How Will Your Lung Cancer Be Diagnosed?
Finding lung cancer early is key to saving lives. Unfortunately, only 16% of lung cancers are diagnosed before the tumor has grown large and the cancer has spread or metastasized, to other parts of the body. One of the reasons it is so difficult to diagnose early is that the early symptoms are similar to those of a common cold. It’s not until later stages of lung cancer do patients begin to show serious symptoms that people take notice of. Conventional chest X-Rays also often miss early-stage lung cancer and doctors now insist on a higher resolution CT scan for screenings of high-risk patients. However, many people who develop lung cancer do not fit the high-risk profile, like never-smokers, people under the age of 55, or people who quit smoking a long time ago.
When lung cancer is found earlier, there is a good chance for survival. The American Cancer Society recommends lung cancer screenings for those who are more at risk to help find and beat the disease. After a medical examination and collection of family history, if you meet ALL of the criteria below, you and your doctors should discuss the benefits and potential harms of an annual lung cancer screening:
- 55 to 74 years old
- In fairly good health (discussed further on)
- Have at least a 30 pack a year smoking history (see previous section)
- Are either still smoking or have quit smoking within the last 15 years
Imaging Screenings For Lung Cancer
If your physical exam and medical history suggest you may have lung cancer, your doctor may order diagnostic screenings to look for the abnormal cell growth. Lung cancer screenings should only be performed at facilities that have years of experience using LDCT scans for lung cancer screening. Once you obtain your scans, our team of experienced radiation oncologists are available to follow up with possible treatment options should the need arise.
Treatment Options For Lung Cancer
Lung cancer treatment is based on a number of factors including: the stage of the cancer, size and location of the tumor, your age and physical health, past surgeries and treatments, and medications. Mat-Su Valley cancer center offers a multidisciplinary approach to your treatment and has the availability of many of the most advanced non-surgical and non-invasive treatment methods available, as well as targeted therapies.
Surgery is the most common method for treating lung cancer, but only when the patient is healthy enough for surgery, and the tumor has been found early and is able to be completely removed safely, and, the cancer has not spread within the chest or to other organs. Lung cancer surgery may be used in combination with chemotherapy and/or radiation therapy, to ensure patients receive the best options to fit their individual needs. This type of procedure can often be challenging and we will work closely with your surgeons, pulmonologists, and medical oncologists to determine the best method for each you. Your medical team will always consider the many non-invasive alternatives available to you.
Types of lung cancer surgery include:
- A lobectomy, in which sections of the lungs (or lobes) affected by cancer are removed
- A pneumonectomy where the entire lung is removed if tumors cannot be fully eliminated from a lobectomy
- A wedge resection, the removal of a small, wedge-shaped piece of lung tissue
- A sleeve resection, in which tumors are removed from the lung and airway.
Radiation therapy is often used to treat lung cancer, sometimes in conjunction with chemotherapy and surgery. It uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy is used in an attempt to cure cancer, control cancer growth, or relieve symptoms caused by the tumor, such as pain.
- CyberKnife (Stereotactic Body Radiation Therapy, or SBRT, also called Stereotactic Ablative Radiotherapy, or SABR) – Because they are attached to or in your lungs, lung tumors are always moving, and can move as much as two inches with every breath. Unlike ALL other treatment systems, the non-surgical and non-invasive CyberKnife Robotic Radiosurgery System synchronizes with the movement of the tumor, continually verifying that it is precisely on target, delivering beams of high-dose radiation from all angles with pin-point precision. The unique combination of a flexible, robotic arm, the intelligent tumor tracking software and real time imaging track the smallest of movements and adjust radiation directly to the cancerous cells while you rest on a comfortable outpatient treatment center table. This focus minimizes the radiation exposure to healthy surrounding tissue and organs and limits some of the short and long-term side effects common with conventional treatments.
CyberKnife is the most recommended type of dedicated SBRT/SABR and in recent studies has proven more effective for early operable lung cancer than surgery. Much shorter than traditional radiation treatment, CyberKnife treatment is administered in one to five days.
If a patient and their lung tumor are not candidates for CyberKnife, or if the cancer is best treated with a combined approach of more than one treatment type, the Clinac iX, Brachytherapy and Hyperthermia treatments offers additional advanced conventional methods of treatment at our Providence Center. Our dedicated team of cancer fighting professionals will determine which method of treatment(s) is best for you. Below are the additional methods and treatments we offer at our center along with CyberKnife stereotactic treatments.
- External Radiation Treatment Options
- 3D Conformal – This type of radiotherapy uses 3D images to plan treatment and to deliver a dose of radiation that projects at the best angles for your tumor, avoiding surrounding healthy structures. Usually CT and/or MRI images are used for mapping out the radiation plan. Higher doses of radiation can be sent to cancer cells while much lower doses are received by the healthy tissue. This technology has allowed great improvements in safely treating lung cancer as the use of multiple beams allows normal tissue such as the heart, spinal cord and normal lung to be spared from high radiation doses.
- Intensity Modulated Radiation Therapy (IMRT)- This versatile radiation treatment is used to treat nearly every type of solid tumor. With IMRT, our Palmer radiation oncologists program the IMRT to ‘paint’ radiation doses onto the tumor with pinpoint precision. Using 3-D scans of your body, the system beams radiation to the tumor from many different angles. At each angle, the dose or intensity of the radiation can be different, and the shape of the beam can be adjusted, based your treatment needs, the shape of the tumor, and surrounding structures. These adjustments enable the prescribed amount of radiation to be delivered to each part of the tumor while minimizing exposure to the surrounding healthy tissue.
- Image Guided Radiation Therapy (IGRT) – Mat-Su Valley Comprehensive Cancer Center houses the most advanced equipment including the IGRT which can track and capture your tumor using high-resolution, three-dimensional images as it moves or adjusts with every breath. During treatment, lung tumors can move up and down and side to side as you breath, as much as two inches in any direction. IGRT, also called Gated RapidArc, pinpoints exactly where your tumor is at any given time so that you can focus the treatment on only that area, leaving the rest of the surrounding tissue unharmed. With IGRT, innovative radiographic, fluoroscopic and cone-beam CT modes are combined with software that automatically repositions the radiation beam and adjusts as the patient moves. This enables clinicians to verify that treatments are completely in sync with respiration. Your initial CT scan can be updated using IGRT each time your visit to ensure your treatment is focused.
- RapidArc Radiotherapy Technology or Volumetric Arc Therapy (VMAT) – RapidArc is a form of IMRT that delivers treatments two to eight times faster than our other dynamic treatments and it increases precision. Unlike traditional IMRT that requires multiple rotations around the patient or makes repeated stops and starts to treat the tumor from different angles, this volumetric arc therapy delivers precise 3-D doses with a single 360° rotation of the machine, typically in less than two minutes. It uses your treatment planning algorithm to simultaneously change the rotation speed, the shape of the treatment aperture, and the delivery dose rate. The shape and position of the tumor are determined from computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) diagnostic studies. This permits improved dose sculpturing over 3-D conformal radiation therapy.
- Internal Radiation Treatment
- Brachytherapy (Endobronchial therapy) – This pain-free, extremely precise radiation therapy destroys lung cancer using an intense source of radiation delivered through temporarily-placed applicators implanted into the tumor site. It is delivered internally via a computer-controlled machine typically in two to ten convenient treatments. HDR minimizes the risk of common side effects due to its ability to focus the radiation directly on the cancerous cells. This also reduces the danger of radiation exposure to nearby vital structures like the heart. The radiation is delivered into the applicators through a wire or cable inserted into a catheter and then removed between treatments. Palmer radiologists can vary the position of the wire and the length the radiation is administered to satisfy the shape and need of the cancer. Because of the high-dose rate and precision, HDR is often used as an alternative to surgery.
Hyperthermia (Thermal therapy or Thermotherapy)
This type of therapy is always used in conjunction with another type, usually radiation or chemotherapy. It focuses on killing cancerous cells by exposing them to extremely high temperatures. Research has proven that this can kill the cancer, even sometimes cells that radiation isn’t reaching, without harming healthy tissues. Hyperthermia may also make some cancer cells more susceptible to destruction from radiation. When hyperthermia and radiation are prescribed together, they are usually given within an hour of each other. Hyperthermia can also enhance the effects of certain anticancer drugs. Ask our Palmer radiation oncologists about the different types of hyperthermia currently available for your treatment.
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