Lung Cancers

At Athens Medical Group we ensure that patients with lung cancer have access to the best possible treatments incorporating the latest advances and research results internationally. At the same time, we support our patients with specialized programs designed to help them face the challenges associated with their diagnosis.

AMG care team

At Athens Medical Group’s hospitals, International Medical Protocols for the prevention, early diagnosis and treatment of lung cancer are implemented.

We support a holistic, multi-disciplinary, approach to the treatment and care for patients of lung cancer, offering expertise from various medical fields in the form of an Oncology Board. A team of leading medical scientists, such as surgeons, pulmonologists, oncologists, radiation oncologists, radiologists, pathologists and thoracic surgeons collaborate combining their expertise and experience in order to provide the best possible treatment for each patient.

The team may also include doctors and nurses, specialized in relevant fields, such as palliative therapy, nutrition and psychotherapy.

Our doctors are equipped with experience and knowledge, as well as all the necessary resources, to treat all types and stages of lung cancer.

At Athens Medical Group, we strongly believe that excellence in medical care can be achieved not only through scientific expertise but also through empathy, compassion and respect for the patient and his or her loved ones.

We make sure you receive care truly tailored to your needs in environment that values you and your life.

Focusing on your case, a multidisciplinary team of lung cancer specialists, your own personal care team, will work with you closely in order to produce a comprehensive and personalized care plan, involving treatments, schedules and supporting services (rehabilitation, nutrition, counseling, etc.) that reflect your needs.

You will consult with some of the best doctors, surgeons in Greece as well as other health experts, all dedicated to preventing, diagnosing and treating lung cancer. Those experts will help you review your treatment and care options and explain the potential benefits and complications of each.

Our lung cancer specialists are widely respected for their expertise and experience in using the most advanced treatment options to their patients.

At Athens Medical Group we offer a full range of treatment and care options for lung cancer, including:

• Holistic and multidisciplinary approach
• The most advanced technology for the quick and accurate diagnosis an staging of lung cancer
• A full range of advanced treatment options including chemotherapy, radiation therapy, targeted therapy, immunotherapy and a variety of surgical operation, including minimally invasive procedures
• Onsite, full-service rehabilitation program
• Counseling for patients and family
• Nutrition counseling
• Personalized care based on your health status and genetics

For patients with metastatic lung cancer depending on the molecular profile of the tumor oral or intravenous systemic chemotherapy is administered, with or without immunotherapy based on the latest international protocols. Best supportive care will be chosen when patients are not fit for full treatment.

The evolution of lung cancer treatment in the past 15 years has emphasized the need for a multidisciplinary approach. According to the latest data from international medical institutions, high-volume centers and multidisciplinary teams are more efficient at managing patients, by providing more complete staging, better adherence to guidelines and increased survival. A proper diagnosis and staging, necessary for treatment decisions, often requires challenging tissue sampling. Multidisciplinary oncological boards reflect that need, with the sampling being carried out by interventional radiologists, interventional pulmonologists or thoracic surgeons.

Lung cancer symptoms occur late in the disease, so the majority of patients with lung cancer are diagnosed with advanced disease.

• Endoscopy

A common diagnostic test for lung cancer is transbronchial needle aspiration and fibreoptic bronchoscopy, often accompanied with evaluation of regional lymph nodes by endobronchial ultrasound and/or endoscopic ultrasound.

Bronchoalveolar lavage, is a procedure in which a bronchoscope is passed through the mouth or nose into the lungs in which a fluid is squirted and then collected for laboratory examination.

• Imaging tests

Radiological testing includes a contrast-enhanced computed tomography (CT) scan of the chest, followed by positron emission tomography (PET) ideally coupled with CT.

PET/CT scan offers, also, the highest sensitivity for mediastinal lymph nodes and distant metastasis assessment.

• Histological tests

Histological diagnosis through small biopsy and/or cytology-type samples is crucial to many treatment decisions and should be exact and detailed.

Immunohistochemistry has become a key technique in primary diagnosis as well as in predictive biomarker assessment.

Therapy-predictive biomarker testing is a practice that has recently evolved into two testing streams, one for the detection of targetable, oncogenic alterations and the other for immuno-oncology therapy biomarker testing.

• Blood monitoring

Blood monitoring through blood tests allows for the detection of oncogenic genomic alterations, as well as factors associated with resistance of the cancer to treatment, in a way that is not feasible with repeated biopsies.

Once the diagnosis and staging procedure has been completed and the precise histological type has been determined, the oncology board team is called upon to decide on the best-expected treatment with the lowest risk, offering the best quality of life and better long-term survival.

The only treatment that offers long-term survival for lung cancer patients is surgery, if the cancer is at an early stage or more rarely when it is advanced, but always after strict selection.

Other forms of treatment include chemotherapy, radiotherapy, interventional radiology, immunotherapy and targeted therapy.

Our surgeons perform the most complex thoracic surgery for lung cancer, even in cases of patients with very limited respiratory reserve. Many of the thoracic surgical procedures performed at the Hospitals of Athens Medical Group require special surgical techniques demanding in terms of both experience and competence.

Complication rates (morbidity and mortality) are at the lowest levels compared to those in the international academic journals.

Finally, patients have access to all the most up-to-date specialized laboratories, at the top of which are the CT tomography, MRI and PET-CT fragments, the endoscopic section, the invasive radiology section, and the Pathological Laboratory. They are staffed by leading experts with tremendous experience in chest conditions.

• Surgery

Surgery for the treatment of lung cancer is constantly evolving: from open surgery to video-assisted pulmonary resection (VATS), which is an alternative to thoracotomy for early stage lung cancer. It is associated with minimal tissue injury, better preservation of respiratory mechanics, less pain and faster return to daily activities. Oncologic outcomes are comparable with, if not better than the traditional open approach.

The surgical procedures for the removal of lung cancer may vary according to the extent of the disease:

• Thoracoscopic (VATS) lobectomy. Thoracoscopic lobectomy is mainly done for the treatment of stage I & II non-small cell lung cancer. The procedure is performed via three ports (keyhole surgery) on the side of the chest wall and is accompanied by radical mediastinal lymph node dissection. Surgical duration is approximately 3 hours and compared with the traditional open approach, it offers reduced postoperative pain, reduced probability for postoperative complications and faster patient recovery.
• Thoracoscopic (VATS) segmentectomy. Thoracoscopic segmentectomy (anatomical resection of one pulmonary segment), whenever technically feasible, is performed for slowly growing tumors less than 2 cm in diameter, as well as in those patients with poor lung function who are not candidates for lobectomy. Lymph node dissection is also performed and the benefits of the procedure include those of minimally invasive surgery. Surgical duration is approximately 2 hours and mean hospital stay is 3 days.
• Thoracoscopic (VATS) wedge lung resection. Thoracoscopic lesser lung resection (wedge resection) is performed via three ports (keyhole surgery) on the side of the chest wall for the management of small peripheral nodules (usually metastases) or tumors less than 2 cm (in patients with poor lung function), as well as for lung biopsy. Surgical duration is approximately 1 hour and the patient is usually discharged after 2 days.
• Bronchoplastic procedures. Special surgical techniques, such as bronchoplasty with or without angioplasty, enable in specific circumstances, the resection of lung cancer without the need to remove the entire lung. They are performed through an incision on the side of the chest wall, surgical time is approximately 3 hours and mean hospital stay is 5 days.

Robotic Surgery

With the help of Robotic Thoracic Surgery, the approach to the lung is done in a very minimally invasive manner.

Also, Robotic Thoracic Surgery performs high-precision robotic lymph node dissection to prevent the spread of cancerous cells.

• Advantages of Robotic Thoracic Surgery:
• Greater precision and skills in surgical procedures
• Avoiding large incisions and faster recovery
• 3D imaging of the surgical field with great magnification
• Minimize blood loss and postoperative pain
• Minimisation of surgical and post-operative complications
• Minimum hospitalization

Surgical treatment of locally advanced lung cancer

There are lung tumors which have progressed and invaded structures such as the chest wall, the airway or one the great vessels. If such a tumor has not spread elsewhere and the surgeon considers that it is technically possible to resect the entire tumor, then a complex operation can be undertaken.

Furthermore, for those patients with locally advanced lung cancer and spread of the disease to the mediastinal lymph nodes induction chemotherapy is followed by repeat staging. If there is no disease progression, surgical resection is a viable option. These operations are more demanding than routine surgeries and require great experience and knowledge in the treatment of lung cancer.

At the hospitals of Athens Medical Group we have treated a significant number of patients with great success and very low risk.

Benign and malignant tracheal and main bronchus tumors

These are very rare, but in many cases need surgical treatment in order to relieve airway obstruction and increase survival rates in case of malignancy. The trachea is resected and an end to end anastomosis is performed without the need for graft. Our expert surgeons at Athens Medical Group have performed a significant number of such operations with very low morbidity and no mortality.

• Radiation therapy

Lung cancer radiation therapy involves the use of powerful, high-energy X-rays to destroy cancer cells or prevent them from growing. Radiation may come from an external source, outside the body or internally, from radioactive materials placed directly inside the tumor. In most cases, external radiation is used.

Radiation therapy may be used before surgery or after surgery, often combined with chemotherapy. If the cancer has metastasized to other organs and areas of the body, radiation therapy may help relieve symptoms. The Hospitals of Athens Medical Group offer cutting-edge radiation therapy technologies.

Interventional radiology

Although lung cancer treatment in early stages is surgical, there are cases where due to associated medical problems, patients are virtually inoperable.

Patients who do not respond positively to chemotherapy or radiation and patients with limited metastatic lung disease, which for many reasons cannot be treated, may be subjected to various methods of interventional radiology that is appropriate to their case, with the safety the great experience and specialization that the Interventional Radiology department provides.

Applications of invasive radiology in the lung include:

1. The percutaneous ablation of tumors. The percutaneous ablation of lung tumors is a relatively new therapeutic method. With the direction of the CT scanner, a needle is percutaneously inserted in the tumor. The radiofrequency channeled through the needle is applied on the tumor, causing high temperatures and thus achieving the controlled coagulative necrosis of the tumor. Although the treatment of lung cancer in early stages is surgical, there are cases where, due to other concomitant medical problems, patients cannot be operated. Moreover, alternative therapeutic methods are sought for patients with more advanced cancer that don’t respond to chemotherapy or radiation. Patients with limited metastatic lung cancer, who cannot be operated for other reasons, constitute a frequent medical problem. All the above mentioned patient groups are candidates for percutaneous tumor ablation.
2. Local intra-arterial chemotherapy. Local intra-arterial chemotherapy for lung cancer up to metastatic stages is also an important therapy method for selected cases. With the above method and by arterial catheterization doctors administer chemotherapeutic drugs and embolic material locally on the tumor. So with smaller drug doses we achieve higher efficacy, avoiding generalized toxic side effects, even the tumor’s ischemia that will lead to its minimization and possible elimination.
3. Intra-arterial embolization. Intra-arterial embolization is a non-surgical, minimally invasive procedure targeting the selective occlusion of the blood vessels, mainly arteries, for therapeutic purposes. In medical science, the method of embolization is used to treat a variety of conditions. Numerous successful embolizations are performed in our Hospitals to treat malignant lung tumors.

• Chemotherapy

Chemotherapy uses specific drugs to destroy cancer cells. The drugs may be given intravenously or from the mouth. Chemotherapy for lung cancer entails, usually, administering a combination of drugs over a period of weeks or months, with breaks in between allowing for the patient to recover. In cases of advanced lung cancer, chemotherapy is carried out as a means of relieving pain and other symptoms.

• Targeted drug therapy

Targeted therapy drugs focus on cancer cells and interrupt their growth and function. They are specifically designed to attach themselves to specific targets unique to cancer cells, such as receptors and proteins.

Targeted therapy may be used in combination with other types of lung cancer treatments, such as chemotherapy and targeted radiation therapy. Targeted therapy drugs work in different ways to chemotherapy.

Not every patient may benefit from targeted drug therapy, since not all be are eligible. Your doctor will explain your testing options and treatment recommendations.

• Immunotherapy

Immunotherapy aims at enabling the body’s own immune system fight the cancer. It is a new approach to treating lung cancer, generally reserved for people with an advanced disease. Some of the patients show positive results. However, not all respond to immunotherapy, since there are many different types of lung cancer with significant differences in the tumors. Current research focuses on understanding why some lung cancers respond better to immunotherapy.

Some of the most frequent questions asked to our doctors include:

• Where is the cancer located in my lung?
• What is the stage of my lung cancer?
• Has my lung cancer spread to other parts of my body?
• What kind of tests will I need?
• What options do I have to treat my lung cancer?
• Can my lung cancer be cured and with which treatment?
• What is the chance of cure for my lung cancer?
• What are the potential side effects of each treatment?
• How will each treatment affect my daily life?
• Which treatment do you feel is best for me?
• How soon must I decide about the type of my treatment?
• Should I seek a second opinion?
• Should I see a specialist? What will that cost, and will my insurance cover it?