Lung nodules generally don’t require treatment if benign. In such cases, doctors typically recommend follow-up scans to monitor for changes.

If an infection causes the nodule, doctors may prescribe treatments like antibiotics or antifungals.

Doctors may recommend surgical removal if a nodule grows, causes symptoms, or is cancerous. Options include minimally invasive procedures, thoracotomy, chemotherapy, and radiation therapy.

Minimally invasive thoracic surgery

This approach is a type of minimally invasive surgery (MIS) that allows diagnosis and treatment of various chest conditions, including lung diseases.

Surgeons perform chest surgery through small incisions between the ribs, rather than a large opening. Using a tiny camera and special surgical instruments, they reach the lungs through these incisions to remove lesions. Compared to thoracotomy, this procedure offers patients several benefits: lower surgical risk, fewer complications, less postoperative pain, shorter hospital stays, and faster recovery. As a result, it’s now used more frequently.

Most commonly used are two types of minimally invasive thoracic surgeries:

• Video-assisted thoracoscopic surgery (VATS): This is the most common procedure for removing cancerous nodules. During VATS, the surgeon makes one or more small chest incisions, then inserts a thoracoscope — a long, thin tube with a tiny camera — and specially designed instruments through these cuts. The surgeon removes the lesion using images from the camera.
• Robotic-assisted thoracic surgery (RATS): A newer option that offers advancements over VATS, though it’s more expensive. Like VATS, RATS uses small incisions to insert a tiny camera and surgical tools. However, in RATS, the surgeon operates robotic arms from a console, using high-definition 3D vision to remove the lesion. This robotic system gives surgeons greater flexibility, precision, and safety.

Thoracotomy

If minimally invasive surgery (MIS) isn’t an option — due to factors like a centrally located tumor, comorbidities, or frailty — surgeons may recommend a thoracotomy.

A thoracotomy is a traditional, open thoracic surgery. Performed under general anesthesia, it allows doctors to diagnose, biopsy, and treat chest organs like the lungs. Most often done on one side of the chest, the procedure involves making a larger incision between the ribs to access the lung directly, removing part or all of it as needed.

In the days after surgery, doctors will place a tube to drain excess fluid or air from the chest.

As a major, more invasive operation, thoracotomy is typically recommended only when simpler, lower-risk approaches haven’t worked. Before choosing this procedure, it’s important to discuss all treatment options with your doctor. They’ll recommend the best surgical approach based on your medical condition, overall health, and possibly your personal preferences.

Chemotherapy / Radiation therapy

These are two common treatments for lung cancer.

Chemotherapy (or chemo): Uses anticancer drugs to target fast-growing cells — a key feature of cancer cells, which grow and multiply much faster than normal cells. This allows the drugs to focus on stopping cancer cell growth, division, and spread. Doctors choose different drugs based on the specific type of lung cancer.

Radiation therapy (or radiotherapy): Uses high-energy radiation to damage cancer cells’ DNA, controlling or destroying them. The most common radiation type is X-rays, but others include protons, gamma rays, and electron beams.

Chemotherapy and radiation therapy are often used together. Combining them is often more effective at shrinking tumors and killing cancer cells.