Lung Cancer

  • Lung Cancer
  • Lung Cancer Facts
  • Testing and Diagnosing
  • TOPS: Thoracic Oncoloy Program
  • Treatment Options


Lung Volume Reduction Surgery team making rounds on
Carolyn Works in the MMC ICU

Like all surgeries, lung cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure.

SIU School of Medicine’s TOPS lung surgeons are among the most skilled in the state. They perform a large number of surgeries for lung cancer each year, using the least invasive and most effective techniques

Lung cancer may be treated with surgery alone or combined with other treatments. Chemotherapy or radiation may be given before surgery to shrink tumors. This is called induction or neoadjuvant therapy. 
Chemotherapy and or radiation therapy after surgery maybe added to help destroy cancer cells that may remain in the body.  This is called adjuvant therapy. Surgery is used less often for small cell lung cancer because this type of cancer spreads more quickly through the body and is not often found in the early stages when it is confined to the lungs.

The most common types of surgery for lung cancer are:

  • Wedge resection: Removal of the tumor and a pie- or wedge-shaped piece of the lung around the tumor
  • Lobectomy: Removal of the lobe of the lung with cancer
  • Segmentectomy or segmental resection: Removal of a segment, or part, of the lobe where the cancer is located
  • Pneumonectomy: Removal of the entire lung
  • Sleeve resection: Removal of part of the bronchus
    In addition, lymph nodes in the chest will be removed and looked at under a microscope to find out if the lung cancer has spread. This will help doctors decide if you need further treatment after surgery.

Video-assisted thoracic surgery (VATS): 

SIU School of Medicine’s TOPS  surgeons are specially trained and highly skilled at performing this minimally invasive surgery.  Wedge resections and lobectomy can be performed using VATS.  Post-operative pain is less and patients are able to leave the hospital sooner.

Other types of surgery

Sometimes surgery is needed to help problems caused by lung cancer or its treatment. This may include:

  • Laser surgery to open a blocked airway
  • Placement of small tubes (stents) to keep airways open
  • Cryosurgery to freeze and destroy cancer tissue
  • Placement of a Pleurx-Denver catheter to drain fluid that may accumulate in the pleural cavity (the layer of tissue that surrounds the lungs)
  • Stereotactic radiosurgery


Simmons Cancer Institute at SIU

Thoracic Oncology/Lung Cancer Program

Lung cancer is the most common type of cancer in both men and women in this country. According to the American Cancer Society, almost 220,000 people are diagnosed with it each year.  Lung cancer is the leading cause of cancer deaths in the United States.  Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancer combined.  Most cases are linked to tobacco smoking.

The lungs, which help you breathe, are two sponge-like, cone-shaped organs in the chest. When you breathe in, oxygen comes through your mouth and nose. It then travels through the windpipe (trachea), which divides into two tubes called bronchi. These take the oxygen to the left and right lungs. The inside of the lungs includes smaller branches called bronchioles and alveoli, which are tiny air sacs.

Each lung is divided into sections called lobes. The right lung has three lobes. The left lung, which has two lobes, is smaller than the right lung because the heart is also on the left side of the body.

The pleura is a thin membrane that covers the outside of each lung and lines the inside wall of the chest. It usually contains a small amount of fluid and forms a protective lining around the lungs that allows them to move smoothly during breathing.

Cancer Grows in Lungs, May Spread

Lung cancer forms in the tissues of the lungs, most often in the cells that line air passages. It occurs when cells in your lungs grow and multiply uncontrollably, damaging surrounding tissue and interfering with the lungs’ normal function.

Lung cancer may spread through your lymph system. Lymph is a clear fluid that contains tissue waste and cells that help fight infection. It travels through your body in vessels that are similar to veins. Lymph nodes are small, bean-shaped organs that link lymph vessels.

Cancer cells can spread, or metastasize, to other parts of your body through the bloodstream as well. When lung cancer spreads to other organs, it still is called lung cancer.

Lung Cancer Types

Lung cancer is classified by the type of cells within the tumor. Each type of lung cancer grows and is treated in a different way. Lung cancers are divided into two main groups.

Non-small cell lung cancer (NSCLC): This is the most common type of lung cancer. The categories of non-small cell lung cancer are named for the type of cells in the cancer:

Adenocarcinoma begins in cells that line the alveoli and make mucus. It is found more often in nonsmokers, women and younger people.

Squamous cell carcinoma (cancer) begins in thin, flat cells in the lungs, and tobacco smoking most often causes it. It also is called epidermoid carcinoma.

Large cell carcinoma (cancer) begins in certain types of large cells in the lungs.

Small cell lung cancer: Also known as oat-cell cancer, this type of lung cancer makes up less than 20% of lung cancers and almost always is caused by tobacco smoking. It often starts in the bronchi, then quickly grows and spreads to other parts of the body, including the lymph nodes.

Other types of lung cancer

Less common types of lung cancer include:

  • Carcinoid tumors
  • Salivary gland carcinoma
  • Some sarcomas
  • Cancer of unknown primary
  • Lung metastases

Cancer found in the lungs is sometimes another type of cancer that started somewhere else in the body and spread, or metastasized, to the lungs. These tumors are called lung metastases, and they are not the same as lung cancer. They usually are the primary, or original, type of cancer.

If you have been diagnosed with lung cancer, we’re here


Doctors aren't sure whether people with no signs or symptoms of lung cancer should undergo screening for the disease. Some studies show that lung cancer screening may save lives by finding cancer earlier, when it may be treated more successfully. But other studies find that lung cancer screening often reveals more benign conditions that require invasive testing and expose people to unnecessary risks.

Screening for lung cancer is controversial among doctors. Studies are ongoing to determine what types of tests may be helpful and who would benefit from lung cancer screening. In the meantime, talk with your doctor if you're concerned about your risk of lung cancer. Together you can determine strategies to reduce your risk and decide whether screening tests are appropriate for you.

Tests to diagnose lung cancer

If there's reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend:

Imaging tests. An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.

Sputum cytology. If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.

Tissue sample (biopsy).

A sample of abnormal cells may be removed in a procedure called a biopsy. Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that's passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest wall and into the lung tissue to collect suspicious cells. A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.

Lung cancer staging

Once your lung cancer has been diagnosed, your doctor will work to determine the extent, or stage, of your cancer. Your cancer's stage helps you and your doctor decide what treatment is most appropriate.
Staging tests may include imaging procedures that allow your doctor to look for evidence that cancer has spread beyond your lungs. These tests include CT scans, magnetic resonance imaging (MRI), positron emission tomography (PET) and bone scans. Not every test is appropriate for every person, so talk with your doctor about which procedures are right for you.

From diagnosis through treatment and follow-up, SIU School of Medicine’s Thoracic Oncology Program (TOPS) gives you comprehensive lung cancer care every step of the way.  We have lung cancer experts who will focus their extraordinary expertise on you. They work together closely to ensure you receive the most advanced personalized care with the least impact on your body.
Our experts have the latest cutting-edge technology and techniques to treat lung cancer, including:

  • Minimally invasive surgery
  • Innovative radiotherapy planning and delivery techniques
  • A wide range of clinical trials for all stages and types of lung cancer

Because your peace of mind is important to us, we specialize in techniques and therapies than can help preserve lung function.  We are one of the world leaders in utilizing brachytherapy (radio-active seed implantation) with lung resection.

If you have been diagnosed with lung cancer, we're here to help. Call 1-877 ????? to make an appointment or request an appointment online.


Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be given through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that you can recover.

Chemotherapy can be used as a first line treatment for lung cancer or as additional treatment after surgery. In some cases, chemotherapy can be used to lessen side effects of your cancer.

Targeted drug therapy 

Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy options for treating lung cancer include:

  • Bevacizumab (Avastin). Bevacizumab stops a tumor from creating a new blood supply. Blood vessels that connect to tumors can supply oxygen and nutrients to the tumor, allowing it to grow. Bevacizumab is usually used in combination with chemotherapy and is approved for advanced and recurrent non-small cell lung cancer. Bevacizumab carries a risk of bleeding, blood clots and high blood pressure.
  • Erlotinib (Tarceva). Erlotinib blocks chemicals that signal the cancer cells to grow and divide. Erlotinib is approved for people with advanced and recurrent non-small cell lung cancer who haven't been helped by chemotherapy or who have tumors that are positive for epidermal growth factor receptor mutations.  Cells taken from your lung cancer will be tested to see whether this medication is likely to help you. Erlotinib side effects include a skin rash and diarrhea. Smokers are less likely to benefit from erlotinib than are nonsmokers.
  • Crizotinib (Xalkori). Crizotinib blocks chemicals that allow cancer cells to grow out of control and live longer than normal cells. Crizotinib is approved for use in people with advanced non-small cell lung cancer whose cancer cells have a particular genetic mutation. ( ALK {'anaplastic lymphoma kinase gene'}) A special laboratory test using your cancer cells determines whether your cells have this certain genetic mutation. Crizotinib side effects include nausea and vision problems, such as double vision or blurred vision.

Radiation Therapy

Brachytherapy is a procedure that involves
placing radioactive material inside your body.
The radioactive 'seeds' being placed.

Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy).

Radiation therapy can be used alone or with other lung cancer treatments. Sometimes it's administered at the same time as chemotherapy.

For people with lung cancers that are very small, one option may be stereotactic body radiotherapy (SBRT).  This form of radiation aims many beams of radiation from different angles at the lung cancer. Stereotactic body radiotherapy treatment is typically completed in one or a few treatments. In certain cases, it may be used in place of surgery for small tumors. 



Support Group

Many patients respond differently to the diagnosis of cancer depending on the individual's situation and support network. A therapist is available to provide counseling services, to act as a patient advocate, and help patients use their own resources to be a partner alongside their health care team during the treatment of the cancer.

The SIU Clinical Trials database - click here