What is the Treatment for Lung Metastasis?
- varies depending on the location of the metastatic mass,
- the number of metastases,
- general condition of the patient, and
- whether the tumor that cause metastasis has been completely or partially cured.
Because metastasis surgery is not applicable for most patients, generally chemotherapy is applied for metastases. In some rare cases, radiation therapy may be needed, as
The photo shows the lung metastasis that occurred in the left lung, 3 years after the malignant melanoma treatment of our 39-year-old female patient.
Why is Metastasis Surgery Needed?
Surgery should always be the first option in the treatment of lung metastases because complete removal of metastatic masses, and ensuring that no metastatic mass was left behind mostly provides complete cure.
The decision on surgery should be taken by oncologists, pulmonologists and thoracic surgeons in consultation with each other.
Which patients with lung metastasis are operable?
- Metastatic cancer should be completely cured (with surgery, drugs or radiotherapy). The physician, who applies the main treatment, should state that the cancer is no longer exists in the body (for example, in a patient treated with surgery and chemotherapy for breast cancer).
- Metastasis should not exist in any place of the body, other than the lung.
- Respiratory functions of the patient should be at an adequate level for surgery.
- Health lung tissues in an amount adequate for a health life should remain after the removal of the metastases from the
In addition, the type of the tumor, longness or shortness of the time elapsed between the first emergences of the cancer and the metastasis, as well as the parameters related to the general condition of the patient, are other important factors for making a decision about surgery.
What do the International Sources Recommend about Lung Metastasis?
Surgical treatment of metastases in the lung under certain rules is a method recommended by all international sources. In international sources, it is recommended to prefer surgical removal of lung metastases as long as possible. The disease-free survival period of patients treated with surgery has been proven to be much better than that of those who had medical treatment.
Decision on surgery should be taken with the approval of an oncologist or an oncology council!
What are the Surgical Methods for Lung Metastasis?
- Removal of the metastatic mass only,
- Removal of the segment,
- Removal of the lobe where it exists or
- Removal of the entire lung (very rare).
Removal of metastasis with open-surgery method is preferred. Closed surgery / surgery, i.e. VATS method is thought be possibly fail in detecting very small metastases. Therefore, mostly open surgery method is used in metastasis surgeries.
What are the Risks of Surgery?
- Prolonged air leak from the lungs,
- Risks associated with receiving anesthesia (such as having a heart attack, and blockage of a blood vessel by a clot) and
- Infection can be listed as its risks.
How Many Days of Stay in Hospital is Required for Surgery?
The average length of stay in hospital for a lung metastasis surgery is 3 to 4 days.
How a Lung Metastasis Surgery is Done?
The method recommended for metastasis surgeries is open-surgery method, i.e. thoracotomy. Since closed technique has a limited ability to detect some very small metastatic lesions of the lung tissue that can be detected only by manual examination, some metastases may not be noticed.
Therefore, the lung tissue is examined by hand after making an opening between the ribs, and then all the detected nodules are removed one by one with staple, laser or cautery, and the resultant defects are closed. After completing the process and making sure that no metastasis was left behind, the lung is controlled for any possible air leak, 1 drain is placed, and then the scar is closed in accordance with the anatomical layout.
In the following instructive video, you can watch a lung metastases surgery that we performed.
Will Radiotherapy or Chemotherapy be Needed after Surgery?
Chemotherapy and/or radiotherapy can be applied in addition to surgical treatment, depending on the pathology result and whether the lung metastasis was fully removed.