Lung Cancer & Other Thoracic Cancers

Our experts with specialized training in oncology, radiology, and lung and thoracic surgery work together with you to design a comprehensive, customized treatment plan that may include: 

Radiation Therapy

• Advanced technologies such as hypofractionated treatment allow us to treat certain lung and other thoracic cancers with shorter periods of radiation, which is often more convenient and just as effective as older radiation methods.
• The latest radiation therapies such as TomoTherapy and brachytherapy minimize the impact on healthy tissues.

Surgery

• Specially trained surgeons and operating room staff provide the widest range of surgical techniques for every stage and type of lung cancer and other thoracic cancers including: Curative Surgery, Preventive Surgery, Diagnostic Surgery, Staging Surgery, Debulking Surgery, Palliative Surgery, Supportive Surgery, and Reconstructive Surgery.
• Minimally invasive surgery uses laparoscopic or robotic tools and cameras to do complex procedures through small incisions instead of a large incision. These specialized procedures allow our team to:
  o Reduce damage to nearby healthy tissue
  o Reduce pain
  o Reduce infection risk
  o Shorten recovery time
• Robotic surgery uses our state-of-the-art da Vinci® Surgical System for the highest level of surgical precision that also helps shorten your recovery time.

Medical Management

• Immunotherapy harnesses your own immune system to fight lung and other thoracic tumors. It is often used along with chemotherapy and is given through a vein in your arm or hand.
• Targeted drug therapy is used to kill cells with cancerous features throughout your body when your cancer has spread to other areas. Targeted drug therapies for lung cancer and other thoracic cancers include hormone therapies, signal transduction inhibitors, gene expression modulators, apoptosis inducers, angiogenesis inhibitors, immunotherapies, and toxin delivery molecules.

Our team of world-renowned scientists and doctors continuously participate in groundbreaking research and clinical trials to advance what is possible for treating lung cancer and other thoracic cancers. Some recent projects include:

• Using lung CT scans to predict possible COVID-19 infection and provide early interventional care.
• Developing novel immunotherapy that will be included in a national clinical trial.
• Increasing education and access to lung cancer screenings and partnering with agencies like Veterans Affairs to provide lifesaving screenings and precision oncology clinical trials to those who served our country.
• Identifying and removing therapeutic resistance during lung cancer treatments.

In addition, our Lung Transdisciplinary Cancer Team brings together experts from different research areas to collaborate on ongoing lung and thoracic cancer research projects.

As South Carolina’s only NCI-designated cancer center, Hollings offers you clinical trials and treatments that aren’t available anywhere else in the state. These opportunities provide you with access to the latest medications, therapies, and surgical techniques that can improve your outcomes. Learn more about clinical trials at Hollings and see our current lung and thoracic cancer clinical trials.

The thorax, more commonly called the chest, includes the upper half of your trunk. It extends from the bottom of your ribs up to the base of your neck. Your chest cavity contains important organs and structures such as your heart, lungs, trachea, esophagus, and the brachial plexus and vagal nerves, which are surrounded and protected by your rib cage and spine.

Thoracic cancers are masses of abnormal cells that grow in and around the organs, glands, and structures of your chest. Lung cancer is the most common type of thoracic cancer. When a thoracic tumor or abnormal growth compresses any of the important organs or structures in your chest, it can cause problems with breathing, eating, blood circulation, or nerve conduction.

Lung cancer is the third most common cancer in the United States after breast and prostate cancer, with about 240,000 people diagnosed each year in nearly equal numbers of men and women. There are two main types of lung cancer. Most (84%) are classified as non-small cell lung cancers (NSCLCs), and about 13% are classified as small-cell lung cancers (SCLCs).

About 64% of people with non-small cell lung cancer (NSCLC) that is localized (i.e., has not spread to nearby tissues) survive for at least five years after diagnosis. About 29% of those with localized small cell lung cancer (SCLC), one of the more aggressive types, survive for at least five years after diagnosis.

Generally, the further a lung cancer has spread when it is first found, the lower the five-year survival rate. However, it is important to remember that your individual case and the many factors that affect survival are unique to you, including your cancer subtype and genetics, your age and overall health, and how well your cancer responds to treatment. Remember that lung cancer treatments are advancing rapidly and survival rates are steadily improving.

The short answer is, yes, you can be cured, but your individual outcome depends on many factors such as how advanced your cancer is, the type of cancer, your unique genetic markers, and how your particular cancer responds to treatment.

All cancer patients enter into a surveillance program that includes routine CT scans to assess their ongoing response to treatment and identify whether you have had any recurrence of your cancer. Following your long-term care plan is one of the most important ways you can support your health and well-being moving forward.

Most people receive several different types of treatment over an extended period of time to make sure their cancer is treated as thoroughly as possible. Early in your treatment journey, minimally invasive surgery may be used to identify the subtype and stage of your cancer. More extensive surgery may be necessary to remove as much cancerous tissue as possible from your lungs and chest including any nearby areas where it may have spread (e.g., your lymph nodes).

You may also receive radiation treatments to destroy any remaining cancer cells in the local area. Systemic treatments like chemotherapy and immunotherapy help ensure there are no cancer cells in other parts of your body and may also be part of your treatment plan.

The exact combination and types of treatment you receive depends on the type and stage of your cancer, whether and where it has spread, and your overall health and personal preferences.

All cancers result from accumulated damage to your cellular DNA that leads to cell mutations and abnormal cell growth. By far, smoking causes the most cases of lung cancer and other thoracic cancers in the US each year. Fully 90% of lung cancers are linked to smoking. If you smoke, the best way to reduce your risk of lung cancer is to quit. You can seek help quitting from our Smoking Cessation Program and Tobacco Treatment Program.

Your genes, age, and hormones can also contribute to your risk. Many people do not realize that your risk for lung cancer and other thoracic cancers is closely tied to lifestyle factors such as your diet, weight, exercise habits, and smoking. 

Environmental risk factors can also contribute to the development of lung cancer and other thoracic cancers, including radon exposure, radiation exposure (e.g., from the UVA and UVB rays in sunlight or radioactive materials), inhaled carcinogenic substances (e.g., asbestos), and certain industrial chemicals. Cancers that start in other parts of your body, such as the breast or pancreas, can also spread to the lungs and chest cavity.

It is important to get screened for lung cancer if you are at risk. Research shows that lung cancer screening is very effective but under-utilized to detect cancer early in people who are at high risk. In particular, current or former heavy smokers (a pack-a-day or more) can benefit from a yearly screening test called a low-dose CT (LDCT) scan.

Screening is also recommended for other people at high risk for lung cancer who do not have any symptoms, because screening can help find lung cancers at an early stage and saves lives. If you think you are at risk for lung or thoracic cancer, talk to your doctor about having an annual screening test. As with all cancers, the earlier a lung or thoracic cancer is diagnosed and treated, the higher your chance of recovery and survival.

Imaging tests are very important for diagnosing lung cancer, determining its stage and how it is responding to treatment (i.e., whether it is shrinking, growing, or staying the same size). Traditionally, CT and positron emission tomography CT (PET/CT) scans are used. Magnetic resonance imaging (MRI) may be used in some cases to assess how much the cancer may involve the chest wall, spine, or adjacent nerves.

Thoracic surgery for lung cancer includes minimally invasive and larger procedures (called open surgeries) to determine the type and stage of your cancer and to remove and repair cancerous areas of your lungs and other chest tissues. Depending on the tumor location, size, and whether and where the cancer may have spread, your surgery may also involve removing tissue from your heart, chest wall, or esophagus.

Specially trained thoracic surgeons remove lung and thoracic cancers and often collaborate with specialized cardiac, neuro-, and vascular surgeons, particularly when the cancer has spread to your heart, blood vessels, or nerves. This team-based approach of bringing multiple specialists together ensures that all of the relevant experts are working together to provide you with the best outcome possible.

A tumor on your chest wall may cause swelling, or you may feel a lump or bump on your ribs, upper back, or chest. You may also have pain or an aching soreness in your chest. Depending on the tumor size and location, you may experience restricted movement in your torso, arm, shoulder, or neck. However, it is not uncommon for people with chest wall tumors to have no symptoms at all, particularly if the tumor is small and at an early stage.