Lung Cancer

The UofL Brown Cancer Center gives you comprehensive lung cancer care every step of the way.

Overview

From diagnosis through treatment and follow-up, the UofL Brown Cancer Center’s Multidisciplinary Lung Cancer Clinic gives you comprehensive lung cancer care every step of the way.

Some of the nation’s top lung cancer experts focus their extraordinary expertise on you, working together closely to ensure you receive the most advanced, personalized care with the least impact on your body.

Our experts have at their fingertips the latest in cutting-edge technology and techniques to treat lung cancer, including:

  • Minimally invasive surgery
  • Innovative radiotherapy planning and delivery techniques
  • Expertise with novel therapies that activate your immune system to fight the lung cancer
  • A wide range of clinical trials for lung cancer

Because your peace of mind is important to us, we specialize in techniques and therapies than can help preserve lung function.

We are often able to offer hope for lung cancer that elsewhere might be considered inoperable.

Leading-Edge Research

We at the UofL Brown Cancer Center are proud of our early focus and early adoption of immunotherapies to treat all types of cancer, including lung cancer. We are a global leader in the clinical testing of novel immunotherapies including Opdivo, Keytruda and Yervoy and have several trials for lung cancer open that offer the potential for markedly prolonged, high-quality life.

UofL Brown Cancer Center has helped advance the treatment of lung cancer in many areas. Our research has helped:

  • Demonstrate that lung cancers take up high levels of sugar
  • Pioneer the use of immunotherapies for lung cancer patients
  • Identify a novel breath test to detect lung cancer early
  • Pioneer the use of blood tests to detect lung cancer
  • Demonstrate a link between Human Papilloma Virus (HPV) and lung cancer
  • Discover nanoparticles that deliver drugs to lung cancer resistant to treatment
  • Establish activity of novel biologic therapies that target specific types of tumors
  • Establish guidelines for lung cancer care in Kentucky to help primary care providers
  • Establish criteria of excellence in the care of lung cancer
  • Provide health service research on lung cancer in Kentucky
  • Improve cost effectiveness of supportive care

UofL Brown Cancer Center offers the most advanced lung cancer treatments, many available at only a few locations in the United States. Your lung cancer therapy may include:

  • Targeted therapies
  • Gene therapy into liver metastases
  • Minimally invasive operations

We are constantly researching newer, safer, more-effective lung cancer treatments – with fewer side effects. If you are diagnosed with lung cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:

  • The stage and type of lung cancer
  • Other lung problems, such as emphysema or chronic bronchitis
  • Possible side effects of treatment
  • Your general health
     

Quit Smoking

If you're ready to quit smoking, the M. Krista Loyd Resource Center offers "Plan to be Tobacco Free" sessions in conjunction with the Kentucky Cancer Program.  A free, educational one-time session that will help those interested in overcoming tobacco use and dependence. Resources and guidance from trained counselors at Kentucky Cancer Program will be available, including creating a customized quit plan. Pre-registration is required. Call 502-562-7092.

 

Understanding a disease is the first step toward finding the right care.

Lung cancer is the most common type of cancer in both men and women in this country.  According to the American Cancer Society, almost 220,000 people are diagnosed with it each year.  Most cases are linked to tobacco smoking.

The lungs, which help you breathe, are two sponge-like, cone-shaped organs in the chest.  When you breathe in, oxygen comes through your mouth and nose.  It then travels through the windpipe (trachea), which divides into two tubes called bronchi.  These take the oxygen to the left and right lungs.  The inside of the lungs includes smaller branches called bronchioles and alveoli, which are tiny air sacs.

Each lung is divided into sections called lobes. The right lung has three lobes. The left lung, which has two lobes, is smaller than the right lung because the heart is also on the left side of the body.

The pleura is a thin membrane that covers the outside of each lung and lines the inside wall of the chest.  It usually contains a small amount of fluid and forms a protective lining around the lungs that allows them to move smoothly during breathing.

Lung cancer forms in the tissues of the lungs, most often in the cells that line air passages.  It occurs when cells in your lungs grow and multiply uncontrollably, damaging surrounding tissue and interfering with the lungs’ normal function.

Lung cancer may spread through your lymph system.  Lymph is a clear fluid that contains tissue waste and cells that help fight infection.  It travels through your body in vessels that are similar to veins.  Lymph nodes are small, bean-shaped organs that link lymph vessels.

Lung Cancer Types

Lung cancer is classified by the type of cells within the tumor.  Each type of lung cancer grows and is treated in a different way.  Lung cancers are divided into two main groups.

Non-small cell lung cancer (NSCLC): This is the most common type of lung cancer. The categories of non-small cell lung cancer are named for the type of cells in the cancer:

Adenocarcinoma begins in cells that line the alveoli and make mucus. It is found more often in nonsmokers, women and younger people.

Squamous cell carcinoma (cancer) begins in thin, flat cells in the lungs, and tobacco smoking most often causes it. It also is called epidermoid carcinoma.

Large cell carcinoma (cancer) begins in certain types of large cells in the lungs.

Small cell lung cancer: Also known as oat-cell cancer, this type of lung cancer makes up less than 20% of lung cancers and almost always is caused by tobacco smoking.  It often starts in the bronchi, then quickly grows and spreads to other parts of the body, including the lymph nodes.

Other types of lung cancer

Less common types of lung cancer include:

  • Carcinoid tumors
  • Salivary gland carcinoma
  • Some sarcomas
  • Cancer of unknown primary

Other types of cancer arising in the chest

  • Mesothilioma            
  • Thymoma
  • Lymphoma

Lung metastases

Cancer found in the lungs is sometimes another type of cancer that started somewhere else in the body and spread, or metastasized, to the lungs.  These tumors are called lung metastases, and they are not the same as lung cancer.  They usually are the primary, or original, type of cancer.

Most cancers have the same symptoms as other, less serious conditions. Still, it’s important to know the signs.

Lung cancer symptoms vary from person to person, and sometimes people with lung cancer at the time of diagnosis don’t have symptoms.  If you have symptoms, they may include:

  • A cough that does not go away and gets worse over time
  • Constant chest pain, often made worse by deep breathing, coughing or laughing
  • Arm or shoulder pain
  • Coughing up blood or rust-colored spit
  • Shortness of breath, wheezing or hoarseness
  • Repeated episodes of pneumonia or bronchitis
  • Swelling of the neck and face
  • Loss of appetite and/or weight loss
  • Feeling weak or tired
  • Clubbing of fingers

If lung cancer spreads to other parts of the body, it may cause:

  • Bone pain
  • Arm or leg weakness or numbness
  • Headache, dizziness or seizure
  • Jaundice (yellow coloring) of skin and eyes
  • Swollen lymph nodes in the neck or shoulder

These symptoms do not always mean you have lung cancer.  However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.

Lung cancer screening exams

At this time, lung cancer screening is recommended only for adults at high risk.  That’s because they have a higher chance of getting the disease.

Being at high risk doesn’t mean you’ll definitely get lung cancer.  But, you may need to start regular screening exams.  So if you do get cancer, your doctor finds it at its earliest stage.  When found early, the chances for successfully treating the disease are greatest.

You should get screened for lung cancer if you:

  • Are a current smoker (or former smoker who quit in the past 15 years)
  • Have a 30 pack-year smoking history (For example, one pack a day for 30 years or two packs a day for 15 years).

If you fall into this group, follow the screening schedule below:

Age 55 to 80

  • Low-dose computerized tomography (CT or CAT scan) every year

Check with your insurance provider before scheduling an exam.  Not all insurance providers cover the cost of this exam.

Along with regular exams, practice awareness.  This means you should be familiar with your body.  That way you’ll notice changes, like a cough that doesn’t go away or chest pain.  Then, report them to your doctor without delay.

The screening plan on this page applies to adults expected to live for at least 10 years.  They’re not for adults who have a health condition that may make it hard to diagnose or treat lung cancer.

Diagnosing Lung Cancer

Blood tests, imaging exams and even surgical procedures are used to check for cancer. If you have lung cancer, it is important to get an accurate diagnosis as early as possible and find out if the cancer has spread.  This will help your doctors choose the best type of treatment.

UofL Brown Cancer Center has the most advanced and accurate equipment available to diagnose lung cancer and find out precisely the extent of the disease.  This helps increase the likelihood that your treatment will be successful.  Our staff includes pathologists, diagnostic radiologists and specially trained technicians who are highly skilled in diagnosing lung cancer.

If you have symptoms that may signal lung cancer, your doctor will ask you questions about your medical, smoking and family history and whether you have been around certain chemicals or substances.

If you have symptoms that may signal lung cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking habits; your family history; and whether you have been around certain chemicals or substances.

One or more of the following tests may be used to find out if you have lung cancer and if it has spread.  These tests also may be used to find out if treatment is working.

Chest X-ray: The main test to find out if you have lung cancer is a chest X-ray (photographs of the lungs to look for abnormal areas).

If chest X-rays show an abnormal area, one or more of these tests may be used to find out if you have lung cancer:

Bronchoscopy: A thin flexible tube with a tiny camera is inserted through the nose or mouth and down into the lungs.  A bronchoscope also can be used to take a small tissue sample for biopsy.

Fine needle aspiration (FNA): A very small needle is placed into the tumor.  Suction is used to remove a small amount of tissue, which is then looked at under a microscope.

Thoracentesis: Fluid from around the lungs is drawn out with a needle and looked at under a microscope.

Endobronchial Ultrasound (EBUS): Guided biopsy to check for lung cancer and find out if cancer has spread to nearby lymph nodes.

Video-Assisted thoracoscopic surgery (VATS)

Imaging tests, which may include:

  • CT or CAT (computed axial tomography)
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans

Common cancer treatments include chemotherapy, radiation treatment and surgery.  Doctors select a treatment plan based on your diagnosis and disease stage.

At UofL Brown Cancer Center, some of the nation’s top lung cancer specialists focus their extraordinary expertise on you.  We customize your treatment to deliver the most advanced, least invasive treatments available for lung cancer.  And because your peace of mind is important to us, we specialize in techniques and therapies than can help preserve lung function.

UofL Brown Cancer Center offers the most advanced lung cancer treatments, many available at only a few locations in the United States.  Your lung cancer therapy may include:

  • Targeted therapies
  • Gene therapy into liver metastases
  • Minimally invasive operations
  • Treatment for lung cancers that elsewhere might be considered inoperable

And we’re constantly researching newer, safer, more-effective lung cancer treatments – with fewer side effects.  

If you are diagnosed with lung cancer, your doctor will discuss the best options to treat it.  This depends on several factors, including:

  • The stage and type of lung cancer
  • Other lung problems, such as emphysema or chronic bronchitis
  • Possible side effects of treatment
  • Your general health

Your treatment for lung cancer will be customized to your particular needs.  It may include one or more of the following therapies to treat the cancer or help relieve symptoms.

Surgery

Like all surgeries, lung cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure.

Lung cancer may be treated with surgery alone or combined with other treatments.  Chemotherapy or radiation may be given:

  • Before surgery to shrink tumors.  This is called induction or neoadjuvant therapy.
  • After surgery to help destroy cancer cells that may remain in the body.  This is called adjuvant therapy.
  • Surgery is used less often for small cell lung cancer because this type of cancer spreads more quickly through the body and is not often found in the early stages when it is confined to the lungs.

The most common types of surgery for lung cancer are:

  • Wedge resection:  Removal of the tumor and a pie- or wedge-shaped piece of the lung around the tumor
  • Lobectomy:  Removal of the lobe of the lung with cancer
  • Segmentectomy or segmental resection:  Removal of a segment, or part, of the lobe where the cancer is located
  • Pneumonectomy: Removal of the entire lung
  • Sleeve resection:  Removal of part of the bronchus

In addition, lymph nodes in the chest will be removed and looked at under a microscope to find out if the lung cancer has spread.  This will help doctors decide if you need further treatment after surgery.

Video-assisted thoracic surgery (VATS): UofL Brown Cancer Center surgeons are specially trained and highly skilled at performing this minimally invasive surgery, and they use the latest equipment available.

Other types of surgery

Sometimes surgery is needed to help problems caused by lung cancer or its treatment.  This may include:

  • Laser surgery to open a blocked airway
  • Placement of small tubes (stents) to keep airways open
  • Cryosurgery to freeze and destroy cancer tissue
  • Placement of a Pleurex-Denver catheter to drain fluid that may accumulate in the pleural cavity (the layer of tissue that surrounds the lungs)

Chemotherapy

UofL Brown Cancer Center offers the most up-to-date and effective chemotherapy options for lung cancer.  Chemotherapy is often the main treatment for small cell lung cancer or if the cancer has spread (metastasized). We offer techniques to help make chemotherapy more effective, including delivery by nanoparticles.  If surgery is not an option for you, your doctor may suggest chemotherapy and radiation.

Targeted Therapies

These innovative new drugs stop the growth of cancer cells by interfering with certain proteins and receptors or blood vessels that supply the tumor with what it needs to grow.

Radiation Therapy

New radiation therapy techniques and remarkable skill allow UofL Brown Cancer Center doctors to target lung cancer more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.  Radiation therapy may be used with chemotherapy and/or surgery.

We provide the very latest radiation treatments for lung cancer, including:

  • Brachytherapy: Tiny radioactive seeds are placed in the body close to the tumor
  • Cyber Knife: Several radiation beams are given in the exact shape of the tumor
  • Intensity-modulated radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor

Immunotherapy

Immunotherapy is a new and effective therapy to treat non-small cell lung cancer by increasing the body's own defense system.

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in lung cancer treatment, visit the UofL Physicians website here.