Lung cancer is the leading cause of cancer death in both men and women, but early detection can save lives. Low-dose computed tomography lung cancer screening (CTLS) scans can detect cancers at early stages and significantly improve survival rates. Among early stage cancer detected by CTLS, the cure rate approaches 80%, and these screenings can reduce lung cancer deaths by 20 to 30%.
If you are between 55 and 80 years old and meet the following criteria, you should schedule a lung cancer screening:
Einstein’s expert team of medical oncologists, radiation oncologists, surgeons, pathologists, radiologists and nurse navigators provide comprehensive, personalized care for lung cancer and cancers of the trachea, chest wall, sternum and surrounding areas.
If you have symptoms such as fatigue, shortness of breath, chest pain, persistent cough, coughing up blood, weight loss or a lack of appetite, your doctor may order a CT or PET scan to check for lung cancer. If the scan detects a tumor or other abnormality, your doctor will likely order a bronchoscopy or surgical thoracoscopy to biopsy the abnormality and determine whether cancer is present.
For heavy smokers between ages 55 and 80, or those who quit in the last 15 years, annual low-dose CT scans can help detect lung cancer early, and reduce the risk of dying from lung cancer. Someone who smoked a pack per day for 30 years or two packs per day for 15 years is considered a heavy smoker. Those with a family history of lung cancer, or who have other risk factors for lung cancer like chronic obstructive pulmonary disease or exposure to asbestos at work, may also want to consider screening.
The latest biopsy technique for lung cancer is endobronchial ultrasound (EBUS), in which a doctor uses a bronchoscope guided by an ultrasound camera to take a tissue sample of your lung tumor or nodule. Performing the biopsy with a bronchoscope eliminates the need for an external incision, reduces the risk of a collapsed lung and will help you recover more quickly.
In cases where an endobronchial ultrasound may not be possible, your doctor may perform a minimally invasive procedure called a thoracoscopy, making a small incision in your chest wall in order to take a tissue sample for a biopsy.
Advanced Treatment Options
Once your doctors have diagnosed your condition, they will meet to discuss your case and develop treatment recommendations, providing comprehensive, coordinated care. During your treatment, your doctors will continue to get regular updates on your progress, and they may recommend adjustments to your treatment depending on how the cancer is responding, and if there are any other concerns.
Interventional bronchoscopy is a minimally invasive technique that is most often used for cancer in the trachea that partially obstructs the airway or causes it to become narrow, making breathing difficult. Using a variety of special tools attached to a bronchoscope, your doctor can shrink or remove the tumor, helping to open the airway. In some cases, this procedure may be the primary treatment for patients who are not good candidates for other therapies, but it is more commonly done to relieve symptoms prior to radiation therapy or other types of surgery.
A common treatment for many types of cancer, radiation therapy targets cancer cells with beams of cancer-killing radiation. At Einstein, we use highly advanced technology to deliver extremely precise doses of radiation, including the Varian TrueBream® linear accelerator (LINAC), which is available at Einstein Medical Center Philadelphia, and the Varian Trilogy®, which is available in both Philadelphia and Montgomery.
By creating a 3D map of the cancer using a variety of advanced imaging systems, we are able to guide the radiation beam with an incredible degree of accuracy, minimizing damage to the healthy tissue surrounding the tumor. The most common form of radiation therapy is stereotactic body radiation therapy (SBRT), or stereotactic radiosurgery (SRS) when targeting tumors in the brain. However, other types of advanced radiation therapy are also available at Einstein:
Image-Guided Radiation Therapy (IGRT) – This type of radiation therapy allows your doctor to adjust the radiation beam as the tumor moves during treatment, which is especially useful for tumors in areas such as the lung.
Intensity-Modulated Radiation Therapy – This type of radiation therapy uses multiple small beams of varying intensities that can change shape during the treatment, helping to deliver higher, more precise doses of radiation with fewer side effects.
RapidArc® Radiation Therapy – One of the fastest and most precise radiation treatments available is RapidArc®, which can deliver the same amount of radiation but up to eight times faster than other leading cancer treatments.
In some cases, your doctors may recommend removing the cancer surgically. Our surgeons use minimally invasive thoracoscopic procedures whenever possible, along with image-guided techniques. These techniques help preserve as much healthy tissue as possible while identifying and removing the full extent of the cancer. Minimally invasive therapies can also reduce post-operative pain and shorten recovery times.
In addition to surgery and radiation, a variety of other therapies may be recommended to kill cancer that has spread to other parts of the body, or prevent it from returning.
Chemotherapy drugs target and kill dividing cells, which makes them an effective treatment against cancer because cancer cells divide much more often than most normal types of cells.
Chemotherapy is often used in combination with other cancer treatments, such as radiation therapy or surgery, and can target cancer cells that may have been missed by other treatments or have spread to other areas of the body.
Your individual chemotherapy treatment plan will vary based on the type of cancer you have, where it is in your body, your overall health and other factors. A typical treatment plan may include four to eight rounds of chemotherapy, with several treatments per round, followed by a recovery period of two to four weeks. Most chemotherapy drugs are administered intravenously on an outpatient basis, but you may also have the option of taking tablets or capsules.
Immunotherapies are treatments that help your body’s immune system identify and attack cancer cells. These treatments may include lab-grown batches of your own cancer-fighting T-cells, drugs that block proteins that stop the immune system from targeting cancer cells, proteins that attach themselves to cancer cells to signal the immune system to target them, and cancer vaccines and other similar treatments.
Targeted therapiesare also cancer drugs like chemotherapy, but they work somewhat differently by targeting cancer-specific genes, proteins or the tissue environment that contributes to cancer growth and survival. Targeted therapies can have effects such as slowing or stopping formation of blood vessels that supply the tumor, triggering the immune system to attack the cancer cells, or increasing the effectiveness of chemotherapy and radiation therapy.
Through our clinical trials program, Einstein offers some of the most cutting-edge and experimental cancer therapies that are available anywhere. Learn more about our clinical trials program, and talk to your doctor to see if you qualify for any ongoing trials.
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To learn more about your lung cancer treatment options, or to get a second opinion, schedule a consultation with an Einstein specialist.
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