Penn Medicine's Abramson Cancer Center and the Abramson Cancer Center at Pennsylvania Hospital offer hope to patients facing lung cancer. Early and accurate diagnosis and the full range of treatment options available at Penn give patients with lung cancer the best chance of being cured.
Penn's Lung Cancer Program features a comprehensive team of thoracic surgeons, pulmonologists, nurses, respiratory therapists, rehabilitation specialists, medical oncologists, radiation oncologists, and pathologists. Each provides comprehensive expertise in treating lung cancer. These specialists incorporate surgery, radiation, chemotherapy and immunotherapy to deliver integrated medicine for complex management of lung cancer.
In addition, Penn researchers are on the forefront of testing new surgical procedures, applying new drug therapies and developing the protocols for proton therapy and other radiation therapies that incorporate cutting edge technology and are changing the way lung cancer is treated.
Small cell lung cancer, often called oat cell carcinoma and small cell undifferentiated carcinoma, makes up about 10 to 15 percent of all lung cancers.
This cancer often starts in the bronchi near the center of the chest. Although the cancer cells are small, they can divide quickly, form large tumors, and spread to lymph nodes and other organs throughout the body.
Because of these traits, surgery is rarely an option for treating small cell lung cancer and never the only treatment given. Chemotherapy, which targets cancer cells throughout the body, is an important part of treatment for all small cell lung cancers. When disease is limited to the chest, doctors often use radiation and chemotherapy together. In addition, these cells can often hide out in the brain despite successful treatment to the chest. Physicians often employ prophylactic cranial irradiation (PCI) as a precaution to prevent recurrence in the brain.
The most common types of lung cancer are three main sub-types of NSCLC. The cells in these sub-types differ in size, shape, and chemical make-up. Treatment for NSCLC may include surgery to remove tumors or part of the lung.
Carcinoid tumors start from cells from the neuroendocrine system, they are like nerve cells in some ways and like hormone-making endocrine cells in other ways. Neuroendocrine cells do not form an actual gland, but are scattered throughout the chest and abdomen.
Lung neuroendocrine cells sometimes grow out of control and form tumors. These are known as neuroendocrine tumors (NETs) or neuroendocrine cancers. NETs can develop anywhere in the body.
There are two other types of lung carcinoid tumors and their differences can be seen under a microscope.
Carcinoid tumors are sometimes also classified by where they form in the lung.
Very little is known about what causes lung carcinoid tumors. They probably develop from tiny clusters of neuroendocrine cells in the lung airways called carcinoid tumorlets. Researchers still do not understand how carcinoid tumorlets develop from lung neuroendocrine cells or why tumorlets sometimes grow to become carcinoid tumors, and why others materialize, but never grow.
Mesothelioma is a rare type of malignancy that affects the lining (mesothelium) around the organs in the chest and abdomen. These cells protect organs by making a special fluid that lubricates the surfaces, allowing the lungs and other organs to move during breathing.
The mesothelium has different names in different parts of the body:
There are several different subtypes of mesothelioma, including epithelioid, sarcomatoid, biphasic and desmoplastic. Epithelioid is the most common, comprising 70 to 80 percent of cases. Mesothelioma is most often attributed to exposure to airborne asbestos particles and occurs in both men and women. Asbestos is a group of naturally occurring fibrous minerals used as a fire retardant, but generally is no longer used in insulation or brake materials. The latency period between exposure and the development of mesothelioma can be as much as 40 to 50 years.
A risk factor is anything that affects a person's chance of getting cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be controlled to help prevent cancer. Others, like a person's age or family history, can't be changed.
Having a risk factor, or even several risk factors, does not mean that someone will develop cancer. And some people who get the disease may not have had any known risk factors. It is often very hard to know how much that risk factor may have contributed to the cancer. For every risk factor listed, the risk is much higher for people who smoke.
Avoiding certain risk factors can reduce the chance of developing lung cancer, but there is no known way to prevent all cases.
The number one thing people can do to reduce their risk of developing lung cancer is not to smoke and to avoid secondhand smoke. Penn offers a Comprehensive Smoking Treatment Program for people who need help to quit smoking.
Other steps that people can take to help reduce the risk for developing lung cancer include:
Most lung cancers do not cause symptoms until they have grown locally or spread. Any of the following problems should be reported to a doctor. Often these symptoms are caused by something other than cancer, but if lung cancer is found, getting treatment right away can help prevent it from spreading and/or increase the chances of it being cured. The most common symptoms of lung cancer are:
When lung cancer spreads to distant organs, it may cause:
In addition mesothelioma may cause pain in the chest due to an accumulation of fluid in the pleura, or lining around the lungs. If mesothelioma has spread beyond the chest to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
Some lung cancers can cause a group of symptoms called syndromes. Most of these symptoms are likely to be caused by something other than lung cancer, but should be checked by a doctor.
Staging is the process of finding out if and how far lung cancer has spread. The treatment plan and prognosis depend on the stage of the cancer. A staging system is a standard way for doctors to describe how large a cancer is and how far it has spread. The stage is based on the results of the physical exam, biopsies, and imaging tests.
The TNM staging system for lung carcinoid tumors and non-small cell lung is used to describe the:
Small cell lung cancer may also be staged as limited versus extensive. In the limited stage, the cancer is only in one lung and perhaps in lymph nodes on the same side of the chest, an area that is small enough to be treated with radiation.
If the cancer has spread to the other lung, to lymph nodes on the other side of the chest, or to distant organs, it is called extensive. Many doctors also consider cancer that has spread to the fluid around the lung as extensive stage.
Patients under the care of Penn's Lung Cancer Program benefit from a multidisciplinary team of specialists and the resources of the Abramson Cancer Center and Abramson Cancer Center at Pennsylvania Hospital. Internationally recognized specialists in pulmonology, oncology, radiation therapy and thoracic surgery are supported by a robust care who are committed to providing the most advanced treatment options, including:
Penn's lung cancer team has established a national reputation with a number of noteworthy attributes including:
The program focuses on:
At Penn, patients with lung cancer and their families receive the support and education they need to understand the diagnosis as well as the vast resources available to them throughout Penn Medicine. In most cases, consultations with all physicians and team members are scheduled on the same day for the convenience of patients and their families.
Penn Medicine's Lung Cancer Program at the Abramson Cancer Center offers hope to patients facing lung cancer. The early and accurate diagnosis and full range of immediate options available at Penn give patients with lung cancer the best chance of being cured.
Early diagnosis of lung cancer can be difficult. The early stages of lung cancer do not usually produce any symptoms, so only a small number of lung cancers are found early. When lung cancer is found early, it is often because of tests that were being done for something else.
The lung cancer specialists at Penn Medicine develop personalized treatment plans designed to give every patient the best possible outcome. Like all of programs at Penn's Abramson Cancer Center, the lung cancer program is focused on patient-centered care and meeting the unique needs of every patient and family.
Treatment options for lung cancer include surgery, radiation therapy and systemic treatment including both chemotherapy and targeted agents, as well as combined approaches utilizing a combination of some or all of these therapies have shown promise in extending survival of some patients with early disease.
Penn's treatment options for lung cancer include:
Each of these treatment options is explained in detail below.
There are more than 12 million cancer survivors living today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete. Survivorship programs at Penn’s Abramson Cancer Center and the Abramson Cancer Center at Pennsylvania Hospital are a distinct phase of lung cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle.
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