Lung Cancer

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
  • Hoarseness
  • "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 cancer

An 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.

Low dose CT

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.

Learn more about low-dose CT

Lung nodule program

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.

Treatments

Photodynamic Therapy for Cancer Treatment

Treatment

Photodynamic therapy is a non-invasive treatment for esophageal and non-small cell lung cancer that precisely targets cancer cells without damaging healthy cells and without severe side effects.

Brachytherapy Treatment

Treatment

Main Line Health offers lifesaving brachytherapy, which uses targeted doses of radiation to treat prostate cancer at its source.

Video-Assisted Thoracic Surgery

Treatment

Main Line Health offers video-assisted thoracoscopic surgery to help diagnose and treat medical conditions in your chest.

Radiofrequency Ablation

Treatment

Radiofrequency ablation uses heat energy to destroy abnormal cells. It may be used to treat various conditions such as cancerous tumors, cardiac arrhythmias, nerve pain and even sleep apnea caused by excess soft palate tissue.

Radiation Oncology

Treatment

At Main Line Health, our expert radiation oncologists use the latest technology to give you powerful, precise treatment.

Chemotherapy

Treatment

Chemotherapy is used to fight almost every type of cancer and is part of the comprehensive treatment plan created by our oncologists.

Access to the latest clinical trials

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.

Nurse navigators: your personal guide through cancer treatment

Cancer treatment can be overwhelming and worrisome. At Main Line Health, you have a nurse navigator (a registered nurse with special training) to help you through each stage of care. Your nurse navigator teaches you about your cancer and treatment, advocates for your best interests and helps you stay organized. Our philosophy is to treat the whole person, to ensure a healthy mind, body and spirit.

Your nurse navigator will also help you find financial advisors, social workers and support groups.

U.S. News & World Report has rated Lankenau Medical Center and Paoli Hospital as High Performing for pulmonology & lung surgery and lung cancer surgery for 2022-2023.

Services

Senior Health

Main Line Health experts provide specialized care so adults of all ages can maintain their independence and live life to the fullest.

Lung and Thoracic

Main Line Health experts use the latest technology to diagnose and treat all types of conditions affecting the chest, lungs and esophagus.

Genetics and Risk Assessment

Genetic evaluation is becoming an important part of personalized care, as many health conditions have a genetic basis and genetic test results can help to guide medical decisions. Our genetic counselors provide consultations related to cancer genetics, cardiovascular genetics and prenatal genetics.

Hematology and Blood Disorders

Whether you are fighting cancer or managing a blood disorder, the hematologists and oncologists at Main Line Health offer the comprehensive care you need.

Cancer Care

From diagnosis and throughout treatment, Main Line Health cancer specialists (oncologists) provide compassionate care for you and your loved ones through all stages of cancer treatment.