Dr. Jonathan Kiev answers questions about lung cancer.

Got questions about lung cancer? Dr. Jonathan Kiev has answers.

Dr. Jonathan Kiev

Dr. Jonathan Kiev

Written by Dr. Jonathan Kiev, a cardiothoracic surgeon at UK HealthCare.

November is Lung Cancer Awareness Month, so now’s a great time for me to answer some common questions about the disease.

Lung cancer is a major problem in Kentucky. Unfortunately, our state leads the nation in both lung cancer incidence and deaths.

The good news is people who are at high risk for lung cancer – specifically, those who have a history of smoking – are eligible to undergo low-dose CT screening for the disease. This diagnostic test allows us to find lung cancer at a much earlier stage, giving us more time to potentially provide life-saving treatments. Even better news? The UK Markey Cancer Center has a Lung Cancer Screen Program for patients at high risk.

So, who’s at risk for lung cancer and what causes the disease?

First and foremost, if you smoke, seek help to quit.

Smoking is by far the No. 1 cause of lung cancer, and it causes head and neck cancers, too. It’s responsible for a variety of health problems not seen in non-smokers. In addition, hypertension and peripheral vascular disease are directly related to smoking, which is why getting on a nicotine cessation program is the first step.

(Related: Check out our tips for conquering a smoking addiction.)

Your doctor will take into account your current health and health history to decide if you are at risk for lung cancer. They will then order the appropriate blood tests and imaging (chest X-ray and CT scan) to see if you have developed early signs of the disease.

Can working in a coal mine or around asbestos cause lung cancer?

Any inhaled substance or chemical can cause lung cancer over repeated exposure, so the short answer is yes.

More importantly, exposure to these types of substances in high-risk professions can lead to other chronic lung illnesses as well. Patients in these professions need to be followed by specialists who understand their occupational risks and hazards.

What is lung cancer staging?

Staging is a way for your physician to determine the type of lung cancer that you have, and whether it has spread to your lymph nodes or to other organs.

Lung cancer can spread to the brain, bones and the adrenal gland. These are all treatable areas, but we like to catch the tumor as early as possible. Staging allows physicians to determine which therapy is best for you: surgery, radiation, chemotherapy or a combination of those. Additionally, your prognosis and risk of recurrence are linked to cancer stage.

How is lung cancer treated?

There are different options to treat lung cancer, so it’s important for you and your family to seek second opinions and find a physician who understands your priorities.

Surgery is best used for early-stage tumors that are smaller, but we can also perform successful operations for larger tumors that have spread to the chest wall. Radiation is available to patients that are not interested in or are not healthy enough to recover from a major chest surgery.

How is lung cancer surgery performed?

Thoracic surgeons specialize in the latest oncology techniques to successfully perform lung cancer surgery.

Typically, surgeons use small incisions and a camera to remove the diseased segments of the lung and its surrounding lymph nodes. Occasionally, a larger incision between the ribs is necessary (this is called a thoracotomy) if the tumor is large or centrally located.

Is robotic surgery available for lung cancer?

Yes, robotic surgery has been available for about 10 years, and it allows your surgeon to remove the affected lung or areas of the lung.

Robotic surgery provides a three-dimensional view, allowing surgeons to better see the areas they’re operating on.


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