Likely Treatment Scenarios
Treatment for thoracic cancer is highly individualized and guidelines and protocols can change frequently based on outcome research and treatment advances. Therapy depends on a host of factors, including the type of chest cancer you have, whether it is confined to one location (localized) or spread to another area (metastasized), your anatomy and the shape and size of your tumor, your own personal medical condition and fitness for surgery, and your response to therapy. Most often you receive a combination of treatment modalities, under close supervision from your team of doctors. Some representative treatment scenarios follow.
Non-Small Cell Lung Cancer
The general treatment in early stage non-small cell lung cancer is surgery for patients who are medically fit, followed by surveillance or chemotherapy depending on tumor size and presence of lymph node metastasis. If for medical reasons you are not able to tolerate surgery, CyberKnife stereotactic radiosurgery or radiofrequency ablation may be the best option for you.
If your cancer involves the lymph nodes of the mediastinum, the central area of the chest, then doctors are likely to recommend a combination of chemotherapy and radiation therapy, to shrink the tumor first, and then if possible, based on your medical condition and the anatomic location of the tumor, surgery to remove (resect) it. If you are not able to tolerate surgery, then chemotherapy and conventional radiation therapy would be the best approach.
If your cancer is at an advanced stage, then doctors are likely to recommend a combination of chemotherapy and/or biologic agents. You will also be offered an opportunity to enroll in one of our cutting-edge clinical trials.
Small Cell Lung Cancer
Treatment for limited-stage small cell lung cancer (confined to the chest area) is generally a combination of chemotherapy plus radiation. Surgery is not usually used to resect (remove) a tumor because small cell generally involves many lymph nodes in the central chest and oftentimes the primary tumor is not well defined. In patients who have a complete response to this treatment, that is, complete remission, then physicians typically recommend prophylactic (protective) cranial radiation to reduce the risk of the tumor recurring in the brain.
For extensive stage small cell lung cancer, where the cancer has spread outside the chest at the time of diagnosis, usually chemotherapy alone is the treatment mainstay, with radiation in certain circumstances.
Esophageal Cancer
Surgery alone is generally the treatment of choice for early stage esophageal cancer. If your tumor extends through the esophageal wall, or involves adjacent lymph nodes, then the standard treatment would be a combination of chemotherapy and radiation therapy together, to shrink the tumor, then if possible, based on your medical condition and the anatomic location of the tumor, surgery to remove (resect) it. In some cases, doctors may recommend chemotherapy and radiation together as the primary treatment.
Thymoma
Tumors of the thymus are generally treated by either surgery alone, if the cancer is early stage, or a combination of surgery, chemotherapy and radiation.
Metastatic Cancer
CyberKnife may be the treatment of choice if your cancer has spread from an original or primary site, such as the colon or kidney, to the lung or chest.
