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Pancoast Tumor Treatment

A Pancoast tumor is an uncommon type of cancer that arises in the very top part of the lung (apex) and can invade the uppermost part of the chest cavity. Due to their unique location—which is near major blood vessels and nerves—Pancoast tumors can be challenging to evaluate and treat.

Often, Pancoast tumor treatment involves a three-part approach consisting of surgery, chemotherapy and radiation therapy. Also known as multimodal treatment, this intensive option is widely recognized as the most effective technique for treating this rare and complex cancer.

Surgery for Pancoast tumors

Highly precise surgery to remove the cancerous tissue is the preferred treatment approach for early-stage Pancoast tumors. Typically, this involves removing the top two ribs, the upper lobe of the affected lung and any portion of the chest wall and other structures invaded by the tumor. In some cases, a major artery located behind the collarbone is also removed and replaced with a vascular tube (graft).

Chemoradiation before surgery

When performed before surgery, a tailored combination of chemotherapy and radiation therapy can destroy some of the cancerous cells, which in turn can shrink the Pancoast tumor and improve the likelihood of its complete removal.

Chemotherapy is a systemic treatment that uses powerful drugs to fight cancer that has spread. After being administered intravenously or orally, the drugs enter the bloodstream and circulate throughout the body to reach and destroy rapidly dividing cells, such as Pancoast tumor cells.

Radiation therapy uses high-energy beams, such as X-rays or protons, to destroy cancerous cells. The most common type is external beam radiation therapy (EBRT), which involves the use of a machine located outside the patient’s body (linear accelerator) to generate the beams and aim them at the tumor.

Before Pancoast tumor surgery, a patient typically receives two or three cycles of chemotherapy and approximately six weeks of EBRT. Up to 75% of patients who begin Pancoast tumor treatment with chemoradiation are subsequently able to undergo surgery.

Chemoimmunotherapy before surgery

Another option that can be used to increase the effectiveness of Pancoast tumor surgery is a combined regimen of chemotherapy and immunotherapy. Unlike chemotherapy, which destroys cancerous cells to slow tumor growth, immunotherapy capitalizes on the power of the body’s own immune system. Special drugs are administered to stimulate the immune response and improve the immune system’s natural ability to fight cancer.

Chemotherapy or radiation therapy as a standalone treatment

Chemotherapy or radiation therapy may also be used as a standalone treatment for a Pancoast tumor that cannot be surgically removed or has metastasized or spread to distant areas of the body. The goal is to slow the growth and spread of the cancer and ease the associated symptoms. For instance, by shrinking the tumor, chemotherapy or radiation therapy can reduce pressure on the lungs and make it easier and more comfortable for the patient to breathe.

Supportive care 

In addition to conventional cancer treatments, supportive care services are available to help patients manage their Pancoast tumor symptoms, strengthen their body and enhance their overall quality of life. Some options include:

  • Nutrition therapy
  • Acupuncture
  • Massage therapy
  • Yoga and meditation
  • Emotional support
  • Spiritual support

Frequently asked questions (FAQs) about Pancoast tumor treatment

The following FAQs-related articles provide additional information about Pancoast tumor treatment:

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s Thoracic Oncology Program takes a highly individualized approach to Pancoast tumor treatment. We offer cutting-edge surgical procedures, chemotherapy drugs, radiation therapy delivery techniques, immunotherapies and supportive care options as well as a robust portfolio of clinical trials. We closely monitor and support each patient throughout their journey, reviewing and refining their care as appropriate based on the latest evidence-based guidelines.

If you have questions about Pancoast tumor treatment, you can talk with a specialist at Moffitt without a referral. Request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online.