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.
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.
Screening is the use of tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.
In the past, no lung cancer screening test had been shown to lower the risk of dying from this disease. Studies involving spiral CT (or helical CT) have shown some promise in finding early lung cancers in heavy smokers and former smokers. So far, major medical groups have not recommended routine screening tests for all people or even for people at increased risk, such as smokers.
People who smoke, who smoked in the past, or who have been exposed to secondhand smoke, as well as those who have worked around materials that increase the risk for lung cancer need to be aware of their lung cancer risk. They should talk to their doctors about their chances of getting lung cancer and the pros and cons of lung cancer screening.
For those who decide in favor of testing, the physicians in Penn Medicine's Lung Cancer Program are experienced in lung scanning and the latest screening techniques for people at high risk.
If patients have any signs or symptoms that suggest they might have a lung tumor, their physician takes a complete medical history, including family history, and checks for symptoms and possible risk factors.
A physical exam provides information about general health, possible signs of lung cancer and other health problems. During the physical exam the doctor pays close attention to the chest and lungs.
If symptoms and/or the results of the physical exam suggest a lung tumor might be present, imaging tests, lab tests and other procedures may be performed to confirm the diagnosis.
There are a number of different tests that take pictures of the chest and lungs. Some of these are used to find lung cancer, to see if it has spread, to find out whether treatment is working, or to spot a cancer that has come back after treatment.
At Penn, pathologists look at cells under a microscope to determine if they are cancerous.
Pulmonary function tests (PFTs) are often done after lung cancer has been found. These tests show how well the lungs are working. PFTs can give the surgeon an idea of how much lung can be removed or whether surgery is a good option at all.
Even if imaging tests such as a chest X-ray or CT scan find a mass, it is often hard for doctors to tell if the mass is a carcinoid tumor, another type of lung cancer, or an area of infection. In many cases, the only way to know for sure is to perform a biopsy, in which cells from the tumor are removed and examined under a microscope.
Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the stage of mesothelioma, so staging may not be complete until all the tests are finished.
The stage of a cancer does not change over time, even if the cancer progresses. A cancer that comes back or spreads is still referred to by the stage it was given when it was first found and diagnosed, only information about the current extent of the cancer is added. A person keeps the same diagnosis stage, but more information is added to the diagnosis to explain the current disease status.
Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's chance of recovery.
The system used to describe the growth and spread of non-small cell lung cancer is the American Joint Committee on Cancer (AJCC) TNM staging system. The TNM system is based on three key pieces of information:
Numbers or letters appear after T, N, and M to provide more details about each of these factors. The numbers zero through four indicate increasing severity, and X means the information is not available.
The TNM staging system is complex and can be difficult to understand. Patients and their families are encouraged to ask the care team for an explanation of their cancer staging.
Once the T, N, and M categories have been assigned, this information is combined to assign an overall stage grouping. The staging diagnosis depends on the type of cancer and the staging system the doctor is using, but in general there are four stages of lung cancer:
Some stages are subdivided into A and B. The stages identify cancers that have a similar prognosis and thus are treated in a similar way. Patients with lower stage numbers tend to have a better prognosis.
For treatment purposes, some doctors prefer the two-stage system that divides small cell lung cancers into limited stage and extensive stage.
Small cell lung cancer is often staged in this way because it helps separate patients who may be able to get local treatments such as surgery and/or radiation therapy to try to cure the cancer (limited stage) from those for whom these treatments aren't likely to be helpful (extensive stage).
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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