Lung Cancer

The Lung Cancer Program at UT Southwestern provides comprehensive and innovative treatment for lung cancer, the most common cause of cancer death in the U.S. and the world. Lung cancer accounts for one-third of all cancer-related deaths in the United States, and although the number of men who get lung cancer has slightly decreased recently, the number of women who get lung cancer has steadily risen.

The most common cause of lung cancer is cigarette smoking. However, 15 percent of people diagnosed with lung cancer are never smokers. Other risk factors include exposure to radon, industrial chemicals, asbestos, air pollution, and having a first-degree relative with lung cancer.

Thoracic surgeons at UT Southwestern Medical Center provide state-of-the-art surgical techniques with a major focus on early diagnosis, better cancer staging, and multidisciplinary care to enhance the treatment of lung cancer. Our NCI-designated Comprehensive Cancer Center, the gold standard for cancer centers, is a center for excellence in patient care, research, and education, and is the only center with this designation in North Texas.

Our team approach ensures that each patient benefits from an individualized, coordinated treatment plan involving thoracic oncology experts from a wide array of specialties, including thoracic surgeons, medical and radiation oncologists, thoracic radiologists and pathologists, nurse practitioners, oncology nurses, and respiratory and physical therapists.

In addition to standard pathology tests, we perform molecular testing of tumors in all patients with non-small cell lung cancer. We are one of only a few hospitals in the world to offer this type of personalized medicine. Our clinicians work together with the patient and his or her primary care physician to create a coordinated treatment plan for all aspects of care to ensure the best possible outcome.

While our surgeons perform traditional open surgeries when needed, the majority of the operations are performed using the latest minimally invasive techniques, including robotic surgery. We are one of the leading and most experienced robotic surgery teams in the world for lung cancer.

UT Southwestern also has one of the most respected and robust lung cancer research programs in the world. Lung cancer tissues removed at UT Southwestern are used to find and develop better methods to diagnose, prevent, and cure the disease.

Types of Lung Cancer

Lung cancer is divided into two categories: small cell lung cancer and non-small cell lung cancer. These two types behave differently and are, therefore, evaluated and treated differently.

Small cell lung cancer is a more aggressive disease and is often more advanced at the time of diagnosis. Treatment usually involves chemotherapy and radiation therapy.

Non-small cell lung cancer includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Surgery is the treatment of choice for early stage, non-small cell lung cancer. Up to 80 percent of non-small cell lung cancer cases can be cured by surgery, depending upon the size of the tumor and if cancer cells have spread to the lymph nodes or other parts of the body.

Symptoms

A large number of patients have no symptoms early in the course of the disease and the tumor may be found on a chest X-ray or CT scan performed for an unrelated illness. When symptoms are present, they include:

  • New cough, or a change in an existing cough
  • Bone pain
  • Facial swelling
  • Headaches
  • Hemoptysis or coughing up blood
  • Hoarseness
  • Phlegm with or without blood
  • Pneumonia
  • Rib, shoulder, or arm pain
  • Shortness of breath
  • Weight loss

Diagnosis

For many people, the first sign that they may have lung cancer is the appearance of a suspicious spot on a chest X-ray or CT scan. Our diagnostic and interventional radiologists, thoracic surgeons, pulmonologists, oncologists, and pathologists are highly specialized and work together to safely and rapidly diagnose and stage lung cancer.

More than ever, determination of an accurate diagnosis of the cell type and the biology of the tumor are critical to determine the best treatment plan.

Options to diagnose and stage lung cancer include:

  • Bronchoscopic techniques that include bronchial brushing, bronchial washing, transbronchial biopsy, endobronchial ultrasound (EBUS), and electronavigational bronchoscopy (ENB)
  • Computed tomography-directed needle biopsy, either fine needle aspiration (FNA) or core biopsy
  • Computed tomography (CT) scan
  • Mediastinoscopy
  • Molecular analysis of tumor cells to determine genomic profile
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Sputum cytology – evaluation of mucus under a microscope to identify tumor cells
  • Thoracoscopic or video-assisted thoracoscopic surgery (VATS) biopsy or wedge resection

 

Lung Cancer Screening

If you have smoked for a long time, you should consider getting screened for lung cancer, which is done using a low-dose CT scan. We recommend screening if you:

  • Are between the ages of 55 and 75, and
  • Smoked at least one pack of cigarettes a day for 30 years

Four Stages of Lung Cancer

  • Stage I— the cancer developed in and is confined to one lung
  • Stages II and III— the cancer developed in one lung but has spread to nearby chest structures or lymph glands
  • Stage IV— the cancer has spread from one lung to the other or to another organ such as the bones, brain, liver, or adrenal gland (a hormone-releasing organ that sits atop the kidney)

Treatments

Our multidisciplinary group of thoracic specialists (the tumor board) reviews all cases of lung cancer to determine the best treatment option for every patient. Through our NCI-designated Comprehensive Cancer Center, we offer state-of-the-art treatment for all stages of lung cancer, including standard and investigational therapies that are not otherwise available.

In general, surgery offers the best chance of a cure for lung cancer and is the treatment of choice for early stage, non-small cell lung cancer (stage I and II). In patients who are a high risk for surgery, specialized radiation therapy (stereotactic ablative radiotherapy or SABR) is an option. Patients with more advanced disease are treated with combinations of chemotherapy, radiation therapy, and surgery. Our integrated approach offers a unique combination of multidisciplinary care and the most advanced medical, surgical, and radiation therapies tailored to each patient.

Our thoracic surgeons treat lung cancer with procedures that include:

  • Lobectomy – removal of an entire lobe of a lung. In many cases, our thoracic surgeons can perform a robotic lobectomy, which is a highly precise, minimally invasive technique pioneered at UT Southwestern by Kemp Kernstine, M.D., Ph.D.
  • Pneumonectomy – removal of the entire right or left lung
  • Segmentectomy or wedge resection – removal of part of a lobe, either minimally invasively or robotically in most cases
  • Sleeve lobectomy – removal of a lobe with part of the bronchus or trachea, along with adjacent lymph nodes

Minimally Invasive Surgery

Compared to surgery performed through an open incision, minimally invasive surgery provides several important benefits for patients, including:

  • Faster recovery and return to normal activities
  • Less pain
  • Little scarring
  • Minimal blood loss
  • No cutting of the ribs or sternum
  • Possible improved cure rates for cancer
  • Shorter hospital stay

Related Conditions

UT Southwestern’s Thoracic Surgery team treats thoracic (chest) conditions that can be associated with lung cancer. These include:

Clinical Trials

UT Southwestern conducts clinical trials aimed at improving the treatment of lung cancer. Talk with your doctor to see if a clinical trial may be right for you.

Meet Our Team

UT Southwestern thoracic surgeons who treat lung cancer include:

Request an Appointment

To schedule an appointment with a lung cancer specialist at UT Southwestern’s facilities in Dallas or to learn more about our services, request an appointment or call 214-645-8300.