Lung Cancer

Overview

Lung cancer is the third most common cancer in men and women. In the U.S., one in 16 people will develop the disease, which means more than 234,000 new cases are diagnosed each year.

Lung cancer is divided into two types: small cell lung cancer and non-small cell lung cancer. Small cell almost always develops in people who are or were heavy smokers. Non-small cell is an umbrella term for several types of lung cancers that function in the same way: squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

The Patricia Lynch Cancer Center at Holy Name has a multi-disciplinary team of experienced and skilled surgical oncologists, medical oncologists, radiation oncologists, nurses and support staff to diagnose and treat lung cancer. Together they provide a compassionate, unified approach in creating a personal strategy for each patient's unique medical, emotional and lifestyle needs.

Symptoms

In its early stages, lung cancer typically doesn't have any symptoms. As the disease progresses, it may cause:

• Persistent cough
• Coughing up blood
• Shortness of breath
• Chest pain
• Hoarseness
• Weight loss without trying

Risk Factors

In addition to smoking, other conditions may increase the risk of developing lung cancer.

• Exposure to secondhand smoke
• Exposure to radon, a natural gas from rocks and dirt that can get into homes and commercial buildings
• Exposure to asbestos and other carcinogens such as arsenic, chromium and nickel
• Family history – a parent, sibling or child who had lung cancer

Diagnosis

Tests for lung cancer typically begin with imaging screenings such as X-rays and low-dose CT scans. Additional tests may include:

• Needle biopsy – a minimally invasive method using CT imaging to accurately guide a needle to sample an abnormal imaging finding.
• Bronchoscopy – a small camera is advanced into the lung to visualize the inside airways and allow the physician to obtain a sample of abnormal tissue.
• Mediastinoscopy – a minor surgical procedure done at the base of the neck to take samples of lymph nodes in the center of the chest.

Treatment

A team of Holy Name oncology specialists, including board certified physicians and other experts, meets regularly to create a personal treatment plan for each patient. They consider the patient's overall health, the type and stage of the lung cancer and the patient's needs and preferences. Based on these factors, the oncology team may recommend surgery, radiation, chemotherapy, targeted therapy, immunotherapy or a combination of these treatments.

Surgery

Surgery is usually recommended for lung cancer in the early stages, depending on the size and location of the tumor and when it can be safely removed entirely. Many patients may be eligible for minimally invasive robotic lung surgery. There are several types of surgical procedures in the treatment of lung cancer:

• Segmental or wedge resection - removal of a small part of the lung
• Lobectomy - removal of a lobe
• Pneumonectomy - removal of the entire lung

Radiation therapy

Radiation is the use of high-powered energy particles or waves to destroy cancer cells. It can be used in combination with surgery. Holy Name's highly trained radiation oncologists have expertise in the use of the most advanced radiation techniques to allow for more precise treatment, minimizing damage to healthy tissue. They use techniques such as:

• Respiratory gating - this tracks a patient's breathing cycle so that a higher dose of radiation is delivered to target cancer cells while avoiding healthy tissue. Holy Name is one of the few hospitals in the region to provide respiratory gating therapy.
• Intensity-modulated radiation - (IMRT) and Volumetric Modulated Arc Therapy (VMAT) use a highly complex algorithm to sculpt the radiation beam so it conforms more precisely to the 3-dimensional shape of a tumor.
• Stereotactic radiotheraphy - involves the administration of very high doses of precisely targeted radiation to small areas of disease, often enabling the delivery of an entire course of treatment over a relatively short amount of time and substantially improving cure rates while decreasing toxicity.

Chemotherapy

Drugs may be given orally or intravenously to kill cancer cells. Chemotherapy is often used in combination with surgery, before or after the procedure.

Immunotherapy

Drugs are used to activate the immune system to fight cancer cells. Often, cancer cells produce proteins that prevent the immune system from working - immunotherapy interferes with that process.

Targeted drug therapy

Certain drugs target specific abnormalities within cancer cells, causing these cells to die.

Palliative Care

Palliative care provides relief for the symptoms of lung disease and side effects from treatment. Based on the patient's preference, a palliative care team can meet with the patient during or after treatment.