Thoracic Surgery

More than 90% of adults who smoke started before they were 21. Around 30% of 9th graders are already smoking, and they keep on doing it. Few manage to quit. Among adults, almost 25% are smokers. Most kids smoke because they think it's cool and makes them look older. And it works! Smoking breaks down firm parts of your skin, the elastin, and gives you wrinkles making you look older than you are.

Occasionally, if a person strains really hard, like when lifting something heavy, they can burst a little bubble in their lung and it can track to the middle of their chest and show up as air around their heart. It can also track up in the skin of the neck and face and more, and feel like Rice Krispies brand cereal under the skin. Usually, there is chest pain. You should definitely go to the ER if this happens to you, because sometimes it needs urgent treatment.

The first distinction is

• Primary lung cancer (started in the lung)
• Cancer metastatic to the lung (started somewhere else, then spread to the lung)

There are several types of primary lung cancer, but they are all essentially treated the same way:

• Surgery if possible
• Radiation and/or chemotherapy if necessary.

Several cancers that spread to the lung also may be treated successfully with surgery.

Lung Cancer remains the leading cause of cancer deaths in the US.  Yet, unlike most other cancers, such as Breast cancer and Colon cancer, there are no recommendations at this time for screening.  

A number of studies have been performed using Cat Scans, chest X-rays and certain breathing and blood tests, but none have been reliable in detecting cancer and only cancer.  

Cat scan has been the most promising, as it can reliably find small cancers, however, it also finds many other things that can mimic cancer.  

The answer to this screening question has not been found, but if you are currently, or were a smoker and have a family history of lung cancer and are above the age of 55, it would be reasonable to have a discussion with your doctor about the possibility of a screening test.

A "nodule" is a lesion in the lung, generally less than 3 centimeters.  Nodules in the lung are not uncommon, and most are not cancer.  However, this is the major question that needs to be answered.   A Cat Scan would be the first step in the evaluation.  The size and shape of the nodule as well as risk factors for cancer, all go into the evaluation.

Simply put, hyperhidrosis is excessive sweating.  It is due to an increased output of the sympathetic nervous system which controls the secretion of sweat.  It usually is very focal occurring in the face, underarms and most commonly the palms of the hands.  Most patients experience sweating that causes water to drip off their hands.  This can be socially and professionally embarrassing.

There are medical treatments including topical agents, iontophoresis and even Botox injections, however these tend to be temporary.  

There is a surgical procedure with a minimally invasive technique that can control the symptoms permanently.

The smoke inhaled from cigarettes contains many chemicals that are absorbed into the blood and are toxic to the body.  Several cancers are associated with smoking, and these include:  lung, mouth, laryngeal (voice box), esophagus, stomach, pancreas, kidney, bladder, cervix, and leukemia.  Besides cancer, smoking is associated with heart attacks, strokes, poor circulation leading to amputations, asthma, emphysema, poor healing, wrinkles, yellow teeth, and more!

The standard treatment for early stage lung cancer continues to be surgical removal of the area of the lung that the tumor is in.  There are multiple options for the type of procedure based on the location of the cancer and the fitness of the patient.  

New minimally invasive techniques are now available to perform theses lung cancer resections in many instances.  These techniques limit the pain and speed the recovery time as well as decrease the risks of the complications.  The techniques are still relatively new, and you can ask your surgeon about their availability and whether you are a candidate. 

They are all bad.  For example, it has long been believed that smoking a joint a day is no big deal because it is only one, and may even prevent cancer.  The opposite is true!  One joint a day seems to carry the same health risks as a whole pack of cigarettes.  Pipes and cigars have risks that are nearly equivalent to cigarettes.

Esophageal cancer is the fastest growing type of cancer in the US.  There is a correlation with reflux although most people with reflux will not get cancer.  

Once diagnosed, a full evaluation to determine the Stage of the cancer by either a Thoracic surgeon or Medical oncologist should be performed.  This usually includes certain radiologic studies, such as Cat Scan and PET scans to be performed as well as certain endoscopic procedures.  

The treatment possibilities include Chemotherapy, Radiation Therapy and Surgery or a combination of these.  The type of treatment depending on the evaluation of the stage and the fitness of the patient.  A multidisciplinary cancer team is usually the best to evaluate what treatment options are best for an individual patient.

Yes! Smoking is our #1 killer and is responsible for 20% of all deaths in the United States each year. These are deaths due to heart attacks, strokes, emphysema, lung cancer and more. 90% of lung cancers occur in smokers. Lung cancer kills more men and women each year than colon, breast, and prostate cancers combined.

With a new diagnosis of lung cancer, a thorough evaluation must be done to determine how advanced the disease is.  This is called "staging" and usually involves a number of mostly non-invasive tests.  Evaluation by a multiple disciplinary team, with physicians from all areas of lung cancer treatment is ideal to determine the best course of treatment which may involve surgery, chemotherapy or radiation therapy, or combinations of these treatments.