Inoperable lung cancer may refer to different types of lung cancer that doctors cannot treat with surgery. They may also use the term unresectable lung cancer.
Although a diagnosis of inoperable lung cancer may feel devastating, it does not mean the same as a terminal diagnosis.
Cancer does not respond to treatment in terminal cancer, and doctors have no cure. Conversely, with inoperable cancer, doctors have various other treatments that can improve a person’s symptoms and slow down disease progression.
This article looks at inoperable lung cancer, the reasons why surgery is not a viable option, and alternative treatment choices.
No single factor makes lung cancer inoperable, and no two cases are the same.
However, because lung cancer surgery is complex and can have severe effects on other aspects of a person’s health, surgeons must carefully consider the following factors:
- Type of lung cancer: Surgery is the best option for localized cancer that has not spread, including early stage non-small-cell lung cancer (NSCLC) and carcinoid tumors. Surgery is not typically an option for small-cell lung cancer (SCLC) because it has spread by the time doctors find it. Less than 5% of people with SCLC have a single lung tumor that has not spread to lymph nodes or other organs.
- Lung cancer stage: People with
earlier stageNSCLC are typically suitable candidates for surgery, including stage 1, stage 2, and potentially stage 3A. Beyond these stages, the cancer has spread and a surgeon cannot remove it by surgery.
- Tumor location: Surgeons may not recommend attempting a surgical procedure for tumors situated deep within the lungs or close to other essential organs.
- Lung function: People with conditions that affect their breathing, such as chronic obstructive pulmonary disease (COPD) and poor lung function, are likely to experience complications following surgery. Therefore, surgeons may decide that the procedure is too risky.
- General health: Although all surgeries carry risks, people with poor overall health may not be good candidates for a major operation such as lung cancer surgery. Individuals require fair health
to help them overcomepotential complications such as anesthesia reactions, blood loss, clotting, infections, and pneumonia.
Surgery for lung cancer has the most chance of success when cancer is in the early stages and has not spread.
However, one of the challenges doctors face is that lung cancer symptoms do not
There are two main types of lung cancer and surgeons may consider both as inoperable depending on the above factors.
Non-small-cell lung cancer (NSCLC)
This is the most common form of lung cancer, making up around
- Adenocarcinoma. This cancer begins in cells that typically secrete mucus. Doctors find adenocarcinoma in the outer parts of the lungs, and they are more likely to find it before it spreads. It usually develops in past or present smokers, but it is also the most common type of cancer seen in non-smokers.
- Squamous cell carcinoma. This carcinoma starts in the flat cells lining the airways, often near the primary airway or bronchus. Doctors also link it to smoking.
- Large-cell (undifferentiated) carcinoma. This rapidly growing and spreading cancer can appear anywhere in the lungs. Therefore, doctors may find it more challenging to treat.
Small-cell lung cancer (SCLC)
Sometimes called oat cell cancer, SCLC makes up around 10–15% of all lung cancers. It grows and spreads faster than NSCLC, meaning that for 7 in 10 people, cancer has spread at the time of diagnosis.
However, because cancer grows quickly, chemotherapy and radiation therapy are usually good treatment options.
Inoperable means that surgery is not a viable option and does not mean the same as terminal. Doctors may not be able to cure the cancer, but they
Additionally, research into finding the best therapies for lung cancer treatment continues. For example, a
Thanks to advances in medicine, lung cancer treatment does not now rely on surgical control of the disease.
Doctors may suggest the following treatment options for individuals with inoperable lung cancer:
- Chemotherapy: Involves medications that kill fast-growing cells, including cancer cells. The drugs stop the cancer cells from growing, dividing, and spreading. Doctors may use it on its own or in combination with other treatments.
- Radiation therapy: This therapy involves targeting lung tumors with high-energy X-rays to destroy cancer cells. Doctors use a machine near the individual’s body to send radiation to the tumor. People may receive radiation alongside other therapies.
- Immunotherapy: This group of medications boosts an individual’s immune system to combat cancer cells effectively. Drugs may alter the immune response or use substances that immune cells make the target cancer cells. Although immunotherapy only works for around
30%of lung cancers, in people who respond, it is highly effective.
- Laser therapy: Doctors can use lasers to surgically shrink or destroy tumors or use them to activate medications in photodynamic therapy (PDT). In PDT, doctors put a special drug into the bloodstream that the tissues absorb and that stays in cancer cells for longer. Doctors can then activate the medication in the cancer cells with a special laser. This causes a chemical reaction that kills the cancer cells.
A person’s outlook depends on the type of lung cancer and the stage at diagnosis. It may also depend on their general health.
In the United States, the overall 5-year survival rate for lung cancer is
This 5-year survival rate is
Five-year survival rates for people who have NSCLC are:
- 63% if the cancer has not spread outside the lung
- 35% if the cancer has spread locally
- 7% if the cancer has spread to distant parts of the body
Five-year survival rates for people who have SCLC are:
- 27% if the cancer has not spread outside the lung
- 16% if the cancer has spread to nearby areas
- 3% if the cancer has spread to distant parts of the body
Inoperable lung cancer is lung cancer that surgeons cannot remove. Surgery is the best option for localized lung cancer that has not yet spread. However, doctors often diagnose lung cancer at a later stage when it has already spread, meaning that surgery is no longer an option.
Sometimes, lung cancer is inoperable because of the tumor’s location or because an individual has other health conditions that affect their breathing or mean their general health is poor.
Although a diagnosis of inoperable lung cancer is serious, doctors still have various options for treatments that can ease symptoms, prolong life, and may shrink tumors. Potential treatment options include chemotherapy, radiation therapy, immunotherapy, and photodynamic therapy using lasers.
Additionally, researchers are continuing to seek new therapies that can help people with inoperable lung cancer live longer.