Pancoast Cancer

Pancoast cancer – also known as superior sulcus cancer or tumor – is an uncommon cancer that arises in the very top part of the lung and invades the upper-most part of the chest cavity.

Most Pancoast tumors are non-small-cell lung cancers. Evaluation and treatment is particularly challenging because of the location of these cancers to major blood vessels and nerves.

UT Southwestern Medical Center’s specialized chest (thoracic) cancer physicians are experts in diagnosing and treating Pancoast tumors.

UT Southwestern is recognized as a pioneer in the treatment of Pancoast cancer, thanks largely to research conducted by thoracic surgeons Robert Shaw, M.D., and Donald Paulson, M.D., in the 1950s and 1960s.

These physician-scientists found that a three-pronged treatment approach – chemotherapy, radiation therapy, and surgery – led to the best outcomes for patients. Thoracic surgeon Kemp Kernstine, M.D., Ph.D., confirmed the value of this tri-modality approach in a 2014 article in the Annals of Thoracic Surgery.


If your doctor suspects that you have a Pancoast tumor, he or she will conduct a physical examination and order tests to confirm the diagnosis. Further tests may be needed to help determine the cancer’s stage and precise location.

Imaging techniques used to diagnose Pancoast cancer might include:

Chest X-ray
X-rays help visualize abnormalities in the lungs.
Contrast enhanced or multidetector computed tomography (CT) scan
CT technology helps physicians visualize the location and extent of Pancoast cancer.
Magnetic resonance imaging (MRI)
MRI helps physicians identify suspicious areas that could indicate Pancoast cancer and learn if, and how far, it has spread.
Positron emission tomography (PET)
Cancer cells absorb large amounts of radioactive sugar that are used in this technique, and a special camera creates images of that radioactivity, enabling physicians to identify Pancoast tumor cells.
Endoscopic ultrasonography
This technology maps sound waves to help doctors visualize the precise location of the Pancoast tumor.

Additional testing also may include a tissue sample (biopsy) of the tumor to determine the presence of Pancoast cancer.


Because of its location, Pancoast cancer can be especially challenging to treat. Treatment options depend on the cancer’s precise location and stage, the patient’s overall health, goals, and preferences, and other factors.

UT Southwestern’s thoracic cancer specialists may consider these therapies for treating a Pancoast tumor:

Medical treatment (chemotherapy)
Chemotherapy drugs, taken orally or intravenously, may be used to target and kill cancer cells in the pericardium. Chemotherapy also may be used in conjunction with radiation therapy (chemoradiation) to treat Pancoast cancer.
Radiation therapy
Radiation therapy uses high-energy radiation, such as X-rays, to destroy cancer cells in the pericardium. UT Southwestern is a recognized leader in the development and use of cancer-fighting radiation therapies. Learn more about radiation therapy for chest cancers.
Highly precise surgery to remove cancerous tissue may be used in some early-stage cases of Pancoast cancer. Learn more about surgery for chest cancers.

Depending on the cause and extent of their Pancoast tumor, some patients may be eligible to participate in clinical trials of new treatments for the disease.

Clinical Trials

UT Southwestern conducts clinical trials aimed at improving the care and outcomes of patients with Pancoast tumors. Your cancer physicians can help you determine if you are eligible to participate in a clinical trial.

Meet Our Experts

UT Southwestern’s lung cancer experts use a variety of advanced techniques and technologies to diagnose and care for patients with Pancoast cancer. Our multidisciplinary team includes these medical oncologists, radiation oncologists, and surgical oncologists:

Learn more about the chest cancer team.

Request an Appointment

To schedule an appointment with a Pancoast cancer specialist, request an appointment or call 214-645-8300.