Living With Lung Cancer
With the advent of smarter, better-tolerated treatment, the prognosis for lung cancer patients has improved. "For many it has become a chronic disease that can be managed," says medical oncologist Robert J. Christie, MD. "Even in cases where the cancer is incurable, we can slow its growth so patients can maintain quality of life longer."
It's estimated that half of all early stage lung cancer tumors can be completely eradicated through surgery. In fact, patients with stage one lung cancer have an 80 percent survival rate. "Before, we were finding the cancer late in the game because symptoms only arise when the disease has advanced, but today tiny tumors are sometimes detected coincidentally during a CT scan for an unrelated condition," Dr. Christie says.
In the Lung Cancer Center at Virginia Hospital Center, pulmonologists, cardiothoracic surgeons, medical oncologists, radiation oncologists and interventional radiologists work collaboratively, and the transition from one specialist to the next is virtually seamless. Synchronized scheduling ensures that patients make fewer trips back and forth to the Hospital. The entire continuum of care—from diagnosis to staging to treatment to rehabilitation— occurs in one convenient location.
When cancer is suspected, a biopsy of the suspicious nodule is obtained via bronchoscope, percutaneous needle or video-assisted thoracic surgery (VATS). The next step is to stage the mediastinum (chest cavity) to see if the cancer has spread to the lymph nodes. Staging techniques may include a PET scan, bronchoscopy with needle aspiration, or mediastinoscopy performed by a cardiothoracic surgeon. "People often assume that lung cancer treatment is solely the domain of pulmonologists, but the role of the cardiothoracic surgeon can be tremendous," says David R. Duhamel, MD, Medical Director of the Lung Cancer Center, who often partners with John R. Garrett, MD, Chief of Cardiovascular, Thoracic & Vascular Surgery, to tackle complicated cases. "We will prioritize a patient's work-up and operate the next day if necessary. Our focus is very patient-centric."
Because every patient is different, accurate staging is critical to forming an individualized treatment plan. Surgery is the best approach when all of the cancer can be removed. Patients with contained tumors are usually candidates for standard lobectomy or a VATS lobectomy. When lymph nodes are affected, nonsurgical treatment options may include chemotherapy, standard radiation, radio frequency ablation or CyberKnife®.
CyberKnife is often recommended for patients with metastasis, or those who are medically unable to tolerate surgery. It may also be used to treat residual disease after surgery. This non-invasive technology delivers high doses of radiation with pinpoint precision and destroys malignant cells while leaving surrounding tissues intact. Available in Northern Virginia only at Virginia Hospital Center, CyberKnife treatments can usually be completed in just three sessions over three days with little to no side effects. "Lung tumors are difficult to radiate because they move as the patient breathes," notes Dr. Duhamel. "The beauty of CyberKnife is that it accounts for respiratory movement and corrects its target accordingly, allowing for the most precise delivery of radiation to the tumor."
For a CyberKnife information packet to share with your physician to determine if you are a CyberKnife candidate, call 877.VHC.CYBER (842.2923).