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There are two main types of lung cancer: non-small cell lung cancer and small cell lung cancer.

Lung Cancer Symptoms

Common lung cancer symptoms include:

  • Shortness of breath, wheezing or hoarseness
  • Chest pain
  • Cough or coughing up blood
  • Fatigue
  • Neck or facial swelling
  • Unexplained weight loss or loss of appetite

These symptoms are not unique to lung cancer. See your primary care physician for further evaluation if you’re experiencing any of these symptoms.

Lung Cancer Diagnosis

Lung cancer typically requires examination of a tissue sample (biopsy) for a definitive diagnosis. Valley offers the latest tools to diagnose lung cancer, including endobronchial ultrasound (EBUS), navigational bronchoscopy and minimally invasive biopsy.

Lung Cancer Treatment at Valley

Lung cancer treatment depends on a variety of factors, including the type of lung cancer and the stage of disease. Your physician can determine the best treatment for you.

At Valley, we use a team approach to lung cancer treatment, including the following therapies:

Targeted Therapy: Personalized Medicine

  • EGFR inhibitors: We focus on identifying EGFR (epidermal growth factor receptor) mutations in lung cancer. That’s because EGFR inhibitors (a class of drugs) can be effective treatments in some lung cancer patients.
  • Mutational analysis: At Valley, we routinely identify EGFR mutations (a process called mutational analysis) in all surgical specimens from lung cancer patients. We do this to determine if the individual will respond to EGFR inhibitors.

For patients who don’t undergo surgery to remove their tumor, we use mutational analysis on all available biopsy specimens as well. 

  • Additional molecular tests: Our pathologists also perform other molecular tests on patients’ tumors to personalize treatment, including:
    • Kras mutational analysis, an indicator of lung cancer aggressiveness
    • ERCC1 expression, an indicator of sensitivity to chemotherapy

Immunotherapy

Through immunotherapy, your own immune system is harnessed to recognize and destroy cancer cells. At Valley, we offer immunotherapy for all FDA-approved uses in lung cancer, including first-line treatment for non-small cell lung cancer (NSCLC). 

Surgery

If patients have non-small cell lung cancer only in their chest (stage I, II and some III), we typically recommend surgery to remove the cancer. Removing the cancer offers the best chance for long-term cure. 

Operations for lung cancer removal involve two parts. At Valley, these are both performed at the same time, through the same incisions. 

  • Lobectomy: When the portion of lung containing the tumor is removed; whenever possible, we perform a lobectomy (vs. a wedge resection or segmentectomy, which removes only part of the lobe). Cancer recurrence rates are lowest after lobectomy.   
  • Lymph node dissection: When lymph nodes near the tumor are removed; we remove lymph nodes because lung cancers can easily spread to the lymph nodes.

Note: There are no side effects of lymph node removal for lung cancer, unlike what can occur when lymph nodes are removed from other parts of the body for other diseases.

Depending on a patient’s needs, we also perform the following procedures:

  • Wedge resection or segmentectomy: This procedure may be appropriate for patients with other lung diseases, such as severe emphysema, who may not be able to handle the whole lobe being removed.
  • Pneumonectomy: Some tumors may be very large, requiring the removal of the entire lung (known as a pneumonectomy).

Valley offers minimally invasive surgery options for lung cancer removal, including: 

During this procedure, our surgeons perform the entire lobectomy and lymph node dissection through a single incision (port), while the telescope is inserted through the chest tube site. This is the most minimally invasive way to perform lung cancer surgery described to date. 

  • da Vinci VATS lobectomy: Thoracic surgeons use the robotic da Vinci® Surgical System to remove one of the lobes of the lungs minimally invasively instead of through a large chest incision.

Radiation Therapy

Radiation therapy may be needed for lung cancers that are not able to be removed surgically. 

At Valley, we use radiation treatments that more precisely pinpoint the radiation to kill cancer cells vs. healthy cells: 

  • SBRT (stereotactic body radiation therapy): Valley offers SBRT using the TomoTherapy system. This form of radiation uses a CT scan before each daily radiation treatment to ensure very precise targeting of the tumor.
  • Respiratory gating: This system also tracks a tumor’s motion while the patient breathes (known as respiratory gating). This tracking provides the most accurate delivery of treatment. In some patients with small tumors in their lung, this has allowed doctors to achieve very high cure rates in as little as four treatments.

Why Choose Valley for Lung Cancer?

  • Minimally invasive lung cancer surgery: At many other institutions, lobectomy and lymph node dissection are performed through a six to eight inch incision in the side of the chest (called a thoracotomy). In a thoracotomy, the ribs are spread so that the surgeon can see and operate inside the chest.

At Valley, we offer minimally invasive options for these procedures. That means you typically have less pain after surgery and a faster recovery. 

  • Complex surgeries performed robotically: the da Vinci surgical system gives surgeons exceptional magnification of the surgical site and flexibility that not even human hands can accomplish. The robot’s precise suturing results in less pain and blood loss and a reduced risk of infection.
  • Clinical trials: Valley offers clinical trials for many different stages of lung cancer. Clinical trials allow you the chance to try new potentially effective therapies before they are widely available.
  • Personalized medicine: Through mutational analysis, we personalize treatments to fit your specific cancer’s mutations. This means that you receive the targeted treatments that will be more likely to work for you.
  • Precision radiation therapy: Through SBRT and respiratory gating, you receive less radiation to healthy cells while maximizing radiation to the cancer cells.
  • Dedicated thoracic surgery hospital unit: Following lung cancer surgery, all patients are cared for in our dedicated thoracic surgery unit at The Valley Hospital. This specialized unit has dedicated thoracic surgery nurses and a high nurse-to-patient ratio to ensure that our patients receive the best care possible after surgery.
  • Less time in the hospital after surgery: The combination of minimally invasive surgery and specialized post-surgical care has resulted in shorter hospital stays for our patients following lung cancer surgery. On average, our patients spend two fewer days in the hospital after single-port VATS lobectomy than the national average.