At Boston Medical Center (BMC), the care of patients with lung cancer is a collaborative, multidisciplinary process. In a highly supportive and patient-focused environment, the Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits.

The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling lung cancer, while managing its impact on quality of life. The Cancer Center’s physicians are pioneering advances in effective, minimally invasive techniques that lower patients’ risk, pain, and recovery time, and enable even very ill patients to improve their quality of life.

Refer a patient with a single telephone call or email to our Cancer Referral Hotline. Call 617.638.5600 for a clinical consult or email [email protected]. Patients with a diagnosis or strong suspicion of cancer are given priority appointments within 72 hours.

What Is Lung Cancer?

Normal cells divide in a regulated way to form new cells, and after performing their functions for a while, they die. Cancer cells do not always die. Instead, these abnormal cells change their makeup and begin to multiply in an uncontrolled way. The cells join together and form a tumor.

Lung cancer is the growth of abnormal cells in one or both lungs. As these unhealthy cells form tumors, they block the ability of the lungs to provide oxygen to the body via the bloodstream. Cancer cells may remain localized, or they may metastasize (spread) and invade other parts of the body.

Lung cancers take a variety of forms, including

  • Squamous cell carcinoma (also called epidermoid carcinoma), which begins in the tissues that line the lungs and is most common in smokers
  • Adenocarcinoma, which is a tumor that starts in the cells lining the glands
  • Bronchoalveolar carcinoma, which is a form of adenocarcinoma that affects more women and nonsmokers than other types of lung cancers
  • Mesothelioma, which is a rare cancer associated with exposure to asbestos and smoking

Resources for more information:

Symptoms of Lung Cancer

In the earliest stages, a patient may not experience symptoms. However, as the condition advances, a patient may notice

  • A new cough that does not go away
  • Changes in a chronic cough
  • Coughing up blood (even a small amount)
  • Shortness of breath
  • Wheezing
  • Hoarseness
  • Pain

Patients with concerns about any of the signs and symptoms listed above are urged to consult their physician immediately.

Causes of Lung Cancer

People who smoke have the greatest risk of cancer. The risk increases with the frequency and duration of an individual’s exposure to tobacco—whether through smoking or by secondhand contact. Tobacco smoke damages the cells that line the lungs. Cigarette smoke contains cancer-causing substances (carcinogens) that alter lung tissue. The damage worsens with repeated exposure. Over time, the injured cells become abnormal, multiply, and form tumors.

People who quit smoking—even those who have smoked for many years—can significantly reduce their chances of developing cancer of the lungs.

Other factors that increase lung cancer risk include:

  • Inhaling secondhand smoke
  • Exposure to radon gas
  • Breathing in asbestos and other chemicals
  • A family medical history
  • A history of certain other lung diseases
  • Excessive alcohol use
  • A combination of the above

Cancer of the lung can also afflict nonsmokers and people who have never had prolonged exposure to secondhand smoke.

Contáctenos

Tratamientos y Servicios

Wedge Resection

Also known as segmentectomy, this treatment for early-stage cancer removes an area of lung smaller than a lobe—usually the tumor and a small area of healthy lung tissue around it.

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Lobectomy

The removal of a lobe, this operation is usually effective at taking out all the cancerous tissue and decreasing the chance of cancer coming back. BMC was the first hospital in New England to perform robotic lobectomies, which require only small incisions. Robotic surgery is less painful and offers faster recovery times than more standard operations for lung cancer.

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Chemotherapy

Chemotherapy is a medication or combination of medications used to treat cancer. Chemotherapy can be given orally (as a pill) or injected intravenously (IV).

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Radiation Therapy

Radiation uses special equipment to deliver high-energy particles, such as x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells. Radiation (also called radiotherapy, irradiation, or x-ray therapy) can be delivered internally through seed implantation or externally using linear accelerators (called external beam radiotherapy, or EBRT).

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Microwave Ablation

Microwave ablation is a cancer treatment in which microwave energy is sent through a narrow, microwave antenna that has been placed inside a tumor. The microwave energy creates heat, which destroys the diseased cells and tissue. It is a newer method of treating lung cancer that can target and kill cancerous cells and relieve pain.

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Radiofrequency Ablation for Cancer

Radiofrequency ablation (RFA) is a cancer treatment in which radiofrequency energy—derived from electric and magnetic energy—is sent by means of a narrow probe that is placed in the center of a lung tumor. Surgical incisions are not required, and the probes are placed into tumors using CT scan to guide the physician. RFA is a newer method of treating lung cancer, as well as cancers of the liver, kidney, and bone. RFA can target and kill cancerous cells sparing healthy tissues that are close to the cancer. Systemic treatments such as chemotherapy and certain types of radiation are absorbed into both healthy and diseased tissue, whereas RFA is delivered directly into a tumor.

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Lung Resection

Lung resection is the surgical removal of all or part of the lung, because of lung cancer or other lung disease. Surgery can provide a cure in some cancer cases, when the tumor is discovered early. For cancer patients, the type of resection will be based on the tumor location, size, and type, as well as the patient’s overall health prior to diagnosis.

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Sternotomy

The surgeon makes an incision in the center of your chest and separates the sternum (breastbone). The surgeon then locates and removes the tumor.

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Thoracotomy

Thoracotomy involves the surgeon making an incision in your side, back, or in some cases between your ribs, to gain access to the desired area.

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VATS

VATS stands for video-assisted thorascopic surgery. This minimally invasive alternative to open chest surgery greatly reduces patient’s pain, recovery time and risk for infection. When using VATS, the physician makes tiny incisions in the patient’s chest and inserts a thorascope (a fiber-optic camera) as well as surgical instruments. As the physician turns the thorascope, its views are displayed on a video monitor to guide surgery. The surgeon has no need to stress or cut ribs, because all movements are performed at the tip of the instrument, at the point of contact with the cancerous tissue.

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Robotic-Assisted Mediastinal Tumor Resection

The surgeon uses a computer-controlled device that moves, positions, and manipulates surgical tools based on the surgeon's movements. The surgeon sits at a computer console with a monitor and the camera provides a three-dimensional view of the heart that is magnified ten times greater than a person's normal vision. The surgeon's hands control the robotic arms to perform the procedure.

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Laser Resection

Some tumors are hard to reach through surgery because of where they are. However, a laser can strike small tumors in delicate or hard-to-reach areas. When conducting a laser resection, the surgeon inserts a tool through a small incision, directs the laser at the tumor, and transmits the high-energy beam, which destroys cancerous tissue by vaporizing it.

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Pneumonectomy

This option, removal of an entire lung, is considered if a tumor is large or located in a difficult-to-reach or central position in the lung. Although pneumonectomy can result in significant loss of function, many people live quite well with only one lung.

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Minimally Invasive Tumor Removal

Video-Assisted Thorascopic Surgery (VATS) is a minimally invasive alternative to open chest surgery that involves less pain and recovery time. After giving you a sedative, the physician will make tiny incisions in your chest and then insert a fiber-optic camera called a thorascope as well as surgical instruments. As the physician moves the thorascope around, images that provide important information are projected on a video monitor. VATS is not appropriate for all patients; you should have a thorough discussion with your provider before making a decision. It is often not recommended in people who have had chest surgery in the past, because remaining scar tissue can make accessing the chest cavity more challenging and thus riskier.

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Tumor Ablation

Tumor ablation is an image-guided, minimally invasive treatment used to destroy cancer cells. In tumor ablation, a physician inserts a specially equipped needle (probe) into the tumor or tumors guided by computed tomography (CT). Once the probe is in place, energy is transmitted through it and into the tumor.

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Radiofrequency Ablation for Cancer

Radiofrequency ablation (RFA) is a cancer treatment in which radiofrequency energy—derived from electric and magnetic energy—is sent by means of a narrow probe that is placed in the center of a lung tumor. Surgical incisions are not required, and the probes are placed into tumors using CT scan to guide the physician. RFA is a newer method of treating lung cancer, as well as cancers of the liver, kidney, and bone. RFA can target and kill cancerous cells sparing healthy tissues that are close to the cancer. Systemic treatments such as chemotherapy and certain types of radiation are absorbed into both healthy and diseased tissue, whereas RFA is delivered directly into a tumor.

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Seed Implantation

This internal form of radiotherapy is delivered during a surgical procedure to remove cancerous tissue. When the resection is complete, the surgeon, in collaboration with the radiation oncologist implants seed-like radioactive pellets near the remaining portion of the lung to prevent new growth of cancer cells. The pellets remain in place for the rest of the patient’s life, although their level of radiation decreases over time.

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Pleurodesis or Pleural Effusion

Pleurodesis is a therapy that we offer for lung cancer patients to remove excess fluid—called pleural effusion—from the space between the lungs and chest wall that line the lungs (pleura). This fluid prevents the lungs from fully expanding as you breathe, causing shortness of breath. Pleural effusion is usually diagnosed by means of a chest x-ray, and a sample of the fluid may be taken to confirm its cause. There are a few ways to perform pleurodesis. One such way is video-assisted thoracoscopy, a new, less invasive method that we offer at BMC. Using a thoracoscope, a small, thin instrument with a light and lens, your surgeon will locate the area to be treated, drain your lung fluid, and then insert a talcum powder or antibiotic solution. This solution will circulate in the space between the pleura lining the chest wall and the lungs, causing some minor irritation and inflammation, which then causes the tissues to stick together, eliminating the space. Further fluid buildup is thereby prevented, allowing you to breathe easier. If the procedure is not successful, it may be repeated. Pleurodesis does not treat lung cancer, but it can be a very helpful tool in reducing symptoms.

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Cryoablation

Cryoablation, sometimes called cryotherapy, is a minimally invasive treatment used to destroy diseased cells in the esophagus caused by esophageal cancer and/or Barrett's esophagus. For cryoablation, a physician inserts a small tube (endoscope) through your mouth and into your esophagus. Once the endoscope is in place, liquid nitrogen is sprayed through the endoscope into the esophagus. The liquid nitrogen freezes the lining of your esophagus. The frozen cells die and are replaced by healthy cells. Cryoablation is used to treat Barrett's esophagus with high-grade dysplasia, and some early stage esophageal cancers. It can also be used to improve symptoms of advanced cancers. These symptoms include difficulty swallowing and bleeding.

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Microwave Ablation

Microwave ablation is a cancer treatment in which microwave energy is sent through a narrow, microwave antenna that has been placed inside a tumor. The microwave energy creates heat, which destroys the diseased cells and tissue. It is a newer method of treating lung cancer that can target and kill cancerous cells and relieve pain.

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External Beam Radiation Therapy

External beam radiation therapy is one of the most common types of radiation for cancer treatment. Radiation comes from a machine outside the body and delivers radiation to a specific location inside the body.

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CyberKnife

CyberKnife delivers highly targeted beams of radiation directly into tumors, in a pain-free, non-surgical way. Guided by specialized imaging software, we can track and continually adjust treatment at any point in the body, and without the need for the head frames and other equipment that are needed for some other forms of radiosurgery.

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Brachytherapy

Also known as internal radiation therapy, brachytherapy delivers radiation directly into the tumor (called interstitial brachytherapy) or into a surgical cavity or body cavity near it (called intracavitary brachytherapy). By delivering the radiation directly into the tumor or into a nearby cavity, the radiation only needs to travel a short distance, causing less damage to the surrounding normal tissue. Radioactive material is sealed in a delivery device called an “implant.” The implant is inserted into the body using an applicator (often a hollow tube called a catheter). Imaging tests, such as x-rays, CT scans, or MRI scans, are used to guide the radiation oncologist in placing the implant. Depending on the location of the tumor or cavity, the patient will receive either general anesthesia (drugs used to put the patient into a deep sleep) or local anesthesia (drugs used to numb the area being treated). Implants can be permanent or temporary. For high-dose-rate (HDR) treatment, the radiation oncologist places high-dose implants into the tumor or cavity for a short period of time (generally less than one hour) and then removes them. HDR treatment is given on an outpatient basis and may be repeated over several days or several weeks. Currently, HDR treatment is offered to patients with gynecologic cancers, such as cervical cancer, endometrial (uterine) cancer, uterine sarcoma (cancer of the muscle and supporting tissues of the uterus), and vaginal cancer.

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Photodynamic Therapy

Photodynamic therapy (PDT), also called photoradiation therapy, phototherapy, and photochemotherapy, has existed for about 100 years and is a type of cancer treatment that uses light to kill abnormal cells. A special drug called a photosensitizer or photosensitizing agent is circulated through the bloodstream.

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Integrative Therapy

Integrative medicine practices have been shown to reduce cancer-related symptoms such as pain, anxiety, nausea, and fatigue. The Program for Integrative Medicine and Health Care Disparities in the Department of Family Medicine at BMC combines conventional medical treatments with evidence-based complementary therapies. Free therapeutic massage to decrease preoperative anxiety and postoperative pain in cancer patients undergoing surgical procedures is available. In the Moakley Building, where BMC conducts much of its cancer care, a registered yoga instructor holds free biweekly yoga classes, and a licensed acupuncturist offers free acupuncture to cancer patients. Participants in these sessions have gained notable clinical benefits, reporting decreases in pain, depression, anxiety, nausea, and fatigue. Services to individual patients complement group activities. Consultations that focus on stress management, nutrition, and coordination of complementary therapies are also available.

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Diagnósticos y Pruebas

Blood Tests

A common tool for disease screening, blood tests provide information about many substances in the body, such as blood cells, hormones, minerals, and proteins.

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Computed Tomography (CT) Scan

CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut.

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MRI Scan

An MRI is a non-invasive diagnostic imaging that doesn't use ionizing radiation. It is painless and a harmless way of looking inside the body without using X-rays. Instead it uses a large magnet and computer to scan the body. This provides the doctor with information not available from other scans.

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Positron Emission Tomography (PET) scan

A PET scan is used to detect cellular reactions to sugar. Abnormal cells tend to react and "light up" on the scan, thus helping physicians diagnose a variety of conditions. For the PET scan, a harmless chemical, called a radiotracer, is injected into your blood stream.

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Pulmonary Function Test (PFT)

To understand how well your lungs are working, your physician may order a series of pulmonary function tests. With each breath you take in and breathe out, information is recorded about how much air your lungs take in, how the air moves through your lungs and how well your lungs deliver oxygen to your bloodstream.

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Stress Test

A stress test is used to gain more information about how your heart functions during exercise. Your physician will monitor your heartbeat and blood flow as you walk on a treadmill, and will then be able to diagnose any problems as well as plan treatment.

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Ventilation and Perfusion Scans

These tests assess breathing and circulation in the lungs. As you inhale a harmless radioactive gas, the ventilation scan monitors your lungs. Next, you receive an injection of radioactive material for the perfusion scan, which monitors blood flow through your lungs. No preparations are needed, but tell your doctor if you are pregnant or breastfeeding. Your physician may also request diagnostic procedures that require sedation.

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Bronchoscopy

During a bronchoscopy, your physician will give you a sedative and then pass a small, hollow tube (bronchoscope) through your nose and throat into the main airway of the lungs. He or she can then see any abnormal areas and extract a tissue sample for analysis.

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Endobronchial Ultrasound (EBUS)

EBUS is a minimally invasive procedure to assess lymph nodes along the bronchial tubes and frequently complements mediastinoscopy. Your physician will give you a sedative and then insert a bronchoscope through your mouth and trachea and into the lungs and surrounding tissues so that samples can be taken from lymph nodes. EBUS does not require any incisions.

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Endoscopic Ultrasound (EUS)

Your physician uses an endoscope (a long, flexible tube) with a small ultrasound transducer on the tip to obtain images of the lymph nodes deep in the chest.

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Mediastinotomy and Mediastinoscopy

When performing a mediastinotomy, the surgeon makes a two-inch incision into the center of your chest cavity (the mediastinum) to evaluate and remove tumors in your heart and lung area.

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Needle Biopsy

Your physician applies an anesthetic (numbing agent) and, guided by CT scan or X-ray, inserts a needle into you to obtain a tissue sample for analysis.

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Video-Assisted Thoracoscopic Surgery (VATS)

VATS is a minimally invasive alternative to open chest surgery that involves less pain and recovery time. It is used to both diagnose and treat a variety of thoracic conditions. The physician makes tiny incisions in your chest and inserts a thorascope (a fiber-optic camera) as well as surgical instruments. As the physician turns the thorascope, its views are displayed on a video monitor to guide investigation or surgery.

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Chest X-ray

Chest x-rays provide an image of the heart, lungs, airways, blood vessels and bones in the spine and chest area. They can be used to look for broken bones, diseases like pneumonia, abnormalities, or cancer.

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Biopsy

Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells.

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Nuestro Equipo

BMC’s comprehensive lung cancer program has earned an international reputation with physicians who are distinguished as national leaders, researchers, and experts in the care of patients at all stages of the disease. The hospital’s patient-centered, multidisciplinary approach assures each patient benefits from the collaborative expertise of physicians uniquely focused on their individual needs.

Thoracic Surgeons

Kei Suzuki, MD

Thoracic Surgeon
Assistant Professor of Surgery, Boston University School of Medicine

Special Interests

Lung Cancer, Esophageal Cancer/Disease, Mediastinal Disease

Medical Oncologists

Umit Tapan, MD

Assistant Professor of Medicine, Department of Medicine, Boston University School of Medicine

Special Interests

Non-Small Cell Lung Cancer, Small Cell Lung Cancer, Mesothelioma, Immunotherapy, Targeted Therapy/Precision Medicine

Pulmonologists

Hasmeena Kathuria, MD

Pulmonologist

Special Interests

Pulmonary/Critical Care, Tobacco dependence treatment, sleep medicine, Lung nodule evaluation, smoking cessation

Christine L Campbell-Reardon, MD

Liaison, Pulmonary Thoracic Oncology Program
Assistant Professor of Medicine, Boston University School of Medicine, Boston MA

Special Interests

Lung Cancer, Chronic Respiratory Failure, Noninvasive Ventilation

Katrina A Steiling, MD

Assistant Professor of Medicine, Boston University School of Medicine, Boston MA

Special Interests

Pulmonary Medicine, Critical Care Medicine, Lung cancer, COPD (chronic obstructive pulmonary disease), Lung nodules

Radiologists

Gustavo A Mercier, MD, PhD

Section Chief, Nuclear Medicine
Clinical Associate Professor of Radiology, Boston University School of Medicine
Nuclear Medicine and Molecular Imaging

Special Interests

molecular imaging, oncology imaging, cardiology imaging, neurology imaging, cross sectional imaging

Avneesh Gupta, MD

Fellowship Director, Abdominal Imaging
Radiology IT Officer
Clinical Associate Professor, Boston University School of Medicine
Abdominal Imaging

Special Interests

Diagnostic radiology

Anuradha S Rebello, MBBS

Section Chief, Chest Imaging
Clinical Associate Professor of Radiology, Boston University School of Medicine
Abdominal Imaging

Special Interests

Thoracic radiology, Abdominal imaging, Pulmonary nodules, Lung cancer screening, Lung cancer

Recursos del Paciente

Lung Cancer Diagnosis

At a patient’s first visit to BMC, he or she will receive highly coordinated, multidisciplinary care that is managed by a thoracic surgeon, a physician who specializes in treating conditions of the lungs, chest wall, and diaphragm.

Additional Information

Follow-Up Care

Periodic follow-up care is very important after treatment for lung cancer to make sure the patient remains free of tumors. At BMC, each patient’s treatment plan includes services that go well beyond the procedures to remove the cancer. A patient’s plan will include

  • Services and guidance to relieve side effects
  • Procedures to monitor and control pain during and after treatment
  • Guidance and follow-up on the details of home care

Management of care continues over the weeks, months, and years following treatment. And for out-of-town patients, this care includes collaboration with local health care providers for follow-up, using the hospital’s nationwide network of health care institutions.

Resumen de la Investigación

Cancer researchers are dedicated to understanding the causes of cancer and improving treatment options. Promising new techniques in the diagnosis, treatment, and care of patients with cancer are tested in research studies called clinical trials. A research nurse will screen all willing patients to determine if they are eligible to participate in a study.

BMC thoracic surgeons lead or take part in a number of national studies advancing new treatment options for patients with all stages of lung cancer. The number and types of clinical trials available for lung cancer patients are constantly changing. View an up-to-date list of ongoing trials here. Those interested in participating in any clinical trials at BMC should talk with their physician.

Afiliaciones

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As the principal teaching affiliate of Boston University School of Medicine (BUSM), Boston Medical Center is devoted to training future generations of healthcare professionals.  Learn more about Boston University School of Medicine.