Thomas Jefferson UniversitySidney Kimmel Medical College

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For Patients

Who Are We?

Pulmonary Medicine:

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Boyd Hehn, MD

Clinical Associate Professor
Director, Bronchoscopy Services

Office Locations
834 Walnut Street Suite 650 Philadelphia, PA 19107

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Mani Kavuru, MD

Professor
Division Director, Pulmonary & Critical Care

Office Locations
834 Walnut Street Suite 650 Philadelphia, PA 19107

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Thoracic Surgery:

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Nathaniel R. Evans, MD, FACS, FCCP

Assistant Professor
Director, Minimally Invasive Thoracic Surgery Program

Office Locations
1025 Walnut Street Suite 607 Philadelphia, PA 19107

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Scott W. Cowan, MD, FACS

Associate Professor

Office Locations
1025 Walnut Street College Building, Suite 607 Philadelphia, PA 19107

 

Medical Oncology:

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Rita Axelrod, MD

Professor

Office Locations
925 Chestnut Street Suite 320A Philadelphia, PA 19107

 

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Barbara Campling, MD

Professor

Office Locations
925 Chestnut Street Suite 220A Philadelphia, PA 19107

 

Radiation Oncology:

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Maria Werner-Wasik, MD

Professor

Office Locations
111 South 11th Street Room G-301, Bodine Center Philadelphia, PA 19107

 

Bo Lu, MD

Bo Lu, MD

Professor
Director, Division of Molecular Radiation Biology

Office Locations
111 South 11th 111 S. 11th Street Philadelphia, PA 19107

 

What is Lung Cancer?

Lung cancer is a tumor growth that arises from the lining of the branching airways of the lung (“bronchogenic carcinoma”).  Uniformly, lung cancer enlarges and spreads or metastasizes over time, like other cancers.  There are different types of lung cancer and the behavior is somewhat variable. Lung cancer remains the leading cause of death from cancer in the US, and cigarette smoking is the single biggest risk factor. Unfortunately, only 15% of patients with lung cancer are diagnosed with early stage disease when surgical resection offers a 70% 5 year survival rate. Most patients present with symptomatic disease at an advanced stage where the survival is dismal. Prevention by aggressive smoking cessation efforts and early detection by screening would seem to be key approaches to improve outcomes.

Even though lung cancer is causally linked to cigarette smoking, ever since the surgeon general's report in the 1960s, the ultimate cause of lung cancer remains unknown, probably a combination of genetic susceptibility and environmental trigger such as cigarette smoking. Up to 60% of lung cancer occurs in either never smokers or ex-smokers.  Lung cancer is more prevalent than the next three leading cancers combined (breast, prostate, and colon).  Lung cancer is the most frequent cause of cancer death in the US as well as worldwide and this is due to the fact that at the usual time of diagnosis the disease is advanced in over 85%.  

Solitary pulmonary nodule or a "spot on the lung" is a very common entity that raises concern amongst clinicians and fear in the lay public. A solitary pulmonary nodule (SPN) or coin lesion is a mass in the lung smaller than 3 centimeters in diameter. It can be an incidental finding found on a chest X-ray or CT scan. The nodule may represent a benign process such as a granuloma or hamartoma, but in around 20-40% of cases, it represents a malignant cancer, especially in older adults and smokers. Conversely, 10 to 20% of patients with lung cancer are diagnosed in this way. Thus, the possibility of cancer needs to be excluded through further radiological studies and interventions, possibly including surgical resection. The prognosis depends on the underlying condition.

Your Initial Evaluation

Your initial visit could be with a pulmonologist, a surgeon, or a medical oncologist depending on how your problem was discovered initially.  Before your first visit with us, all relevant medical records should be faxed to our office or brought with you. Please bring to the visit or mail ahead, copies of your most recent chest x-rays, CAT scans of the chest (often available on a computer disk), if already performed.  The imaging center where performed will be happy to make a copy of the images on a CD upon your request.  At the time of your visit, additional tests such as pulmonary function tests may be performed. And depending upon the results, a biopsy procedure such as a bronchoscopy or needle aspirate might be recommended.  These can ce arranged by our office staff and coordinated with you.   Treatment plans will be developed based upon confirmation of the diagnosis and the preferences of the patient and family.  Family members are often important to help develop treatment plans, so we encourage all patients to bring a close family member to the visit.

Diagnostic testing available as part of the evaluation at Jefferson:

  • Pulmonary function testing (PFTs)
  • 6 minute walk test
  • Complete cardiopulmonary metabolic evaluation to assess functional status
  • Quantitative Perfusion (Q) lung scan
  • CT scan of the chest, with CT/PET fusion study as warranted
  • Bronchoscopy including the latest staging techniques such as EBUS and EUS
  • CT guided fine needle aspirate of the lung lesion
  • Latest molecular diagnostics for genetic characterization of tissue
  • Cervical mediastinoscopy and/or biopsy of other sites
  • Echocardiogram to assess the heart if required

Multi-disciplinary Team-Based Approach to Lung Cancer at Jefferson

Specialists of Jefferson's Thoracic Oncology Program provide care for patients who have been diagnosed with, or are suspected of having, lung cancer or other types of cancers in the chest cavity, including squamous cell carcinoma, adenocarcinoma, large cell carcinoma and small cell carcinoma.

It is one of only a few centers in the U.S. providing such an advanced level of treatment and research for lung cancer.

The Program brings together Jefferson specialists with extensive expertise in treating lung cancer to provide patients personalized treatment plans that address every aspect of their care.

Through a collaborative, multidisciplinary approach, patients are continually evaluated throughout their entire course of treatment by a team of specialists that, depending on a patient's needs, may include pulmonologists, thoracic nurse navigator, thoracic surgeons, medical oncologists, radiation oncologists, chest radiologists, chest pathologists, clinical trials research coordinators, smoking cessation specialists, psychologists, complementary medicine specialists and support program facilitators.

State-of-the-Art Lung Cancer Treatments

Lung cancer is most often cured by early surgical removal or resection.  This will be pursued whenever possible based on the latest guidelines.  Our surgeons are trained at the finest institutions  and are aggressive and current with the most minimally invasive techniques, including VATS, robotic surgery, sub-lobar resections in patients with severe co-morbid emphysema.  These advanced approaches have dramatically shortened the post-operative course and minimized complications. 

The medical oncology program is at the forefront of using new targeted “designer” drugs and new combinations of radiation therapy, surgery and chemotherapy to improve treatment success of patients with every type of lung cancer. Patients for whom conventional therapies have proven ineffective may be able to gain access to new or experimental therapies for lung cancer through national clinical trials in which Jefferson participates.

Our physicians and researchers have aided in the development of advances in the treatment of lung cancer in addition to offering traditional surgical approaches to lung, esophageal, mediastinum and chest wall procedures. Some of the state-of-the-art treatments available at Jefferson include:

 Minimally invasive video-assisted thoracic surgery (VATS) lobectomy

Robotically assisted esophagectomy (removal of the esophagus) through a minimally invasive method

Brachytherapy, or internal radiation treatment, for lung cancer. This procedure involves implanting tiny radioactive seeds at the site of the tumor, which, compared with external radiation therapy, allows for a higher dose of radiation to be safely administered.

An experimental light treatment called photodynamic therapy that may reduce the need of lung removal for patients with mesothelioma (cancer of the chest cavity) and lung cancer that has spread in the chest cavity

Lung volume reduction surgery for patients with emphysema

Transcervical thymectomy, a minimally invasive surgical treatment for myasthenia gravis that enables patients to recuperate in less time

Advanced surgery of the airway, including tracheal and bronchial sleeve resection

Interventional bronchoscopy, including the use of photodynamic therapy, stents and laser treatment to remove obstructions in the bronchial airway