Frequently Asked Questions | White Plains Hospital

Frequently Asked Questions

Questions about surgery

What is a segmentectomy?
You have 2 lungs. Each lung is broken down into small parts known as lobes. On the right you have 3 lobes, an upper, middle, and lower lobe. On the left, you have 2 lobes, an upper and lower lobe.

Each lobe can then be broken down into smaller parts know as segments. Each segment contains its own small airway, artery and vein. A segmentectomy is when a segment is removed and not the entire lobe.

What is a lobectomy?
You have 2 lungs. Each lung is broken down into small parts known as lobes. On the right you have 3 lobes, an upper, middle, and lower lobe. On the left, you have 2 lobes, an upper and lower lobe.

A lobectomy is when a lobe of the lung is removed. A lobe is defined by its own main artery, vein and airway.

What is a wedge resection?
A wedge resection is a term used when a wedge shaped piece of lung is removed. This is generally smaller than removing a segment or a lobe of the lung.

What is a pneumonectomy?
On rare occasions, the location of a lung cancer requires the entire right or left lung to be removed in order to get the entire cancer out. The removal of an entire lung is known as a pneumonectomy. Patients who may require removal of an entire lung are evaluated both before and during surgery to access the effects removal of an entire lung will have on their lifestyle.

What is a bronchoscopy?
A long thin camera about the diameter of a pencil or small, known as a bronchoscope, can be used to look into your airways. There are no incisions when you have a bronchoscopy. While under sedation, the scope can be placed into your mouth or through a breathing tube and guided into your airways. In general, bronchoscopy is an ambulatory procedure which means you come in for the procedure and go home that day.

What is Endobronchial Ultrasound (EBUS)?
An Endobronchial Ultrasound (EBUS) utilizes a bronchoscope that has a special ultrasound on its tip. Much like a regular bronchoscopy, this is generally performed as an ambulatory procedure. You receive sedation and this state-of-the art bronchoscope is guided into your airway. In addition to being able to evaluate your airways like a regular bronchoscopy, EBUS allows for lymph nodes or masses around the airway to be evaluated and sampled.

What is a cervical mediastinoscopy?
A mediastinoscopy is a way to sample lymph nodes that are along your airways. Sometimes the nodes are in a difficult position or they are too small for endobronchial ultrasound (EBUS) to reach. A small 1 inch incision is made at the base of the neck. With this incision, we are able to pass a camera known as a mediastinoscope which can be used to sample the lymph nodes in question. This is an ambulatory procedure and you should expect to go home the same day as the procedure.

What is a thoracotomy?
A thoracotomy is an incision made in the chest to allow your surgeon access to the organs inside the chest cavity. It usually begins just below your axilla and extends around the side towards your back. The muscles overlying the rib case are cut and the ribs are spread apart. At the conclusion of the procedure, the ribs are returned to their normal position and the muscles sewn back together.

What is VATS?
A VATS is Video Assisted Thoroscopic Surgery. Instead of one large incision, several small incisions 1-2 inches in size are made. Through these incisions a camera and instruments are used to perform surgery inside the general, this surgery does not divide any muscles and the ribs are not spread apart.

What is the difference between a thoracotomy and VATs?
A thoracotomy refers to a larger incision with the spreading of the ribs to open the chest cavity to allow surgery to be performed inside the chest. A VATS utilizes small incisions, does not spread the ribs apart, and uses a camera and long small instruments to perform surgery inside the chest. Usually there is lest discomfort, a shorter hospital stay, and a quicker return to normal activities for patients who undergo a VATS procedure.

How is it decided how much lung should be removed for lung cancer?
The amount of lung removed depends on a number of factors. First and foremost is the reason the lung is being removed. A malignancy requires a wide normal margin of tissue to offer the best change of cure. A benign mass can be removed with less tissue.

Changes may be made during the surgery depending on the individual circumstances and the result of the intra-operative pathology encountered.

Prior to undergoing lung surgery, pulmonary function tests (PFTS) will be performed which will help the surgeon determine how much lung can be removed while preserving enough function to allow the patient to return to activities of their daily lives.

Questions about Diagnostic Tests

What is a PET scan and how is it different than a CT scan?
A PET scan is a radiologic test in which you are given a special sugar known as FDG. This material is absorbed by very active cells. Both cancer and inflammatory cells may absorb the PET scan material. The PET scan is helpful to evaluate if there is disease in other parts of the body. A PET scan evaluates the function of the cells in your body. A CT scan looks a t the structure of these cells.

Questions about Cancer

What does cancer stage mean?
In general terms, lung cancer staging refers to how big your tumor is and whether or not the cancer has travelled to your lymph nodes and/or other organs.

What are the different lung cancer stages?
Stage I cancers are small cancers limited to the lung itself, without spread to lymph nodes or other sites in the body.
Stage II cancers are defined as those that have presence of cancer to lymph nodes within the lung.
Stage III cancers are categorized as such because of lymph node involvement outside of the lung, but still within the chest cavity.
Stage IV lung cancer are those whose cancer has spread to other parts of the body.

What is the treatment for each Lung Cancer Stage?
For patients that are good candidates:
Stage I cancers, surgery is often best;
Stage II cancers receive surgery and then chemotherapy;
Stage III cancer patients often receive a combination of chemotherapy, radiation therapy, and surgery;
Stage IV patients usually receive just chemotherapy.

How is the stage of the cancer determined?
At White Plains Hospital, we have state-of the art technology that allows us to use a variety of methods to help stage your cancers. These are some of the test and tools that we may use:

What is a biopsy?
In order to confirm a diagnosis, it is important to obtain a tissue sample from the lesion. Obtaining this tissue is called a biopsy. A biopsy can be done many ways. Some of these ways include:

  1. CT guided biopsy
  2. Bronchoscopy
  3. Endobronchial Ultrasound
  4. Video Cervical Mediastinoscopy
  5. Video-Assisted Thoracic Surgery (VATS)

Once a biopsy is performed, how is the diagnosis determined?
Our Board-Certified Pathologist will look at the specimen under a microscope to determine the diagnosis. For lung cancers, additional tumor tests are performed which can help guide and personalize your treatment plan.