I have a friend that was recently diagnosed with non-small cell lung cancer. He has a tumor within the sac lining the right lung. He has been told that this type of tumor is non-surgical b/c it is within the sac around the lung and not in the lung itself. His wife recently heard of a doctor that did some surgery on a friend's mother to remove her lung and surrounding lining to remove a tumor she had in her lining. Can you give me any info or any insight on area to look at to do some research to see if my friend would be a candidate?

Joseph B. Shrager, Assistant Professor of Surgery and Director of General Thoracic Surgery at the at the Hospital of the University of Pennsylvania responds:

A lung cancer that has spread to the lining, or pleura, around the lung is in stage 3B, and this stage has traditionally not been treated by surgical resection since the chances of cure by surgical treatment have been very low. However, there are a few people around the country who have been trying to add novel adjuvant treatments to resection in patients with this type of disease, and they have been having some success, although it is still an open question whether these approaches will ultimately show any benefit.

Among the adjuvants that have been tried include pumping chemotherapy drugs or hot fluid into the space around the lung (the pleural space) after the lung resection, or removing the pleura as well as the lung, and following it up with something called photodynamic therapy to remove any traces of tumor in the lining. My bias, if your friends would like to try something aggressive and experimental, is towards the approach with photodynamic therapy. You may want to try the OncoLink/Emerging Med Clinical Trials matching service to see if you qualify for trials using this therapy.