VATS more effective in early-stage lung cancer surgeries

Though now standard for early-stage lung cancer surgeries worldwide, this type of surgery is less known and underutilized in the country.

Many lung cancer patients in other hospitals don’t opt for video-assisted thoracic surgery (VATS) as much as the more conventional open surgery, according to Lung Center of the Philippines (LCP) thoracic surgery specialist Dr. Antonio B. Ramos.

With a five-year survival rate of 4 to 54 percent, lung cancer not only is deadly, but also posts a lot of serious concerns for the patient. According to the World Health Organization, lung cancer claims 1.59 million lives around the world every year. Common causes of lung cancer include smoking, air pollution, exposure to asbestos and radon gas, and genetics.

Leading cause

In the Philippines, lung cancer is the leading cause of cancer-related deaths among men, and the third cause of cancer deaths among women (after breast and cervical cancer), according to the 2012 Globocan statistics of the International Agency for Research on Cancer.

Operating on early-stage lung cancer can prevent complications. Through VATS, doctors can view and operate on the insides of the chest cavity with very small incisions. Viewing through a high-resolution videoscope inserted in 2- to 6-centimeter incisions between the ribs, the surgeon can perform the lobectomy, or the surgical excision of a lobe of the lung.

Open surgery requires 10- to 15-cm cuts on the ribs. Also, the chest is spread widely or the breastbone is cut. The lobes of the lungs are also difficult to view under this more conventional surgery.

The VATS method leads to the reduction in the intensity and duration of postoperative pain and allows patients to heal and return to their daily activities. Although VATS would cost around P140,000—higher than open chest surgery—the total expense will be the same since patients don’t need to stay long at the hospital, and there is less pain medication, Ramos said.

VATS is the default procedure for lung resections in LCP, with the open surgery reserved for large tumors that need complex resections. In 2014 and the first half of 2015, 36 cases of lung cancer there utilized the VATS procedure, Ramos said.

Ramos encouraged lung cancer patients to take an active role in making decisions and talk to their physicians for surgery options, including VATS. VATS can be recommended for all lung cancer cases, except for those with big tumors which need large incisions, he added.