Thoracic Oncology

For cancer of the oesophagus and heart, surgery is the standard of care for medically fit patients. Patients with locally advanced disease are downstaged with chemotherapy or a combination of chemo and radiation therapy and are then re-assessed for surgery. Patients with advanced cancer and poor general condition are palliated with a self-expanding stent.

Surgery provides the best chance of cure for early stage lung cancer. Surgical options include lobectomy, sleeve lobectomy and pneumonectomy. In patients with compromised lung function, segmentectomy or wedge resection is an option in selected cases. To improve the operative outcome, surgery can be performed using the video-assisted thoracoscopic technique in cases where indicated. Mediastinaladenopathy is not a contraindication for surgery as many of these patients can be downstaged by induction chemotherapy. Patients with locally advanced cancer, such as those with invasion of the chest wall, vascular structures and tracheo-bronchial tree, can be considered for aggressive surgical approaches. Patients with advanced stage disease are treated with a combination of chemotherapy, radiation, pleurodesis and are provided supportive care, including management of cancer pain.