Diagnosing lung cancer
Lung cancer typically does not show symptoms until it is in advanced stages. However, if you suspect lung cancer, see your physician. You may be asked about personal, work, and family medical history, you may have blood and other tests, including chest x-rays or a CT scan.
The only sure way to diagnose lung cancer is for a pathologist to check cell samples or tissue. These are gathered in several different ways ranging from collected sputum coughed up from the lungs to inserting a needle to remove fluid or tissue to surgery involving small or long incisions.
Mission Hospital has facilities to perform endobronchial ultrasound (EBUS) for some patients. This innovative procedure can sometimes be used in place of more invasive chest surgery to gather tissue needed for diagnosis.
Many health care professionals are involved in helping decide course of treatments based on diagnosis. While this approach assures thoughtful, reasoned treatment, it may also cause confusion and added stress. That's why Mission Hospital uses a multidisciplinary approach that includes treatment planning and a nurse navigator. Patients or their physicians may request these services.
Treatment Planning
All of the medical professionals involved in lung cancer care, including surgeons, pulmonologists, radiation and medical oncologists, pathologists, radiologists, a nurse navigator, clinical cancer research and other support staff are involved in planning patient treatment. Once a diagnosis is made, the patient's findings are reviewed at a treatment conference. The iIndividual patient's medical history and diagnosis are reviewed to develop a recommended plan of treatment.
Treatment planning puts the community's specialists best minds in lung cancer care around the same table, and gives patients confidence that everyone involved in their care is on the same page. After the group agrees on a course of treatment, the patient's physician reviews the findings with the patient to decide on a course of action. A nurse navigator (who attends the treatment conference) also works closely with patients, providing education and assistance as needed.
Nurse navigator key to process
An experienced cancer nurse serves as patient advocates in the Lung Program. Becky Pitts provides support, education, coordination, and interpretation for people with lung cancer. She also refers patients to support resources.
Treatment
Treatment options for lung cancer include surgery, chemotherapy, radiation therapy, targeted drug therapy, or a combination of these. Clinical trials are also an important option - Mission Hospital is currently participating in several lung cancer clinical trials, and these trials will increase with the UNC Lineberger Comprehensive Cancer Center connection.
People with non-small cell lung cancer may have surgery, chemotherapy, radiation therapy, or a combination, depending on the stage of the cancer.
- Stage I and II lung cancer patients will usually have surgery to remove part or the entire lung. Stage II patients also receive radiation and chemotherapy.
- Stage III and IV lung cancer patients usually receive radiation therapy and chemotherapy.
Sometimes radiation and chemotherapy are used prior to surgery to shrink the tumor. However, your treatment team will help you to determine what course of treatment will work best for you.
Depending on the size and location of the tumor, patients may receive video-assisted thoracic surgery (VATS), a new less invasive procedure available at Mission that usually has a shorter recovery time.
If radiation therapy is recommended, some patients may receive a specialized treatment with the Cyberknife™. This treatment focuses higher doses of radiation directly on the tumor.
Some patients with non-small cell lung cancer may also receive targeted drug therapy. These drugs work best in patients whose tumors have specific mutations. There are many new targeted drugs being tested alone and in combination with standard chemotherapy drugs in clinical trials.
Limited stage small cell lung cancer patients usually receive radiation and chemotherapy. With extensive stage small cell lung cancer, patients are treated with chemotherapy.
For more information on the Lung Program call 828-213-0885.
