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Thoracic Cancer

VATSEndobronchial UltrasoundFAQs

Thoracic cancer refers to several types of cancers that can develop in the different types of cells within the lungs, as well as less common cancers of the esophagus (which carries food from the mouth to the stomach), the trachea (windpipe), or the chest wall. Sometimes these cancers spread to nearby lymph nodes.

Overall, lung cancer is the second most common cancer for men and women in the U.S. The most frequent types of lung cancer are non-small cell lung cancers (adenocarcinoma, squamous cell carcinoma and large cell carcinoma) and small cell lung cancer. Carcinoids and salivary gland carcinomas are less common types of lung cancer.

Certain symptoms may suggest lung cancer and should be explored further by your doctor. Symptoms include: a cough that lasts for several weeks, discomfort in the chest, wheezing and difficulty breathing, hoarseness, fatigue, loss of appetite, unexplained weight loss, or coughing up blood. These symptoms can be caused by many conditions besides cancer, so it's important to get them checked out as soon as you notice them. Sometimes, there are no noticeable symptoms of lung cancer until the disease is advanced. But earlier treatment offers the best chance for full recovery.

How is it diagnosed?
How is it treated?
How does Advocate Christ Medical Center make a difference?
Frequently Asked Questions

How is thoracic cancer diagnosed?

A physical exam by your doctor is the first step for diagnosing lung cancer. Depending on symptoms, your doctor may order a chest X-ray. If the X-ray shows a spot or mass, your doctor may order additional tests, including a biopsy that takes a sample of tissue to confirm whether or not the area is malignant (cancerous). Tissue sampling is done by a biopsy or needle biopsy. If the tissue is malignant, further pathology tests can determine the specific type of cancer, such as adenocarcinoma, carcinoid or other type, as well as the stage, whether it has spread, and other characteristics. Knowing as much as possible about the type and nature of the cancer is important to help determine the best treatment options.

Other procedures that may be recommended to diagnose and stage lung cancer include:

  • Mediastinoscopy - a minimally invasive surgical procedure that requires a small incision at the base of the neck or near top of the chest, just above the breast bone. The physician inserts a thin scope (mediastinoscope) through the opening, down the esophagus and into the lung to collect tissue samples for biopsy. Mediastinoscopy also enables the physician to check the esophagus and lymph nodes for cancer.
  • Bronchoscopy - a procedure that also uses a scope to view insidef the esophagus, lungs and airways and to take tissue samples for biopsy tests. The bronchoscope is inserted through the mouth and down the throat, so there is no incision.
  • Endobronchial ultrasound (also called endoscopic ultrasound) - a newer technique for diagnosing and staging thoracic tumors. Endobronchial or endoscopic ultrasound uses soundwaves to create an image of the lung or other organs. A thin endoscope equipped with a light and a lens for viewing is directed down the throat and into the airways. The probe bounces high-energy sound waves off of internal organs to create a picture of internal organs and structure, called a sonogram.
  • Computed tomography (CT scan) - a CT scan takes multiple X-ray "slices" to reconstruct a detailed image of the lung or other organs.
  • Positron Emission Tomography (PET) scan - a nuclear medicine procedure that assesses metabolic activity within organs or tissue, and can be useful in detecting cancer. The metabolic activity within malignant tissue differs from metabolic activity in non-cancerous tissue. PET is not effective at detecting carcinoid tumors in the lung.

Surgery ("lobectomy") - is often considered as a treatment for lung cancer in its early stages, especially for localized large-cell adenocarcinomas and squamous cell carcinomas. Depending on the size and location of the tumor, the surgeon may consider removing a portion or a lung, a lobe (large section) of the lung, or the entire lung, as well as lymph nodes where cancer has metastasized. Newer surgical approaches like video-assisted thoracic surgery (VATS) enable surgeons to resect (remove) some lung tumors that previously were considered "inoperable." Surgery also may be recommended for early-stage esophageal cancer, in which the thoracic surgeon can remove a portion of the esophagus. More advanced esophageal cancer may require removal of the entire esophagus, which has dramatic implications on the patient's quality of life. Surgery is generally not considered an option for small-cell lung cancer because of this cancer's likelihood to metastasize.

Radiation therapy - may be a treatment option for lung cancer that has spread to the lymph nodes. More advanced methods of radiation therapy destroy cancerous tissue while minimizing damage to surrounding healthy tissue.

CyberKnife® radiosurgery - is a painless technique that uses highly targeted, high doses of radiation to destroy tumors with sub-millimeter accuracy. CyberKnife may be an option for patients who are not candidates for conventional surgery because of the type or stage of lung cancer they have, or because they have emphysema, COPD, or other complicating factors. CyberKnife also can be used to treat brain metastases, which often occurs with late-stage lung cancer.

Brachytherapy - involves implanting seeds, wires or rods that contain radioactive isotopes inside the body, close to the tumor site. These implanted devices allow high doses of radiation to be concentrated right at the tumor site, so there is less damage to surrounding non-cancerous tissue. Sometimes radiation oncologists combine brachytherapy with external beam therapy for a more powerful effect.

3-D conformal therapy - allows for more precise delivery of radiation treatment than traditional radiation therapy methods. In 3-D conformal therapy, a CT scan (computerized tomography) pinpoints the location of cancer. A sophisticated computer assists with calculating the most effective volume of radiation to use and the precise area of distribution. The computer then helps guide radiation beams to the specific target area, thereby minimizing the effect on surrounding healthy tissue.

Intensity modulated radiation therapy (IMRT) - an advanced method of high-precision radiotherapy that uses a linear accelerator to deliver radiation to the tumor site, based on 3-D imaging of the tumor dimensions obtained through CT scanning. The linear accelerator focuses high-dose radiation beams directly on the tumor, thereby minimizing radiation exposure to healthy tissue near the tumor site. For more impact, the linear accelerator delivers radiation from several different angles around the tumor.

Chemotherapy - uses special drugs to destroy cancer. Small-cell carcinoma usually responds to chemotherapy; however, it cannot be completely eliminated by chemotherapy drugs currently available. New promising drugs may be available to some patients through clinical trials.

How Does Advocate Christ Medical Center make a difference?

Advocate Christ Medical Center's experience and resources truly make a difference for individuals facing thoracic cancers. Our physicians are known for treating patients with newly diagnosed cases of lung cancer. Research shows that more experience leads to better results. Beyond our impressive experience with lung cancer, our team has much experience treating cancers of the esophagus, chest wall, and cancer that has metastasized to lymph nodes in the chest.

Christ Medical Center uses some of the most advanced technologies available to diagnose and treat thoracic cancers, including complex cancers that other hospitals may consider too difficult to treat. State-of-the-art methods such as CyberKnife radiosurgery, video-assisted thoracic surgery (VATS), endobronchial endoscopy, and new anti-cancer drugs available through clinical trials offer new hope to adults with cancers of the lungs, esophagus or chest wall. Physicians at Christ Medical Center are leaders in applying these new advances. In fact, radiation oncologists at Christ Medical Center were the first physicians in Illinois to use CyberKnife technology to treat lung cancer.

Our multidisciplinary approach means that patients benefit from the collaborative expertise of thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, pathologists, cardiologists, and nurses with special training in the care of patients who have cancers of the lung or esophagus.

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