Treatments & Services
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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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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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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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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Diagnostics and Tests
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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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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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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