non-small cell lung cancer. This type of tumor grows more quickly and is more likely to metastasize to other organs.
Epidemiology
Lung cancer has been the most common cancer in the world for several decades. It accounts for 13% of new cancer cases each year. In Portugal, its incidence is around 30 cases per 100,000 inhabitants per year.
Lung cancer is also the most common cause of cancer death, accounting for almost 20% of cancer deaths. In Portugal, as in the rest of the world, the survival rate of these patients is one of the lowest among all cancers.
Smoking is the main risk factor for lung cancer. Between 80 and 90% of lung cancer patients smoke or have smoked. Tobacco is thought to cause 70% of lung cancers, but only 20% of smokers develop lung cancer.
Prevention and early diagnosis
Preventing lung cancer involves adopting healthy habits, such as not smoking and avoiding smoky environments. It also involves being alert to the symptoms of the disease and should consult your doctor if you experience any.
If you are a regular smoker, you should have regular check-ups with your family doctor or a pulmonologist to diagnose lung cancer early.
Symptoms
The symptoms of lung cancer are not exclusive; they can appear in other diseases. The fact that you have one or more of the symptoms described here does not mean that you have lung cancer.
You should be alert and consult your doctor if you have the following symptoms:

• pneumonia that does not go away;
• chest pain;
• shortness of breath;
• coughing up blood.
  Diagnosis
  The most frequently used tests to diagnose lung cancer are imaging tests such as X-rays, Computerized Axial Tomography (CT) and fiberoptic bronchoscopy. If the results of these tests indicate a suspicion of lung cancer, a lung biopsy will be necessary for evaluation by Pathological Anatomy, the only way to confirm the diagnosis of the disease.
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  Treatment
  The vast majority of patients diagnosed with lung cancer are diagnosed in advanced stages of the disease and are not candidates for curative treatment.
  Approximately 9% of all lung cancer patients are diagnosed at an early stage and are immediate candidates for curative treatment. Combinations of chemotherapy and/or radiotherapy are adjuvant strategies that allow an additional percentage of approximately 6% to be recovered for curative treatment. Thus, approximately 15% of all lung cancer patients can benefit from curative treatment, which consequently increases their quality of life and survival expectancy.
  The only curative treatment available is SURGERY.
  Surgery
  Video-assisted thoracoscopic surgery (VATS) has revolutionized the way surgeons diagnose and treat lung disease, ushering in a new era of progress and development in thoracic surgery. Technical advances have made it possible to perform anatomical lung resections for the treatment of lung cancer using a minimally invasive approach, through a reduced number of access ports and without the need for a rib retractor. The number of anatomical lung resections performed using this approach has grown exponentially throughout Europe, becoming the approach of choice in many referral centers.
  At the Cardiothoracic Surgery Department of CHVNG/E, we have a specialized team trained to treat lung cancer using a single-port approach of approximately 3 to 4 cm (Uniportal VATS).

The benefits of this approach include:

• Less pain
• Better aesthetic and functional results
• Shorter hospital stay
• Faster recovery and return to normal daily activities