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Lung Cancer

At Rush, we know that a lung cancer diagnosis can turn your life upside down.

That's why we don't just treat the cancer, we provide the support you and your family need to keep doing the things that are important to you. Our team of thoracic surgeons, oncologists, pulmonologists, palliative care specialists and other caregivers work with you to maintain or improve your quality of life during and after treatment.  

Of course, we also offer outstanding treatment, including minimally invasive surgery and targeted radiation therapy. So you can rest assured that when you come to Rush, you are in capable and caring hands. 

What is lung cancer?

Most lung cancer begins in the cells that line the bronchi, the two large tubes that carry air from the trachea down into the lungs.

There are two main types of lung cancer:

  • Non-small cell lung cancer (including adenocarcinomas, squamous cell carcinomas and large cell carcinomas) is the most common type. It is usually slow-growing and does not spread (metastasize) as fast as small cell lung cancer.
  • Small cell lung cancer (small cell carcinoma and combined small cell carcinoma) is very aggressive, growing and spreading rapidly.

Some people have both types at the same time. This is called mixed small cell-large cell cancer.

Cancer that spreads to the lungs from another part of the body is called metastatic cancer to the lung. It is not considered to be lung cancer. For example, when breast cancer metastasizes to the lungs, it is still called breast cancer.

Lung cancer symptoms

Symptoms of lung cancer include the following:

  • A persistent cough (one that won’t go away) that is worsening over time
  • Constant chest pain
  • Coughing up blood
  • Shortness of breath (dyspnea), wheezing or hoarseness
  • Unexplained weight loss or loss of appetite

Lung cancer causes and risk factors

  • The most common cause of lung cancer is cigarette smoking. The earlier you started smoking and the more cigarettes you smoke, the higher your risk.
  • You can also get lung cancer from secondhand cigarette smoke, so if you live or work with smokers and start having symptoms, talk to your doctor.
  • These are some of the other leading risk factors for lung cancer:
    • Air pollution
    • Radiation to the lungs
    • A family history of lung cancer
    • Exposure to asbestos

How can I get help for lung cancer?

Talk to your doctor if you experience any of the following symptoms, especially if you smoke or used to be a smoker:

  • Constant chest pain
  • A cough that does not go away and gets worse over time
  • Coughing up blood
  • Fatigue
  • You are losing weight without trying or don’t have an appetite
  • Shortness of breath (dyspnea)
  • Wheezing or hoarseness
  • You keep getting pneumonia or bronchitis

If lung cancer is suspected, you may be sent for a biopsy, a procedure in which surgeons remove a small piece of lung tissue. The tissue is then examined under a microscope to see if cancerous cells are present.

Rush also offers endobronchial ultrasound (EBUS), a less invasive way to biopsy for lung cancer that eliminates the need for even minor surgery.

In the procedure, doctors thread a bronchoscope with an ultrasound sensor on its tip through the mouth and into the airways around the lungs. If they spot something suspicious, they can pass a hollow needle through the bronchoscope to get a sample of tissue or fluid to test for cancer cells.

In a standard needle biopsy, doctors may have to go through the lung to get a sample of cells or make a cut in the neck to pass the tube through. But since EBUS goes through the mouth, it doesn't leave a wound. EBUS can also detect smaller abnormalities than a standard biopsy, which helps with early diagnosis.

Care for lung cancer at Rush

Specialists at Rush offer a full range of treatments to treat lung cancer and, when needed, to relieve the side effects of treatment. Your care team will design a plan for you that includes one or more of the following treatments, depending on the type and stage of the cancer:

Chemotherapy and other drug regimens.

Targeted therapies for non-small cell lung cancer that are gentler on patients because they zero in on cancer cells while sparing healthy surrounding tissue. These are some of the targeted therapies currently available for lung cancer:

  • Monoclonal antibodies (bevacizumab, ramucirumab)
    • Man-made versions of specific immune system proteins
    • Prevent the tumor from developing new blood vessels to feed it (tumors can't grow without a blood supply).
    • Specifically target vascular endothelial growth factor (VEGF), a protein essential to the formation of new blood vessels.
  • EGFR inhibitors (erlotinib, afatinib, gefitinib) 
    • Target epidermal growth factor receptors (EGFR), proteins found on the surface of cells that helps cells to grow and divide; work by blocking EGFR from signaling the cells to grow, which can help keep some lung tumors under control.
    • Can be used alone (without chemotherapy) as first treatment for advanced non-small cell lung cancers that have certain mutations in the EGFR gene.
    • Erlotinib can also be used for advanced NSCLC without these mutations if chemo isn't working.
  • EGFR inhibitors that also target cells with the T790M mutation (osimertinib) 
    • Can help fight against cells with T790M mutation (typically, EGFR inhibitors stop working after a few months because the cancer cells develop another mutation in the EGFR gene).
  • EGRF inhibitors for squamous cell non-small cell lung cancer (necitumumab) 
    • Can be used along with chemotherapy as the first treatment in people with advanced squamous cell NSCLC.
  • Drugs that target the ALK gen (crizotinib, ceritinib, alectinib) 
    • Block the abnormal ALK protein (a rearrangement of the ALK gene, found in about 5 percent of non-small cell lung cancers, creates an abnormal protein that makes the cancer cells grow and spread)
    • Can often shrink tumors.
    • Can help after chemotherapy has stopped working, but are also often used instead of chemotherapy in people whose cancers have the ALK gene rearrangement.
    • Crizotinib is also approved as a first-line therapy for patients with advanced non-small cell lung cancer whose tumors have a rearrangement in the ROS1 gene.

Biologic therapies, which help the body's immune system fight cancer and control the side effects of other treatments such as chemotherapy.

Photodynamic therapy, which uses a light-activated drug that kills cancer cells. Photodynamic therapy is used when a typical treatment program is not appropriate and to relieve symptoms in patients with non-small cell lung cancer that obstructs the airways.

A vaccine, MAGE-A3 Antigen-Specific Cancer Immunotherapeutic, that triggers the patient’s immune system to identify and attack specific tumor cells without harming normal cells.

Radiation therapy, which may include TomoTherapy, other forms of intensity-modulated radiotherapy and stereotactic body radiation therapy.

Surgery to remove cancerous tumors. This is called lobectomy. For most lobectomies, thoracic surgeons at Rush use video-assisted thoracoscopic surgery (VATS), a minimally invasive approach. There are many benefits to a VATS lobectomy — including less pain and fewer complications after surgery, less time in the hospital and a speedier recovery.

NanoKnife, offered by interventional radiologists at Rush, which uses bursts of electricity to create microscopic holes in cancer cells to kill them.

Rehabilitative services, including physical therapy, occupational therapy and speech-language pathology, to help you recover and restore function that may have been affected by your tumor or treatment.

Complementary and alternative therapies, including acupuncture, massage therapy and counseling, to accompany your medical treatment plan.

Why choose Rush for lung cancer care

  • The cancer program at Rush is consistently ranked among the best in the nation by U.S. News & World Report.
  • The International Association for the Study of Lung Cancer (IASLC) chose Rush's lung cancer care team as one of only five worldwide recipients — one of two in North America — of the foundation's inaugural Cancer Care Team Award in 2017. Acknowledging cancer care teams across the globe who go above and beyond to provide the highest-quality patient care, the award is unique in that the recipients were nominated by patients.
  • The Society of Thoracic Surgeons has designated the Rush Department of Cardiovascular and Thoracic Surgery as a three-star program for lobectomy, the most common operation performed to remove lung cancers. It is the society's highest rating and is bestowed only on the top five percent of thoracic surgery programs in the U.S.
  • Thoracic surgeons at Rush have performed around 900 lung surgeries over the past three years. And they perform more minimally invasive lung cancer surgeries than any other hospital in the region. People who have minimally invasive procedures have shorter hospital stays and a faster recovery compared to those who undergo traditional open surgery.
  • The lung cancer team at Rush treats the whole patient, not just the cancer. Our specialists strive to relieve pain, ease breathing problems and help you have a better quality of life during and after treatment.

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