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A Pancoast tumor is a relatively uncommon malignancy that occurs when non-small cell lung cancer develops in the rounded top portion of a lung (apex) and invades nearby chest wall structures, such as lymph nodes, muscles, connective tissues, nerves, the upper ribs or the upper vertebrae. Unlike other lung tumors—which typically cause coughing and other lung-related symptoms—the most common sign of a Pancoast tumor is severe shoulder pain that extends down the arm.

Determining the progression of a Pancoast tumor

Like all types of cancer, Pancoast tumor treatment can vary depending on its extent and spread (stage). After confirming a diagnosis, a physician will perform a process known as staging to make that determination. In the case of a Pancoast tumor, the staging process is usually based on the National Cancer Institute TNM classification system, which involves an assessment of:

  • The location and size of the primary tumor (T)
  • Any lymph node involvement (N)
  • The presence or absence of distant cancer metastasis (M)

Because the lung apex is generally difficult to visualize in imaging scans, many early-stage Pancoast tumors cannot be detected in chest X-rays. Therefore, due to their location, most Pancoast tumors are classified as stage T3 or T4 at minimum. A stage T3 classification indicates that the tumor has invaded the chest wall or sympathetic nerves. A stage T4 classification indicates that the tumor has invaded other chest wall structures, such as the brachial nerves or vertebrae.

Rely on the expertise of the multispecialty team at Moffitt Cancer Center

If you have questions about Pancoast tumor stages or treatment, you are welcome to reach out to an expert in the Thoracic Oncology Program at Moffitt Cancer Center. To request an appointment, please call 1-888-663-3488 or complete our new patient registration form online.

Moffitt is proud to offer a comprehensive range of Pancoast tumor diagnostic and treatment options in a single location, making the process as streamlined as possible for our patients. Whether you require an initial diagnosis, a second opinion or a first, second or third line of treatment, you can expect a rapid response from Moffitt as soon as possible.