Lung, Thymus & Mediastinal Tumors

Lung & mediastinal tumor (including thymoma) surgeries can be performed by conventional open method or by laparoscopy (VATS-video assisted thoracoscocpic surgery /Throracoscopy). Laparoscopic or Laproscopic cancer surgery has several advantages over conventional open surgery with same cure rate. Only surgery is curative in most of the cancers. Additional therapies (chemotherapy & radiotherapy) are mostly supportive. But, many patients and their relatives try to avoid surgery for the fear of the immense trauma for their loved ones, resulting in patient getting wrong or less effective treatment. With laparoscopy the trauma is much less and makes the treatment more acceptable. The Team MACS precisely addresses all these issues and works relentlessly for a better life.

comparing the wounds
Dr. Sandeep Nayak


MBBS, MRCSEd, DNB (Gen Surg),
MNAMS (Gen Surg), DNB (Surgical Oncology),

Fellowship in Laparoscopic and Robotic Onco-Surgery.
Dr Nayak is one of the leading senior Surgical Oncologists (cancer surgeon) of Bangalore. He is one of the pioneers of Laproscopic (laparoscopic) cancer treatment (surgery). He is the Director of Surgical Oncology at Fortis Hospital, Bangalore.

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    MBBS from KIMS, Bangalore
    MS from NHLMMC, Ahmedabad
    M.Ch Surgical oncology from Tata Memorial hospital,Mumbai


    Assistant Professor in RRMCH, Bangalore

The Advantages Of Laparoscopic Cancer Surgery Over Conventional Open Surgery (Macs Advantages) Include

About Lungs, Thymus And Mediastinum

Lungs a pair of air filled spongy organs located within chest that are involved in exchange of gas. The trachea or wind pipe carries inhaled air to the lungs. Trachea divides in br¬onchi which further divide into smaller branches before becoming microscopic and ending alveoli. Tumors of lung can arise from lung tissue itself (small cell cancer, squamous, adenocarcinoma, etc.) or could have spread from other organs (colon, rectum, kidney, etc.) or due to some infection (Tuberculosis or Hydatid cyst).

Mediastinum is the area in between the two lungs. This contains the heart, main blood vessels of the body and lymph nodes (small nodular structures that are present throughout the body that clear the tissue fluids). It also contains an organ called thymus. Thymomas refer to tumors arising in thymus and these can be cancers or non-cancerous. Also some thymomas can produce a form of paralysis called Myasthenia Gravis which can be life threatening. Apart from these the lymph nodes in the mediastinum may get affected (lymphomas) when they need to be biopsied for confirmation.

Symptoms And Diagnosis

Lung and mediastinal tumors (including thymomas) do not produce symptoms to begin with. As they grow they cause symptoms related to chest due to pressure on adjoining organs. Patients with thymomas may develop weakness, difficulty in talking and breathing, etc. (Myasthenia Gravis). The symptoms related to any mass in the lung like cancer, abscess, and parasitic (hydatid) cyst are similar and can only differentiated by CT scan or after surgery. Common symptoms that are encountered include.

  • A persistent cough that does not get better.
  • Chest pain that is often worse with deep breathing, coughing, or laughing.
  • Blood or rusty stained sputum
  • Hoarseness.
  • Weakness, Weight loss and loss of appetite.
  • Breathlessness

These tumors are diagnosed by a scan guided needle biopsy (FNAC) and need a scans (CT scan or PET CT) to determine the stage of the cancer.

Staging & Treatment

The curative treatment of lung and mediastinal tumors is surgical removal of tumor bearing tissue. Surgery is possible only in early stages of lung cancer. Tumors in the front of medistinum always needs to be removed by surgery.


Lung Tumors:

solitary pulmonary nodule is a single abnormality in the lung that is smaller than 3 cm in diameter. These usually do not cause any symptoms. But, could be early stage of cancer. These are usually observed over time to see if they grow, in which case surgery is performed.

All lung nodules larger than 3 cm in size are treated as cancer and need to be removed by surgery. The confirmed lung cancers are treated based on their stage as follows.

Stage I & II

Where the cancer is limited to lung with few removal lymph nodes, surgery is feasible. The surgery could be wedge resection, segment resection or lobectomy, pneumonectomy depending on the location of the tumor.

Stage III A

The cancer has spread to the chest wall or other nearby structures that can be removed by surgery, a surgery can be performed followed by chemotherapy (injections).

Stage III B

The cancer has spread to the lymph nodes above the collar bones or in the opposite side of the chest. Most of these patients are treated with chemotherapy and radiotherapy alone as surgery does not help in this stage. Rarely some patient may benefit from surgery.

Stage IV

The cancer has spread to far away organs (liver, opposite lung, adrenrenals, brain, etc.). Cancer cannot be cured in this stage. These patients do not benefit from surgery and are treated with chemotherapy or radiation.

Thymus And Other Mediastinal Tumors

Thymomas need to be removed by surgery as they can put pressure major blood vessels and wind pipe in the chest. The patients with Myasthenia Gravis banefit from removal of thymus in the long run. The cancers of thymus also need surgical removal. Many of these patients may benefit from chemotherapy or radiotherapy before or after surgery.

The surgeries for lung and mediastinal tumors can be performed by conventional open method or by laparoscopy (VATS-video assisted thoracoscocpic surgery /Throracoscopy). Laparoscopic surgery has great advantages to the patient.