Lessons from Patients with Inoperable Lung Cancer

Lessons from Patients with Inoperable Lung Cancer

Inoperable Lung Cancer: A Changing Outlook

By David Mannino, MD, medical director and co-founder, COPD Foundation, as told to Janie McQueen


Receiving a diagnosis of inoperable lung cancer is undoubtedly devastating. It means either the cancer has spread to a point where surgery cannot remove it all, or the patient’s medical condition makes them unable to tolerate surgery. However, it is crucial to recognize how the outlook for inoperable lung cancer has dramatically changed over the past few decades.

From Death Sentence to Hope

Around 20 years ago, a diagnosis of inoperable lung cancer was essentially seen as a death sentence, with a survival rate of only about 5% beyond a year. However, the landscape of lung cancer today is remarkably different. Survival rates have increased significantly due to advancements in targeted therapies and the introduction of immunotherapy.

Targeted Therapies: Precision Medicine at Its Best

One of the most encouraging developments in treating inoperable lung cancer is the advent of targeted therapies. These treatments focus on proteins that control the growth and spread of cancer, providing patients a much better chance of survival. The introduction of these therapies has increased the one-year relative survival rate to over 50%.

Moreover, surgical procedures have seen remarkable improvement. Video-assisted thoracoscopic surgery (VATS) is becoming increasingly common as a less invasive alternative to traditional open surgery. This procedure involves inserting tiny tools through smaller incisions while using a camera to provide real-time visuals on a video monitor. Not only does VATS yield better surgical outcomes, but it also leads to smoother recoveries.

Flipping the Downside

The introduction of new therapies has added months, and sometimes even years, to survival rates. Unlike traditional chemotherapy that often causes severe side effects, these newer, more targeted treatments offer the benefit of improved outcomes without significant downsides. They have revolutionized the treatment of various lung cancer types, including metastatic disease.

Team Treatment for Comprehensive Care

Treating lung cancer is a collaborative effort involving an entire team of specialists. Lung doctors, cancer doctors, radiation therapists, nurses, pharmacists, and social workers band together to provide comprehensive care. Their support extends not only to medical treatment but also to ensuring a patient’s emotional well-being throughout this challenging time. When the time comes, palliative and hospice care teams ensure patients can pass with dignity while surrounded by loved ones.

Screening: A Game-Changer

Screening programs have played a significant role in the declining numbers of lung cancer cases. These programs have been instrumental in identifying cancers that can be treated through surgery. Low-dose computed tomography (LDCT) is the go-to screening test for lung cancer. It involves a brief and painless procedure where a small amount of radiation scans the lungs using an X-ray machine.

Importantly, lung cancer screening is not exclusive to smokers. Approximately 10% to 20% of lung cancers each year occur in nonsmokers or occasional smokers. Factors such as secondhand smoke, exposure to radon, genetics, and air pollution can contribute to the development of lung cancer. Consequently, the proportion of inoperable lung cancers has naturally decreased as a result of successful screenings.

Facing the Hard Truths with Hope

Despite the significant progress made in the treatment of inoperable lung cancer, it remains a tough diagnosis. Having to tell someone, “We can’t do much for you,” is undoubtedly heartbreaking. The reality is that not everyone will respond favorably to available treatments. However, there are always remarkable stories of individuals defying the odds.

Remembering a friend with inoperable lung cancer who has undergone radiation therapy, one cannot help but feel a mixture of sadness and hope. Although not a common occurrence, there are cases where individuals have survived for a decade or longer with no signs of cancer progression.


The outlook for inoperable lung cancer has shifted dramatically in recent years. With the introduction of targeted therapies, immunotherapy, and advancements in surgical procedures, survival rates have improved significantly. The collaborative efforts of medical teams, comprehensive screening programs, and the advent of less invasive diagnostic techniques have all played a crucial role in enhancing patient outcomes. While a diagnosis of inoperable lung cancer is undoubtedly challenging, it is no longer the life sentence it once was. There is hope, and with each new breakthrough, the prospects continue to brighten for those facing this formidable disease.