Treatment

Lung cancer treatment is either curative (to eliminate the cancer) or palliative (to reduce pain and discomfort for patients whose cancer cannot be cured). In either case surgery, radiation, chemotherapy or a combination of two of the treatment types may be used.

• Surgery
  Surgery is most often used to remove stage I non-small cell lung cancer tumors and some NSCLC stage II tumors. Surgery for lung cancer may involve removal of part of a lobe (wedge resection), removal of an entire lobe (lobectomy) or removal of an entire lung (pulmonectomy). Surgery is seldom performed on small cell lung cancer because the disease has usually spread beyond the lung by the time it is detected and diagnosed.

• External Radiation Therapy
  External radiation therapy is used in both curative and palliative treatment, alone and in combination with chemotherapy. In external radiation therapy a map of the tumor's location is created with a CT scan, either before the treatment is planned or, with TomoTherapy, at the time of treatment, and then on subsequent visits the tumor is radiated from different angles to maximize the dose delivered to the tumor with minimum impact on surrounding healthy tissue.
  • TomoTherapy
    TomoTherapy is a new radiation therapy technology which has pioneered at Thompson downtown. Here the world's first clinical use TomoTherapy has achieved lung cancer tumor volume reduction of as much as 60%.

  • IMRT
    Thompson Cancer Survival Center was one of the first facilities in the world to treat patients with intensity modulated radiation therapy. Since 1998 more than 1,000 patients have received IMRT treatment at Thompson. Now both Thompson Downtown and Thompson at Methodist offer this treatment. In IMRT the multileaf collimator reshapes the treatment field between individual doses of radiation, so the beam is matched to the shape of the tumor from all angles.

• HDR brachytherapy
  In high-dose-rate brachytherapy radioactive pellets are implanted into the tumor. The benefits of the technology are significant. Treatment time is reduced, affected areas receive a maximum dose and surrounding healthy tissue is spared.

  Thompson at Methodist pioneered high-dose-rate brachytherapy in 1998, and has done more than 700 procedures with this technology. The HDR brachytherapy team here is the most experienced in the area.

  Thompson's Downtown facility has the area's first dedicated brachytherapy suite. The patient's scan is made and all preparation for treatment is done right in the HDR brachytherapy suite. Since the patient doesn't have to be transported from a separate CT room to the treatment area, the placement of the radioactive pellets is more precise. And with a dedicated suite, treatment can always be scheduled exactly when needed.

• Chemotherapy
  Both non-small cell and small cell lung cancer are treated with chemotherapy. This chemical treatment is especially effective in treating small cell lung cancer, and can increase patients' expected survival by four or five times what it would be otherwise. The latest chemotherapy drugs are tested in clinical trials.
  • Clinical trials
    Thompson brought the first clinical trials to the East Tennessee area. These trails are tests of the newest drugs and treatments. Thompson currently participates in five lung cancer clinical trials:

  Lung, Non-Small Cell	SWOG S0536	Advanced: Carboplatin/Paclitaxel/Cetuximab + Bevacizumab ?Cetuximab and Bevacizumab.
  	SWOG S0426	Stage IIIb or IV, Pemetrexed Disodium (ALIMTA®) + Bevacizumab.
  	TCSC RT 0301	TomoTherapy - solitary lung lesion
  Molecular	SWOG S0424	Biologic sample in Smoking and Non-smoking men and women diagnosed with NSCLC.
  Lung, Small-Cell	SWOG S0124	Extensive SCL: Cisplatin and Irinotecan versus Cisplatin and Etoposide.

• Photodynamic therapy
  Thompson is a world leader in photodynamic therapy, and is now the first facility in Tennessee - and one of the few in the world - using this technology to treat early endobronchial lung cancer.

  The treatment is usually performed on an outpatient basis, has limited side effects and preserves healthy lung tissue.