ProHealth Care has a team approach to lung cancer that focuses on individualized care. It includes the involvement of physicians from specialties like pulmonology, thoracic surgery, medical oncology and radiation oncology, as well as other health care professionals, such as specially trained nurses, social workers, dietitians and counselors.
Regular communication among team members is an important element to our approach, as is access to a full range of therapy options, care that is in line with national standards, and involvement of patients in their care discussions and management.
PET scans: Positron emission tomography (PET) scans measure metabolic activity in the body to determine the stage of a patient's cancer and indicate whether it has spread to lymph nodes, bones or other organs.
CT-guided needle biopsy: This minimally invasive outpatient procedure is performed by a trained radiologist who uses CT imaging technology to guide a needle through the skin into the lung to remove cells or tissue from a lung mass or lymph node for biopsy. It is most effective for tumors located near the chest wall.
Electromagnetic navigation bronchoscopy: Also a minimally invasive outpatient procedure, ENB uses electromagnetic navigation (similar to a car GPS system) with real-time chest CT pictures to guide a scope to a desired spot, usually deep in the lung. It allows a pulmonologist to remove tissue samples for biopsy from masses inside the lung or place markers for radiation therapy while the patient is under anesthesia.
EBUS: Endobronchial ultrasound or EBUS is an outpatient procedure where an ultrasound probe at the end of a scope is passed into the patient’s windpipe while he or she is under anesthesia. It allows a lung specialist to see and biopsy enlarged lymph nodes in the center of the chest.
Minimally invasive thoracic surgery: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgery that allows the surgeon to view the inside of the chest cavity. It is used to diagnose and treat problems in your chest. A small camera allows the surgeon to examine the outside of the lungs and inner surface of the chest wall. Abnormal looking areas on the lung’s surface or within the lung can be biopsied during the procedure.
Molecular profiling: This is a method of testing cells from a lung cancer tumor for abnormal changes in genes or altered proteins that boost cancer growth. The information gathered is used to identify “targeted therapies,” which block the specific molecule that is involved in the growth and spread of these cancer cells and which can provide better treatment of lung cancer.
Two types of robotic-assisted surgery:
- RATS with wedge resection/segmentectomy is a minimally invasive type of robotic video-assisted thoracoscopic surgery that allows the surgeon to remove a small wedge-shaped piece of lung that contains the cancer as well as a margin of healthy tissue around the cancer. Nearby lymph nodes also are removed and then examined for possible spread of the cancer. This type of surgery is likely to be done when the patient’s lung function would be decreased too much by removing a lobe of lung.
- RATS with lobectomy is another minimally invasive type of robotic video-assisted thorascopic surgery in which the surgeon removes the entire lobe of the lung containing the tumor. Nearby lymph nodes also are removed and examined for possible spread of the cancer. This is the preferred operation for early stage non-small cell lung cancer if it can be done.
Two types of radiation:
- Intensity modulated radiation therapy is a type of conventional external beam therapy that uses a computer to aim radioactive rays at tumors from outside of the body, killing cancer cells over time. Radiation is administered based on tumor size, shape and location. The intensity of the beams can be adjusted as needed to match the exact shape of the tumor, minimizing damage to surrounding tissue. Generally, five treatments are required each week for a period of several weeks. The treatments cause no pain and only last a few minutes each.
- CyberKnife® is a very precise form of radiation treatment that uses a computer-controlled robotic arm to aim highly concentrated beams of radiation at tumors with pinpoint accuracy. The precisely directed radiation attacks cancer cells while minimizing injury to healthy tissues surrounding the tumor. This type of radiation does not require an incision. CyberKnife treatments are provided in an outpatient setting and typically range from three to five visits lasting a little over an hour at each visit. CyberKnife treatment may be a great alternative for patients with an inoperable lung tumor.
Chemotherapy: The use of drug therapy to kill cancer cells. It may be administered before surgery, after surgery, in conjunction with radiation therapy or as a single treatment.
Molecular targeted therapy: Different from traditional chemotherapy, this approach involves drugs that work by targeting specific genes or proteins found in lung cancer cells or in cells related to cancer growth, such as blood vessel cells. They block or turn off the signals that tell these cells to grow and divide, thereby slowing or stopping their growth. A primary goal of targeted therapy is to fight cancer with more precision and potentially fewer side effects.
Immunotherapy: This new approach to treating advanced lung cancer uses medicines to stimulate a person's own immune system to recognize and destroy cancer cells more effectively.
Clinical trials: We may recommend research studies that offer access to the most advanced, clinically approved treatments available, including molecular targeted therapies and immunotherapy.