Lung Cancer

You are more than just your cancer. We want you to thrive. 

If you’ve been diagnosed with lung cancer, Siteman is here to help. Our WashU Medicine physicians create a plan that’s customized to treat your cancer based on your age, your lifestyle, and your goals. Siteman’s advanced approach to lung cancer is redefining outcomes, with effective treatments available even for more advanced stages. 

What Are My Treatment Options for Lung Cancer?

Lung cancer treatment depends on several factors, including whether you have non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC), the stage of your cancer, and your overall health. Many patients receive a combination of treatments. Your WashU Medicine team will explain every option and what to expect. 

The main treatment options for lung cancer include: 

• Surgery 
• Radiation therapy 
• Chemotherapy 
• Chemoradiation 
• Immunotherapy 
• Targeted therapy 
• Palliative care and supportive services 

What is drug therapy for lung cancer?

Drug therapy is a broad term for any lung cancer treatment delivered through medication. These medications can be a pill, capsule, or infusion. It is one of the most common and rapidly advancing areas of lung cancer care. 

Depending on your diagnosis, drug therapy may be used to shrink a tumor before surgery, destroy remaining cancer cells after surgery, slow the growth of advanced cancer, or improve your quality of life during treatment. 

Types of drug therapy

At Siteman Cancer Center, drug therapy for lung cancer includes: 

Chemotherapy uses drugs that destroy cancer cells. Patients usually get this medicine in cycles over several weeks.   

Chemoradiation increases the effectiveness of chemotherapy and radiation therapy by using them together. This is also called chemoradiotherapy. This approach is a standard of care for patients with locally advanced NSCLC, especially for those who can’t have surgery.  

Immunotherapy helps your body’s own immune system attack cancer cells. These medicines have become a standard treatment for patients whose cancer has spread or come back. These drugs usually cause fewer side effects than chemotherapy and may help some patients achieve long-lasting results.  

Targeted therapy medicines attack specific features of cancer cells that help them grow. These drugs cause cancer cells to stop growing and multiplying. Over time they cause cancer cells to die off.   

What surgeries does Siteman offer for lung cancer?  

For patients with early-stage lung cancer, surgery is often the most effective treatment option and may increase survivability.  

At Siteman Cancer Center, our WashU Medicine thoracic surgeons are among the most experienced in the region, using the latest minimally invasive techniques to remove cancer while preserving as much healthy lung tissue as possible. 

Types of surgery 

The type of surgery recommended depends on the size and location of your tumor, how much of your lung is affected, and your overall lung function. Your surgical team at Siteman will walk you through every option before making a recommendation. 

Robotic-Assisted Lobectomy A lobectomy removes an entire lobe of the lung and is the most common surgical treatment for early-stage non-small cell lung cancer. At Siteman, many lobectomies are performed using robotic-assisted surgery. This is a minimally invasive approach where your surgeon uses a precise robotic system to operate through several small incisions. Robotic-assisted lobectomy offers patients many benefits like shorter hospital stays, faster recovery, and fewer complications. 

Segmentectomy A segmentectomy removes a small, defined section of the lung rather than an entire lobe. This lung-sparing approach may be recommended for patients with small, early-stage tumors or those who may not tolerate the removal of a full lobe.  

Wedge Resection A wedge resection removes the tumor and a small margin of surrounding healthy tissue, without following the natural boundaries of a lung segment or lobe. It is typically used for very small tumors or for patients whose lung function makes a larger resection too risky. 

Pneumonectomy In some cases, when the tumor is centrally located or involves a large portion of the lung, removal of an entire lung — called a pneumonectomy — may be necessary.  

Video-Assisted Thoracoscopic Surgery (VATS) VATS is another minimally invasive surgical approach in which a small camera and instruments are inserted through tiny incisions in the chest wall. VATS offers patients a faster recovery and less post-operative discomfort compared to traditional open chest surgery. 

When do patients with lung cancer receive radiation therapy?

Radiation therapy uses high-energy beams to target and destroy cancer cells. It is a versatile treatment for lung cancer and can be used at nearly every stage of the disease. Sometimes it’s used as the primary treatment, and sometimes it works alongside surgery, chemotherapy, or immunotherapy. 

Your WashU Medicine radiation oncologist will make a personalized recommendation that accounts for your cancer type, stage, tumor location, and overall health. Radiation may be recommended:

• Before surgery to shrink a tumor and make it easier to remove 
• After surgery to destroy any remaining cancer cells 
• Instead of surgery for patients with early-stage lung cancer who are not surgical candidates 
• Alongside chemotherapy. Chemoradiation combines radiation and chemotherapy to increase the effectiveness of both for locally advanced lung cancer 
• To treat metastatic sites where lung cancer has spread, such as the brain or bones 
• To ease symptoms like pain, ease breathing, or address complications from advanced disease. This is called “palliative radiation.” 

At Siteman Cancer Center, radiation therapy for lung cancer is delivered with the exceptional precision it needs.  

Lungs move constantly, so with every breath, lung tumors become moving targets. Siteman’s radiation technology uses imaging technology to identify tumors in the chest while protecting surrounding healthy tissues, including the heart, spinal cord, and remaining lung.  

Siteman offers some of the most advanced radiation delivery systems available, including image-guided and MRI-guided radiation therapy. 

Types of radiation therapy

Image-Guided Radiation Therapy (IGRT) Image-guided radiation therapy uses real-time imaging immediately before and during each treatment session to pinpoint the exact location of the tumor before delivering radiation. Because lung tumors can shift slightly with breathing and body changes over the course of treatment, IGRT allows your radiation team to adjust the beam with precision each day. This ensures radiation hits the tumor accurately while minimizing exposure to healthy surrounding tissue.  

IGRT is now considered a standard component of high-quality lung cancer radiation treatment and is used at Siteman to improve both safety and effectiveness. 

MRI-Guided Radiation Therapy (MRgRT) MRI-guided radiation therapy is one of the most significant advances in radiation oncology in recent years. MRI provides superior soft tissue contrast, so your care team can see the tumor and the structures around it in exceptional detail, in real time, during treatment delivery. 

This level of precision is called adaptive radiation therapy. The radiation can be adjusted in real time to protect healthy structures near the lungs like the heart and esophagus. 

Brachytherapy is a form of internal radiation therapy. This means that the radiation is implanted inside the tumor, rather than transmitted from a machine. It allows less radiation exposure to surrounding organs. 

The radiation used for brachytherapy is contained in tiny seeds. After being implanted in the tumor, they will release the radiation over a period of time ranging from minutes to days. 

Intensity Modulated Radiation Therapy (IMRT) is an advanced treatment that maps radiation doses to match the exact 3D shape of your tumor. Doctors can control how much radiation goes into each beam and can turn it on and off during treatment. This helps keep radiation away from healthy tissue around the tumor and is especially useful for irregularly shaped tumors in the head and neck area. 

Proton Beam Therapy uses a narrow stream of particles called protons to attack cancer cells. The big advantage for proton therapy is that doctors can control exactly how deep the radiation goes and what shape it takes. Unlike regular radiation that passes through your body, proton beams stop right at the tumor, delivering most of their energy there and leaving little to no radiation beyond it. This treatment works well for tumors near sensitive areas. Siteman’s S. Lee Kling Proton Therapy Center was the first in the St. Louis region to offer patients this option.  

Stereotactic Body Radiation Therapy (SBRT) may be used for patients whose cancer has returned or spread. This treatment uses many radiation beams that come from different angles to meet right at the tumor. Where they meet, they deliver a powerful dose while limiting the amount of radiation exposure to surrounding tissues. This approach can also allow doctors to treat areas that have received radiation before.