Lung Cancer Treatment Program

Overview

At the Center for Thoracic Cancers, our multidisciplinary team of lung cancer specialists put together a comprehensive treatment plan just for you. Many lung patients benefit from our approach. You will see lung cancer specialists from medical oncology, radiation oncology and surgery. We:

• Offer a collaborative approach to lung cancer diagnosis and treatment
• Provide care and support tailored to each patient’s needs
• Combine clinical expertise, cutting-edge research and medical technologies to offer patients the most appropriate therapies
• Ensure patients fully understand their diagnosis and treatment options
• View patients and their family and friends involved in their care as team members

Patients are usually seen within one week of referral. Next day appointments are available - learn more in this video.

Innovative Approaches

The Center for Thoracic Cancers is among the first in the nation to provide new targeted therapies for non-small cell lung cancer. Consistently ranked as one of the best in the country by U.S. News & World Report, we provide the promising new therapies and innovative approaches to clinical care, including:

• Expertise in minimally invasive surgery for lung cancer, including lung-sparing techniques
• Genotyping (molecular fingerprinting) to determine which lung cancers carry genetic mutations that might be treated with targeted therapies
• Rapid diagnosis and staging of all biopsied tumors by pathologists who specialize in lung cancer
• Groundbreaking research regarding the molecular basis of some lung cancers
• Access to Proton Therapy at New England’s only proton radiation facility
• Access to one of New England’s only Advanced Endoscopy Services

Lung Cancer Symptoms, Staging and Treatment

Information About Lung Cancer

Cancer that begins in any part of the lungs is called lung cancer. The two basic types of lung cancer are non-small cell lung cancer and small cell lung cancer. There is also a third type of lung cancer that is very rare, called mesothelioma.

The American Cancer Society estimated that about 234,030 new cases of lung cancer (both non-small cell and small cell) would be diagnosed in the United States in 2018. It is important to remember that great strides have been made in our understanding of lung cancer. Ways to treat lung cancer have advanced even from just a few years ago.

Find additional educational information about lung cancer.

Lung Cancer Symptoms

A cough that does not go away is the most common lung cancer symptom. Symptoms depend on if the cancer is localized or if/where it has spread. Other symptoms include:

• Chest pain
• Shortness of breath
• Wheezing
• Bloody or rust-colored sputum (a mixture of saliva and mucus coughed up from the lungs)
• Hoarseness
• Swelling of the neck and face
• Weakness in the shoulder, arm or hand
• Feeling tired
• Loss of appetite or unintentional weight loss
• Fever
• Night sweats

The symptoms of lung cancer may look like symptoms of other medical conditions.

Staging Lung Cancer

These tests and procedures can also help your doctor determine the stage of lung cancer. Staging is a way of describing how much the cancer has grown, how big it is and whether it has spread to other parts of the body. Staging is important because it helps your doctor plan your treatment and determine your outlook (prognosis). Lung cancer has 4 stages, numbered from 1 to 4.

• Stage 1 means that the cancer is relatively small and contained within the lung.
• Stages 2 and 3 mean that the cancer is larger than stages 1 and 2 and may have spread into lymph nodes and surrounding tissues close to the tumor.
• Stage 4 means that the cancer has spread to the lung lining, the opposite lung, or another body organ. This is also called metastatic cancer.

Expertise in Diagnosing and Staging Lung Cancer

All members of our team of pathologists and radiologists are nationally recognized for their expertise. Our pathologists participate in weekly tumor board meetings, sharing information about each patient’s unique cancer with the entire team to help guide care planning. Our radiologists use the most advanced imaging tools to diagnose and stage thoracic cancers and to detect changes in tumors. Our imaging methods include:

• Chest radiograph
• Computed tomography scan (CT or CAT scan)
• MRI
• PET and nuclear medicine scans
• Our minimally invasive image-guided procedures for diagnosis include:
• Percutaneous needle biopsy and molecular diagnostic tests
• Esophageal ultrasound
• Navigation bronchoscopy for biopsy of peripheral lung nodules

Treating Lung Cancer

If you are diagnosed with lung cancer, your care team will work with you to develop a treatment plan that is right for you. This plan will depend on the type and stage of your cancer, your general health, and your treatment preferences.

Lung Surgery

Lung cancer surgery may involve removal of a tumor and some nearby healthy tissue, part of a bronchus, an entire lobe (section) of a lung or an entire lung. Chemotherapy or radiation therapy may also be used to kill any cancer cells left behind.

• Sleeve resection: Part of a bronchus, the main airways of the lungs
• Wedge resection: A tumor and some nearby healthy tissue
• Lobectomy: An entire section of a lung
• Pneumonectomy: An entire lung

Excellence in Surgical Care

Our team of dedicated surgeons treats some of the most challenging and complex cases from across the US. We focus only on thoracic surgery and have pioneered many now-standard procedures used to treat thoracic cancers. The team provides state-of-the-art evaluation, treatment and post-surgical services, including:

• Chest and airway reconstruction
• Laser surgery
• Minimally invasive video-assisted thorascopic surgery
• Resection of tumors in the chest wall, lungs and mediastinum
• Lung-sparing techniques for benign and malignant neoplasms of the lung
• Resection of tumors obstructing a bronchus or in the trachea

We offer many minimally invasive surgical procedures, such as:

• Bronchoscopy to explore the bronchial passages
• Navigation bronchoscopy to biopsy peripheral lung nodules or placement of radiosurgical markers to enhance tracking of the lung tumors during radiation treatment
• Esophagoscopy to sample lymph nodes around the airway or lung
• Mediastinoscopy to explore the area between the lungs and nearby lymph nodes
• Thoracoscopy to explore the thorax
• Esophageal endoscopic ultrasound
• Endobronchial ultrasound

Learn more about Mass General's Lung Cancer Surgery Program.

Non-surgical Lung Cancer Treatments

Other common treatment options for lung cancer include the following:

• Immunotherapy helps your immune system fight cancer. The immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues that are part of the lymph system. Some types of immunotherapy are also sometimes called biologic therapy or biotherapy.
• Chemotherapy kills cancer cells through the use of intravenous (IV) or oral drugs.
• Targeted therapy uses drugs that attack specific parts of cancer cells, depending on if you have a genetic mutation and what type of mutation it is. These drugs work differently from standard chemotherapy drugs.
• Radiation therapy uses high-energy radiation beams to kill or shrink a tumor while sparing healthy tissue. The radiation source can come from outside the body (external radiation therapy) or from implants inside the body (internal radiation therapy).
• Thermal ablation uses needles introduced through the skin to kill a tumor while sparing healthy tissue.
• Clinical trials may provide access to new and promising therapies for lung cancer.

Pioneering Radiation Therapy Programs

Specialists in the Thoracic Radiation Oncology Program employ high-precision radiation therapy to treat patients with lung cancers and other cancers in the chest with the overarching goal of causing little or no side effects. Pioneering technological advances for the benefit of our patients include:

• Intensity-modulated radiation therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for reducing side effects and improving tumor kill
• Stereotactic Body Radiation Therapy (SBRT) for the treatment of early stage lung cancers and increasingly also metastatic cancers
• 4-dimensional (4D) CT scanning and respiratory gating for treatment of lung tumors that move around with breathing
• Proton beam therapy in patients with certain lung cancers

Our radiation oncologists are part of a highly specialized multidisciplinary team that closely coordinates the care of each patient. Cutting-edge research aims at increasing the efficacy and reducing the side effects of radiation therapy as well as integrating radiation with revolutionizing biological drug therapies.

For more information, please see the Thoracic Radiation Oncology Program.

Lung Cancer Clinical Trials

Clinical trials are research studies which are conducted to answer questions. They can test many things including new drugs, new combinations of drugs, or already approved drugs being studied to treat patients in new or different ways. They may include new drug doses or new ways (schedules) to give the drugs. Clinical trials are run under strict guidelines with specific criteria for eligibility and treatment. Their purpose is to help find out whether new cancer treatments are safe and effective or better than the standard (current) treatment.

The Mass General Hospital Thoracic Oncology Program has a very active clinical research portfolio with the latest, top-notch investigational studies covering a wide spectrum of thoracic cancer care. The ultimate goal of clinical research is to improve the outcomes for all of our patients. If you are eligible for a clinical trial, your physician will offer you the chance for participation. We will comprehensively review the logistics and purpose of the trial and also offer alternatives including the standard of care.

Find Clinical Trials for Lung Cancer.