Keerthana Keshava, M.D., spends much of her working day exploring the intricate world that lies deep inside the airways, lungs and the lung lining.

Meet Keerthana Keshava, M.D., Attending Interventional Pulmonologist at NYM.

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Lung Cancer


Lung cancer develops when genetic changes occur in a normal cell within the lung. As a result, the cell becomes abnormal in shape and behavior, and reproduces endlessly. The abnormal cells form a tumor that, if not surgically removed, invades neighboring blood vessels and lymph nodes and spreads to nearby sites. Eventually, the cancer can spread to locations throughout the body. Learn more about lung cancer by visiting our Health Library.

Lung cancer is typically diagnosed through a physical examination, chest x-rays, and computed tomography, or a CT scan. Learn about the Fred L. Mazzilli Lung Cancer Screening Program at New York Methodist Hospital.

Lung Cancer Treatment

A multi-disciplinary team of pulmonologists, oncologists, radiation oncologists, and thoracic surgeons work to evaluate each patient's medical condition and recommend an appropriate treatment.

Lung cancer is generally diagnosed in older individuals so there's an increased need for techniques that are well tolerated among the elderly. For a variety of reasons, seniors recover more easily following minimally invasive techniques.

The type of surgery a patient needs depends on the amount of lung or other tissue that needs to be removed. Surgical advances are allowing a wider range of options, including minimal surgeries for early cancers and surgeries that relieve cancer symptoms in the late stages of the disease.

  • Thoracoscopy, also known as video-assisted thoracic surgery (VATS), is a less-invasive technique that uses a thin tube containing a miniature camera and surgical instruments. It involves much smaller incisions than open surgery and speeds recovery to the point that patients are up within hours. Though the procedure is not appropriate in all cases, it offers significant advantages, especially in older or frail patients.
  • Laser surgery allows surgeons to remove small amounts of lung tissue. Laser surgery may also be beneficial in treating cancers that have spread to and are obstructing the throat.
  • Photodynamic therapy uses bronchoscopy and special laser light beams combined with a light-sensitive drug, called porfimer sodium (Photofrin), to kill cancer cells.
  • Cryosurgery uses a probe chilled to below freezing to destroy the tumor cells on contact. It is being investigated in combination with radiation therapy. It may also be an alternative in early stage cancer for patients who cannot have surgery.
  • Electric cauterization, which uses electricity to produce heat that destroys tissue, is also under investigation as a treatment for early-stage disease.
  • Radiofrequency ablation is a non-surgical technique that uses an x-ray guided electrode to deliver heat to tissues may benefit lung cancer patients who are not eligible for surgery, radiation, or chemotherapy.

Radiation Treatments
The goal of radiation treatment is to administer doses as high as possible to kill as many cancer cells as possible, without destroying surrounding healthy tissues or causing a dangerous reaction. Doctors may try different procedures for the same patient. The exact radiation procedure depends on the site of the cancer or how far it has spread.

  • External-beam radiation therapy focuses a beam of radiation directly on the tumor. It is generally used for cancer that has spread.
  • Brachytherapy implants radioactive seeds through thin tubes directly into the cancer sites. Brachytherapy may be used for lung cancers that have spread to the throat and caused obstruction. High-dose-rate brachytherapy may also have some value for patients with inoperable tumors in the central region of the lung.

Three-Dimensional Conformal Radiotherapy
Three-dimensional (3-D) conformal radiotherapy delivers external-beam radiation specifically to targeted organs or tissues. This allows doctors to administer significantly higher doses to attack the cancer, while reducing the risk to healthy cells. This technique is generally considered the standard method of delivering radiation to lung tumors.

Learn more about radiation oncology treatments at New York Methodist.

Chemotherapy Treatments
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells that may have spread beyond the tumor.

Learn more about chemotherapy and infusion therapies at New York Methodist.

For more information on lung cancer diagnosis and treatment at NYM, please call 718.780.5835.

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