Lung cancer is the most deadly of cancers in the U.S., resulting in more than 160,000 deaths of men and women every year. It occurs most frequently after repeated exposures to substances that cause tissue irritation, such as tobacco smoke, asbestos, and radon gas. These substances, called carcinogens, result in the uncontrolled growth of abnormal cells in one or both of the lungs. Tumors grow and interfere with the normal functioning of the lung.

Lung cancer usually begins in one lung and then spreads (metastasizes) to the lymph nodes or other tissues in the chest. It also can spread to other organs in the body, such as the brain, liver and bones. Surgery, radiation therapy and chemotherapy are used to treat lung cancer. How they are used, alone or in combination, depends on how far the cancer has progressed.

Lung cancer is believed to develop over a period of many years. Cancers that begin in the lungs are divided into two major types, non-small cell lung cancer and small cell lung cancer.

• Non-small cell lung cancer is the most common type. There are four major types of non-small cell lung cancer: squamous cell carcinoma, adenocarcinoma, bronchoalveolar, and large cell carcinomas. This type of cancer is staged according to size of tumor, presence of lymph node involvement, and presence of tumor outside of the chest.

• Small cell lung cancer is less common than non-small cell lung cancer. It arises from a neuroendocrine cell that is present in many areas of the body. This cancer is considered limited if it exists only in the chest and extensive if it is present in multiple areas of the body.

It is estimated that up to 90 percent or more of all lung cancers could be prevented if people did not smoke. The Lankenau Hospital Cancer Center is committed to helping individuals confront nicotine addiction through free community-based and inpatient initiatives based on smoking cessation counseling. Lankenau's SmokeFREE programs address the physical and psychological addiction to smoking in a state-approved program that has been in existence since the 1980s. Our qualified instructors follow-up with program participants by telephone, offering support and encouragement throughout the smoking cessation process.

A Collaborative Team Approach
The multidisciplinary Lung Cancer Program at Lankenau Hospital has been serving the Philadelphia and Delaware Valley region since 1996 with a collaborative approach to patient care. We work together with patients, their loved ones, and referring physicians throughout the diagnosis and treatment process, providing expert guidance and support along the way.  Our expert team includes board-certified physicians, nurses and other professionals with special skills and training in their respective fields:

• Pulmonology (lung diseases)
• Medical oncology (treatment, including chemotherapy)
• Radiation oncology (radiation therapy)
• Surgical oncology and cardiothoracic (chest) surgery
• Oncology nursing
• Social work

In the Lankenau Lung Cancer Program, doctors evaluate an individual's personal and family medical history, tobacco use, and exposure to environmental and occupational dangers. A physical examination also is performed, and specially trained physicians and technical staff use some of the latest diagnostic tools, such as CT volume measurement, to provide an expert diagnosis. Once a diagnosis is confirmed, we conduct additional tests to stage the cancer, or determine if the cancer has spread and how far.

Treatment is based on the type, stage, and size of the lung tumor, and the patient's personal preferences. We thoroughly review test results and discuss treatment options in detail with patients and their families, addressing any questions and areas of concern. When necessary, we can begin treatment the very same day. We directly communicate our team's recommendations to primary care and referring physicians as part of our collaborative approach.

Advanced Diagnostic Imaging Capabilities
A full range of diagnostic imaging tests is available to patients at Lankenau Hospital. From chest x-ray to CT scan and (Positron Emission Tomography) PET scans, doctors and surgeons can order tests to get the best possible view of the lungs. With PET scanning capabilities available onsite, doctors have access to one of the best tools for selecting treatment options and accurately staging lung cancer. The PET scan reveals the metabolic activity of a tumor, or how likely the cancer is to spread, and allows the surgeon to chart a precise course for tumor removal.

Common Treatment Options
Treatment for lung cancer is based on the type, stage, and size of the lung tumor, as well as your personal preferences, prognosis, and ability to tolerate certain medical procedures or medications. The goal of treatment is to preserve healthy tissue while destroying the tumor at its point of origin, in addition to any cancer cells that have spread throughout the body.

• Early-stage non-small cell lung cancer (Stages I, II, and some IIIA): Early-stage non-small cell lung cancer is typically treated surgically. In this procedure, a thoracic surgeon removes one or more lobes of the lung in addition to surrounding lymph nodes. Before such an operation, patients are evaluated by their physicians to make sure that they can tolerate the procedure. Treatment after surgery may involve chemotherapy or radiation therapy depending on the size of the tumor and lymph node involvement.

• Locally advanced non-small cell lung cancer (Stage IIIA): Many patients present with a large tumor with known lymph node involvement. These patients have locally advanced disease. Treatment for patients with locally advanced lung cancer may involve surgery, chemotherapy, and radiation—either individually or in combination. Chemotherapy shrinks the tumor before surgery. Radiation, high-energy beams of energy, may be administered after the tumor is removed to eliminate the last traces of disease.

• Late-stage non-small cell lung cancer (Stages IIIB and IV): Although surgery is not recommended for patients with late-stage lung cancer, chemotherapy and radiation are frequently used. The goal is to enhance quality of life and minimize pain and discomfort.

Small cell lung cancer is typically treated with a combination of chemotherapy and radiation therapy, depending on the extent of disease. Surgery typically is not recommended for patients with this type of lung cancer.

Clinical Research: A Key Component
As part of the Main Line Health Community Clinical Oncology Program (CCOP), which is funded by the National Cancer Institute, patients have access to clinical trials of recent advances in the treatment and prevention of lung cancer. We carefully explain to eligible patients the benefits and risks of participating in clinical research. Participation in a clinical trial is voluntary, and patients may decline to participate without prejudice to future medical care. By increasing the number of patients who participate in clinical trials, we soon may find the answers to critical questions about lung cancer.

Meet Our Physician Specialists...

• Thomas Meyer, M.D.; Medical Director, Lung Cancer Program

For more information or to schedule an appointment with the Lung Cancer Program, please call 610-642-3796.

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