Common clinical symptoms include:
- Persistent cough
- Shortness of breath
- Weight loss
- Non-specific chest pain
- A change in the nature of an existing cough
- Blood in sputum
- Difficulty swallowing
Non-small cell lung cancer (NSCLC) accounts for 80 percent of lung cancers and represents the majority that can be treated surgically. The most common types of NSCLC include:
- Squamous cell carcinoma
- Large cell carcinoma
Early-stage cancers can be treated with surgery alone. You and your HQMP cancer team will collaborate on a treatment plan customized to your diagnosis, tumor size, location and extent of disease. Our thoracic oncology team is skilled at using minimally invasive techniques to remove lung cancer, such as robotic-assisted thoracoscopic surgery (RATS) with the da Vinci® surgical system.
Small cell lung cancers are types of neuroendocrine tumors. These cancers are aggressive tumors that metastasize early to lymph nodes, which means surgery is not always the best treatment option. Chemotherapy and radiotherapy may be used. Your cancer team will discuss these treatment options with you.
Advancements in targeted therapy and immunotherapy for lung cancer
Targeted therapy and immunotherapy are the future of cancer treatment. These treatments act on specific molecular pathways in lung cancer cells. The HQMP cancer team offers advanced genetic testing for thoracic cancers including the following:
- Epidermal growth factor receptor (EGFR)
EGFR is a member of the tyrosine kinase receptor family. Inhibition of this receptor blocks cell growth.
- Anaplastic lymphoma kinase (ALK)
The ALK gene codes for an abnormal protein that causes cell proliferation and spread.
- BRAF (Rapidly accelerated fibrosarcoma)
BRAF is another gene that codes for an abnormal gene that allows excessive cell growth.
- Programmed death ligand-1 (PDL-1) Cancer cells may increase response to PDL-1 to evade the body’s immune system which allows their growth to go unregulated.
- Immunotherapy agents also include a monoclonal antibody that acts at the receptor activator of nuclear factor kappa-B ligand. It may be useful for metastatic lung cancer.
Esophageal cancer is a malignant tumor of the esophagus, the tube that connects the throat to the abdomen. Common types of esophageal cancer include squamous cell carcinoma and adenocarcinoma. The HQMP thoracic surgery team has expertise treating esophageal cancer using the following procedures:
- Ivor Lewis esophagectomy is a procedure where your esophageal tumor is removed through surgical incisions in the stomach and chest. The reconnection of the esophagus and stomach is then located in the upper chest. This procedure can be done using video-assisted thoracoscopic surgery.
- Three-hole or McKeown esophagectomy procedure is where your surgeon makes incisions in your neck, abdomen and upper back. This approach is used when a more extensive esophagectomy is needed.
Mesothelioma is a rare but aggressive cancer that arises from the layers of tissue covering the lungs. It is frequently associated with asbestos exposure. Symptoms include chest pain, cough, weight loss and lethargy. Treatment often includes a combination of chemotherapy, radiotherapy and surgery. Surgical options may include:
- Pleurectomy/decortication is the removal of the pleural linings and all visible masses of tumor, leaving the affected lung in place.
- Extra pleural pneumonectomy is the removal of the affected lung, its pleural lining, part of the diaphragm and the pericardium (lining around the heart).
Chest wall tumors can arise from any soft tissue or bony structure of the thoracic cavity (chest). They can originate from the chest wall or be metastatic (spread) from other regions of the body.
Chondroma, osteochondroma and fibrous dysplasia are the most common benign tumors. Sarcomas are the most common primary malignant tumors. Symptoms of these tumors include:
- Pain or soreness of the involved chest area
- A lump protruding from the chest
- Impaired movement of the chest wall
Surgical intervention and reconstruction are often recommended as well as radiotherapy and chemotherapy. Talk with your HQMP cancer care team about these options.
Targeted resection of pulmonary nodules and lung cancer
The HQMP thoracic surgery team uses state-of-the-art approaches and treatments to remove nodules and cancers of the lung in a targeted and precise fashion.
Electromagnetic navigational bronchoscopy is an advanced technique that allows for the localization and targeting of lung nodules in a manner similar to GPS guidance. In this procedure, a patient’s CT scan is synchronized to their anatomy in the operating room, creating a “virtual reality” environment. This technique allows for:
- Precise localization
- Better cancer-free margins
- Sparing of normal lung tissue
- Shorter operating times
- Exceptional planning
Diagnosis, identification and surgical removal of lung tumors can all happen at the same time using this approach.
Tracheal and Bronchial Stenosis
Tracheal stenosis is a narrowing of the trachea, which can make it difficult to draw air into the airway. Common causes include tumors, airway trauma (tracheostomy or tracheal intubation), inflammatory diseases of the airway (e.g. Wegener’s granulomatosis or Granulomatosis with polyangiitis) and infections. Due to a high rate of recurrence, patients may often need repeat therapies. Treatments include the following:
- Endoscopic treatment is the preferred treatment for most. A small video camera (also called an endoscope) is inserted so that your doctor can see the trachea and remove excess tissue that is causing narrowing of the airway using laser or other tools. Spray cryotherapy is an alternative to thermal treatments (sometimes heat can cause scare tissue to re-form). In cryotherapy, liquid nitrogen is used to remove the excess tissue.
- Airway stenting is the use of a cylindrical, hollow prosthesis called a stent to maintain and open and functional airway. Stents are commonly used for malignant obstruction of the trachea and bronchi. Stents can be silicone (commonly used for benign disease) or metallic stents (commonly used in malignant disease).
Endobronchial Ultrasound (EBUS)
- Endobronchial Ultrasound (EBUS) allows your doctor to view your airway by combining ultrasound with a bronchoscope. It can be used to diagnose lung conditions and to obtain a biopsy with a transbronchial needle aspiration. When using this procedure for biopsy or cancer staging, there is no need for any invasive procedures, incisions or external scarring.
Tracheal tumors are rare and can be malignant or benign. Smoking is a known risk factor. Tracheal tumors usually do not produce symptoms until the tumor is large enough to cause airway obstruction. When symptoms do occur, they include cough, blood in sputum, wheezing, shortness of breath, hoarseness and difficulty swallowing.
The HQMP thoracic cancer team offers various approaches to managing tracheal tumors. Your care plan will depend on the extent of your disease and your unique diagnosis. Some treatments your doctor may discuss with you include:
- Surgical resection with or without adjuvant therapy
- Stent placement to maintain use of the airway
* Disclaimer: The content contained on this website is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.