At Main Line Health, our surgeons perform advanced minimally invasive and robotic thymectomies to help you heal faster.
What is lung cancer?
Among men and women in the United States, lung cancer remains the leading cause of cancer deaths, killing more people every year than breast, prostate, colon and ovarian cancers combined.
There are two types of lung cancer:
- Small-cell lung cancer – less common type found mostly in heavy smokers
- Non-small cell lung cancer – more common type that includes different types of lung cancers
Most lung cancers are caused by smoking. Your risk also increases if you have had long-term exposure to secondhand smoke, radon gas, asbestos and other cancer-causes substances. Lung cancer also runs in families so you may be more susceptible if you have a mother, father, sibling or close relative who has or had the disease.
While there are known risk factors for lung cancer, there are people who get the disease who never smoked or had extended exposure to smoke in their lives.
Symptoms of lung cancer
There are generally no signs or symptoms of lung cancer until the disease has significantly progressed. In the advanced stages, you may experience:
- Chest pain
- Coughing up blood
- Difficulty breathing
- "Smoker's cough"
If you are asymptomatic (have no symptoms) but you are a smoker or you smoked in the past, you may meet certain requirements for lung cancer screening. We offer lung cancer screenings at eight convenient locations in the Philadelphia suburbs. A specially trained nurse at each location will make sure your scan is read quickly and guide you through the next steps of your care if needed.
Be sure to talk to your doctor about your concerns and options. After a complete physical exam and review of your medical history, your doctor may recommend certain tests, such as a chest X-ray, CT scan, sputum cystology (a test that examines your sputum for cancer cells) or biopsy.
If you are diagnosed with lung cancer, your doctor will discuss lung cancer treatment options with you. Treatment depends on your age, health, what stage of lung cancer you have and other factors.
Diagnosis and testing for lung cancerAn early diagnosis of cancer usually means less invasive treatment and better outcomes. Until recently, it was difficult to detect lung cancer in its early stages since symptoms generally don't appear until the disease is somewhat advanced. At that point, treatment must be aggressive and outcomes, statistically, are poorer.
Now, a scan of the lungs can identify a spot, or nodule, in the lung when it is still quite small, and easier to treat. Radiologists use computed tomography or "CT" scans, using low doses of radiation. CT combines x-ray with computer technology to produce cross-sectional images of the body and has proven to be quite effective in identifying small nodules in the lungs. In fact, studies have shown that low dose CT can lower the risk of death from lung cancer by 20% in people who are at high risk. Low dose CT is available at eight locations throughout the Main Line Health system.
If the scan reveals a nodule, you want to know quickly how serious it is. At Main Line Health, a nurse navigator works with you, your primary care physician and a pulmonologist to review the findings and determine a treatment plan that's right for you.
In many instances, a lung nodule is quite small and treatment is not indicated at this time. It does, however, require diligent monitoring and regularly scheduled follow-up. Your physicians will discuss the findings with you and recommend next steps.
Depending on the size and location of the nodule, further action may be recommended right away. This usually involves a pulmonologist getting a tissue sample from the lung either through a CT guided needle, a bronchoscopy (a tube into the lungs) or an endobronchial ultrasound. All of these procedures are minimally invasive and can be done on an outpatient basis with no overnight stay in the hospital. The tissue sample is then read by a pathologist to determine if cancer is present. The goal is to provide results of the biopsy to your physician within 48 hours. If cancer is detected, it's important to know how far it has progressed. This is called 'staging,' and may require additional imaging, either using a PET scan or MRI. A PET scan, or positron emission tomography, reveals the metabolic activity of a tumor or how likely the cancer is to spread. It allows the surgeon to chart a precise course for the tumor removal.Learn more about the lung nodule program
Lung cancer treatment options
In the earlier stages, lung cancer usually involves surgical removal of the tumor, with radiation treatments and/or chemotherapy to follow. Sometimes a piece of the lung will need to be removed as well. Main Line Health's thoracic surgeons specialize in minimally invasive surgical techniques, including:
- Video-assisted thoracic surgery (VATS) involves making small incisions around the lungs and removing the tumor with the assistance of video cameras. It is less invasive than making a large incision in the chest and is quite effective in treating early stage non-small cell lung tumors. Because it is minimally invasive, recovery is quicker.
- Robotic-assisted thoracic surgery uses a surgical robot to access the tumor in the lung through small incisions in the chest area. It is also minimally invasive and results in a quicker recovery for the patient.
- Photodynamic therapy is sometimes used to treat non-small cell lung cancer that has not spread to other areas. The procedure involves injecting light-sensitive medication into a vein. The surgeon then shines a light on the tumor through a bronchoscope which is passed through the mouth into the lungs. The light destroys the cells that have absorbed the medication.
In cases of very advanced disease, or because of other health factors, surgery may not be an option and radiation therapy will be prescribed as the initial treatment. Stereotactic radiation therapy (SRT) often is suggested for treatment of lung cancer where surgery is not an option. This involves very high doses of radiation aimed at the tumor. Radiation therapy centers offering SRT are available at all four of Main Line Health's hospitals as well as at its outpatient centers throughout the Philadelphia region.
In many instances, surgery and radiation are combined with chemotherapy which involves drug therapy usually by injection into a vein. Chemotherapy is prescribed and administered by a medical oncologist, in consultation with the surgeon, radiation therapist, pulmonologist and other members of the care team. The frequency and length of the treatment process depend on your individual treatment plan.
Clinical trials and lung cancer treatment
Clinical trials involve the introduction of new medications or a combination of therapies to patients undergoing cancer treatment. Participation is always voluntary but can bring you a new approach—and hope.
Main Line Health has been recognized by the National Cancer Institute (NCI) Community Oncology Research Program (NCORP) for its research focus. It is the only community-based cancer program in the Delaware Valley to receive this designation and one of only 34 recipients nationally. NCORP designs and conducts cancer research. Through this designation, Main Line Health patients can participate in the latest studies and trials within their communities.
If you have been diagnosed with lung cancer, and you are interested in exploring all of your treatment options, talk to your cancer team about clinical trials that might be right for you.
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