What Is Unresectable Lung Cancer?

When your doctor tells you that your lung cancer is unresectable, it means you can't get surgery to treat it. It might be because your tumor is in a hard-to-reach spot or for other reasons, like your cancer has spread outside your lungs.

But just because you can't have surgery doesn't mean you can't do anything for your lung cancer. Treatments like radiation, chemotherapy, targeted therapy, and immunotherapy can slow your cancer, even when an operation isn't an option.

How Unresectable Lung Cancer Is Diagnosed

Symptoms like a nagging cough, chest pain, and shortness of breath often don't start until lung cancer has already spread. The lack of early symptoms is why many people aren't diagnosed until their cancer is unresectable.

One way to diagnose lung cancer is with a test called bronchoscopy. A thin tube with a light on the end lets your doctor see inside your lungs and remove a small piece of tissue. A lab then examines the tissue sample to see if it's cancer.

A few other tests can show where in your body the cancer has spread and help your doctor decide that surgery isn't an option for you:

X-ray. It uses radiation in low doses to make pictures of your lungs and other organs.

CT (computed tomography). It's a powerful X-ray that makes detailed pictures of your lungs, lymph nodes, and other organs.

MRI (magnetic resonance imaging). It uses powerful magnets and radio waves to create images of structures inside your body. It can find lung cancer that has spread to your brain or spinal cord.

Ultrasound. Your doctor uses sound waves to make pictures of the inside of your body.

PET (positron emission tomography). It uses a radioactive sugar that cancer cells absorb. Then a special camera gets a close-up look at areas that have absorbed the sugar. PET is often combined with a CT scan.

Bone scan. It uses a radioactive substance and special camera to show whether cancer has spread to your bones.

Thoracoscopy. This procedure uses a lighted tube with a video camera on the end to see if the cancer has spread outside of your lungs.

Mediastinoscopy. Your doctor uses a thin, lighted tube to see inside your lungs and remove tissue to check for cancer.

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Reasons Why Lung Tumors Can't Be Removed

Some reasons why surgery might not be right for you:

Your cancer has spread. The goal of lung cancer surgery is to take out the whole tumor. Doctors can't do that if it's spread outside your lung.

Once the cancer has reached distant lymph nodes or other organs, surgery won't cure it.  Removing the main tumor in the lungs won't stop the cancer that is already in other organs. In later-stage lung cancer, treatments like radiation, chemotherapy, or immunotherapy work better than surgery.

You have small-cell lung cancer. Surgery is one of the main treatments for early stage non-small-cell lung cancer. Doctors rarely treat small-cell lung cancer with surgery because the cancer has often already spread by the time it's diagnosed.

The cancer is in a tricky spot. A tumor that is very close to other organs or to blood vessels may be hard to remove without causing a lot of damage. This can make the surgery too risky.

Your lungs aren't healthy enough. Lung cancer surgery removes part, or all, of the diseased lung. You need enough healthy tissue left behind to be able to breathe well after the surgery.

You'll get lung function tests like spirometry before your procedure. These tests measure the force of your breath to make sure your lungs are in good enough shape for surgery.

You have heart disease. In that case, there's a small chance your lung surgery could cause complications like a heart attack or another serious heart problem. Your doctor will do tests to check your ticker's health before surgery.

You have other serious health conditions. Lung surgery and the anesthesia used during it can cause complications. The operation may be too risky for you if you're in poor health.

What to Do if Surgery Isn't an Option

If you can't have surgery, your doctor will help you choose another treatment based on your cancer stage and health.

You can also join a clinical trial. It's a type of study that tests new treatments for lung cancer before they're available to everyone. Your doctor can tell you if one of these trials might be a good fit for you.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on March 03, 2019

Sources

SOURCES:

American Cancer Society: "Surgery for Non-Small Cell Lung Cancer," "Surgery for Small Cell Lung Cancer," "Tests for Non-Small-Cell Lung Cancer," "Treatment Choices for Non-Small Cell Lung Cancer, By Stage."

Annals of Oncology: "Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up."

Annals of Thoracic Surgery: "Recalibration of the revised cardiac risk index in lung resection candidates."

Canadian Cancer Society: "Surgery for non-small cell lung cancer."

Journal of Thoracic Disease: "Preoperative evaluation for lung cancer resection."

Lungcancer.org: "Diagnosing Lung Cancer," "Symptoms of Lung Cancer."

National Cancer Institute: "Non-Small Cell Lung Cancer Treatment (PDQ)-Health Professional Version."

Seattle Cancer Care Alliance: "Lung cancer treatment."

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