A National Cancer Institute-designated Comprehensive Cancer Center

Make an appointment: 800-826-HOPE
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Lung Cancer

Each year, 220,000 Americans are diagnosed with lung cancer, making it one of the most common cancers in the United States. However, with timely diagnosis and
 
Download and reproduce our lung cancer infographic for lung health and education purposes.
appropriate therapies, the disease can be effectively treated with minimal impact to quality of life.
 
City of Hope's lung cancer program is comprised of a world-class, multidisciplinary team of experts is dedicated to using the most innovative approaches to screen, diagnose and treat lung cancers. Our lung cancer physicians and scientists collaborate across a wide spectrum of research, from basic biological studies to developing and testing new patient therapies. This “bench to bedside” collaborative effort allows us to quickly translate new discoveries into promising tests and therapies to better detect and treat the disease.
 
 
As one of a handful of institutes to attain the elite designation of Nationally Ranked Cancer Center , City of Hope is acknowledged as a leader in the research and treatment of lung cancer. With our decades of experience, specialized therapy protocols and extensive program of clinical trials, newly diagnosed or relapsed patients can find a treatment regimen that is tailored to their needs and gives them the best chance for survival. U.S.News & World Report also named City of Hope as one of the top cancer hospitals in the country for the 11th year.
 
 
City of Hope’s lung cancer program is comprised of a multidisciplinary team of surgeons, medical and radiation oncologists, nurses, therapists, social workers and supportive care professionals. Together, they provide coordinated, compassionate care tailored to the individual patient.
 
Highlights of our lung cancer treatment program include:
 
  • Our surgeons are trained in minimally invasive and robotically-assisted surgical techniques that are as effective as traditional open surgeries, but are less painful and allow for faster recovery
  • Helical TomoTherapy , which sculpts radiation precise at the tumor and minimizes radiation exposure to surrounding healthy tissues.
  • Chemotherapy and targeted therapy drugs that can be used alone or in conjunction with other therapies to treat lung cancer. In addition to FDA-approved drugs, patients may be eligible for clinical trials investigating promising new therapies.
  • Supportive and palliative care to help boost and maintain quality of life during and after treatment.
  • Genomic testing that can identify lung cancer subtypes and the most effective treatments against them.
 
In collaboration with other departments and cancer centers, City of Hope’s lung cancer program has an active portfolio of lung cancer clinical trials studying novel treatments, including trials of new surgery, radiation and drug therapy regimens that are more effective against the disease and/or less harmful to the patient. Many of these promising therapies are only available to patients being treated at the City of Hope.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 

Lung Cancer Team

About Lung Cancer

Lung cancer is typically classified by their different cell structures when examined under a microscope.
 
  • Non-small cell lung cancer: is the most common type of lung cancer, representing approximately 85% of lung cancers. Non-small cell lung cancer has three main subtypes:
    • Adenocarcinoma: Adenocarcinoma, which begins in cells that line the alveoli, is the most common type of lung cancer. While this type of lung cancer occurs mainly in current or former smokers, it also is the most common type of lung cancer seen in non-smokers. It is more prevalent in women than in men and is more likely than other types of cancer to occur in younger people.
    • Squamous cell (epidermoid) carcinoma: Representing approximately 25 to 30 percent of all lung cancers, squamous cell carcinoma begins in thin, flat cells that line the bronchial tubes in the center of the lungs, near a bronchus. It is most often caused by tobacco smoking.
    • Large cell (undifferentiated) carcinoma: Large cell carcinoma, which can start anywhere in the lungs, is almost always associated with smoking.
    • Other subtypes: Other forms of non-small cell lung cancer are rarer and include adenosquamous carcinoma, carcinoid (well-differentiated neuroendocrine tumor) and sarcomatoid carcinoma.
  • Small cell (oat cell) lung cancer: This type of lung cancer makes up about 15% of lung cancers and almost always is caused by tobacco smoking. It tends to grow quickly and spread widely to other parts of the body fairly early in the course of the disease, but often responds well to chemotherapy.
  • Pulmonary metastases: Sometimes tumors found in the lungs are not lung cancer at all, but a cancer from another organ that have spread to the lungs. These are identified by their primary cancer type. The most common cancers resulting in pulmonary metastases include breast, colorectal and kidney cancers.
 
Each type of lung cancer grows and is treated in different ways. Your City of Hope team of lung cancer experts will carefully study your individual case and work with you to determine the best treatment plan for you. Learn more about our approach to diagnosis and staging.
 
Signs and Symptoms of Lung Cancer
 
Symptoms of lung cancer can include:
 
  • a cough that worsens or does not go away
  • breathing trouble, such as shortness of breath
  • constant chest pain, worsened by deep breathing, coughing or laughing
  • coughing up blood or rust-colored spit
  • persistent hoarseness
  • frequent lung infections, such as pneumonia or bronchitis
  • swelling of the neck and face
  • arm or shoulder pain
  • ongoing fatigue
  • loss of appetite or unexplained weight loss

Early lung cancer detection is critical to successful treatment, so if you or a loved experience any of the above symptoms, please contact a doctor for further evaluation.
 
Lung Cancer Risk Factors
 
  • Smoking: Tobacco smoking is by far the most important risk factor for lung cancer, causing 90 percent of cases in men and about 80 percent of cases in women. Cigarette, pipe and cigar smoking all add to the risk of lung cancer. Low tar or nicotine cigarettes do not lower that risk.
  • Secondhand smoke: People exposed to secondhand tobacco smoke are also at a higher risk of developing lung cancer. People who breathe in the smoke exhaled by smokers are exposed to cancer-causing agents.
  • Radon exposure: Exposure to radon, a radioactive gas, can increase the risk of lung cancer. A product of uranium breakdown, radon can come up through the ground and leak into buildings. Of nonsmokers killed by lung cancer, about 30 percent had been exposed to radon.
  • Family history: A person with a family member who has had lung cancer may be at an increased risk of developing the disease.
  • Exposure to other substances: Exposure to substances such as asbestos, arsenic, diesel exhaust and some forms of chromium are linked to a higher lung cancer risk.
 
If you suspect that you or a loved one may have an elevated risk of lung cancer, please consult with a doctor on preventive and early detection measures that are available.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about  becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society, National Cancer Institute and Centers for Disease Control and Prevention
 

Lung Cancer Screening

Why Screen for Lung Cancer ?

Screening increases the chance of diagnosing lung cancer at an early stage when it is more treatable. Screening can also lead to identification of other treatable tobacco-related disease such as emphysema and heart disease.

How is Lung Cancer Screening Performed?
The only screening test proven to effectively reduce death from lung cancer is a high resolution computed tomography (CT) scan of the chest. The scan captures images of the entire chest cavity during a single breath.

What are the Risks of Radiation?
The ultra low-dose CT scan used at City of Hope for lung cancer screening uses far less radiation than standard CT scans, and is slightly higher than the radiation dose used in a standard mammogram. We use some of the most advanced equipment and techniques to enable the lowest radiation dose for your CT scan. For those at high risk for lung cancer, the value of screening far outweighs the minimal risks of radiation.
 
Who is Eligible for Screening?
 
Individuals aged 55-80 who are current or former smokers with a history of at least 30 pack years of smoking. A pack year is considered the equivalent of smoking a pack a day for a year, so 30 pack years can equal someone with a pack-a-day habit for 30 years, two-pack-a-day habit for 15 years, three-pack-a-day habit for 10 years and so forth.
 
What if the screening comes out with a positive finding?
Approximately 15 percent of all lung cancer screens will identify a lung nodule that requires followup, but 90 percent of those will be benign and will not require treatment. If the screen is positive, an appointment will be made with the program nurse practitioner, under the supervision of a thoracic or pulmonary physician, to discuss the findings and any additional testing that may be necessary.
 
What if screening is negative?
If the screen is negative, a repeat scan should be repeated in one year.
 
Where Should I be Screened?
Screening should be performed as part of a multidisciplinary program in order to minimize unnecessary tests and maximize patient safety.  The Lung Cancer Alliance designates Screening Centers of Excellence.
 
Is Lung Cancer Screening Covered by Insurance?
Currently, most insurance companies do not cover lung cancer screening. Our team of financial services specialists will work with you to identify your coverage and discuss payment plans.
 
Current patients should ask their primary physician for a referral to the Lung Cancer Screening Program, or call 626-218-9410 to speak with someone from the Lung Cancer Screening Program.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 

Lung Cancer Diagnosis and Staging

If you have lung cancer, it is important to get an accurate diagnosis as early as possible so your medical team can plan the best treatment options for you.
 
The process starts with a thorough physical examination, during which your doctor will ask about your general health, symptoms, family history, lifestyle – including smoking habits and possible exposure to cancer-causing substances.

If lung cancer is suspected following the physical exam, your doctor will order additional tests, which include:
 
  • Imaging Tests: This can include computed axial tomography (CT or CAT), magnetic resnonance imaging (MRI) and/or positron emission tomography (PET) scans, all of which take images of your lungs to determine presence and location of lung cancer.
  • Needle biopsy: CT scan images guide a needle through the skin into the lung tissue to collect cells. A biopsy sample may also be taken from lymph nodes or other areas in the body where cancer has spread.
  • Endobronchial Ultrasound (EBUS): This minimally invasive technique uses a thin, flexible camera with an ultrasound probe to examine and biopsy structures near the windpipe and its branches. At City of Hope, this has largely replaced mediastinoscopy, which is a procedure that gives the same information but requires an incision in the neck and passage of surgical tools to take tissue samples from lymph nodes.
  • Navigational Bronchoscopy: A special computer creates a three-dimensional map of the lungs and helps guide a thin, flexible tube down the mouth, through the windpipe, and directly to the tumor. This allows the doctor to take biopsies or place markers for other treatments much more accurately than with traditional methods.
  • Thoracentesis: Fluid from around the lungs is drawn out with a needle and looked at under a microscope.
 
In addition to the above tests, City of Hope is on the forefront of genomic testing, a revolutionary diagnostic tool that can classify lung cancer beyond its physical characteristics. By looking at the cancer’s molecular and genetic characteristics, our physicians can determine whether the disease is sensitive or resistant to specific therapies—allowing them to plan a treatment regimen that is more effective.
 
Staging
 
To properly plan for treatment, lung cancer patients are staged in accordance to how advanced the disorder is. This is primarily done by taking a number of factors into consideration, including:
 
  • Size of the tumor
  • If the tumor have grown into the chest wall, diaphragm, main brochus or tissue surrounding the heart
  • Whether the cancer has spread to nearby lymph nodes and how many lymph nodes are affected
  • If the cancer has metastasized to distant organs, such as the bone, liver or brain
 
Based on these factors, patients are staged according to their risk level, with higher risk patients typically requiring more intensive treatments.
 
More information on lung cancer staging criteria is available on the American Lung Association’s website.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Lung Cancer Treatment Approaches

Our multidisciplinary lung cancer team provides compassionate, leading-edge, personalized care. Treatment options include surgery, radiation therapy, drug therapy or a combination of these treatments. Our clinicians and researchers are also constantly working to develop novel treatments that are more effective against lung cancer with fewer side effects for the patient.

Additionally, our supportive care and long-term follow-up programs to help patients and their families manage the process of treatment and recovery.

Surgery

For early stage lung cancers, surgical removal of the tumor can often by the only treatment needed. For most patients, a lobectomy (removing the entire lobe of the lung) is recommended, but more limited surgery may be suggested for patients with very small tumors or limited lung function.
 
Our surgeons specialize in  minimally invasive, robotically-assisted procedures using the da Vinci Surgical System. Robotic lobectomy is done through small incisions and is associated with less pain and quicker recovery compared with more traditional forms of lung surgery, with most staying in the hospital for only two days after the procedure.
 
For patients with advanced lung cancer, surgery is still a viable treatment option in combination with other therapies. We offer complex procedures including airway surgery, chest wall resection and spine resection that can improve outcomes and quality of life, and City of Hope surgeons have helped patients overcome lung cancer that other health professionals had considered inoperable.
 

Radiation Therapy

Radiation therapy may be used to treat lung cancer alone or in tandem with other therapies. For early stage lung cancer patients, stereotactic body radiation therapy (SBRT), which uses small beams of high-dose radiation, may be used to treat early stage lung cancer when surgery isn’t an option. This can be due to the patient’s health, diminished lung function, tumor location or other factors.
 
City of Hope also offers Helical TomoTherapy, which focuses radiation on to the tumor from all directions by using hundreds of beams rotating around the tumor. The radiation can be “sculpted” to fit the exact shape of the tumor, resulting in less radiation exposure in adjacent normal tissue and fewer complications.
 
For late stage lung cancer patients, radiation may also be used to palliatively to treat pain and other symptoms associated with the disease.
 

Drug Therapy

Chemotherapy and targeted therapy drugs can fight lung cancer throughout the body and can enhance other therapies by shrinking tumors beforehand, making them easier to target, or reducing likelihood of recurrence afterwards.
 
By looking at the cancer's biological or genetic profile, City of Hope clinicians can determine whether a cancer is vulnerable or resistant to specific drugs. This enables them to plan a treatment regimen that is more effective against the cancer and/or less toxic for the patient.
 
City of Hope doctors are also on the forefront of developing and studying new drugs, or new combinations of existing drugs, that can better treat lung cancer with fewer side effects for the patient. Many of these promising therapies are available to our patients through our clinical trials program.
 

Become a Patient

If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

Lung Cancer Research

There is extensive collaboration between lung cancer clinicians and researchers develop and evaluate new therapies designed to improve survival and quality of life outcomes. City of Hope patients have access to a wide variety of clinical trials ranging from new chemotherapy and targeted therapies, hormone therapies, novel surgical techniques and new radiation approaches — all focused on enhancing lung cancer treatment, detection and prevention.
 
Some of our current research projects include:
 
  • Our researchers are currently studying markers of metastatic potential within lymph nodes of patients with completely resected non-small cell lung cancer (NSCLC). This allows them to better understand how the tumor and the immune system interact to facilitate cancer spread. By understanding these mechanisms, targeted molecules can then be developed to block tumor metastasis and improve survival.
  • As we gain knowledge into the biology of lung cancer, our clinicians have also incorporated the evaluation of biomarkers into our trials to better tailor therapies to our patients, particularly those with advanced disease.
  • The signaling pathway cyclooxygenase-2 (COX-2) plays a key role in lung tumor growth, spread and therapy resistance, so our researchers developed a drug trial to see if the COX-2 inhibitor, celecoxib, can improve outcomes by enhancing the effectiveness of another lung cancer drug.
  • Patients with advanced lung cancer frequently have immune system abnormalities, including depletion of the B cells and T cells, which make up the body’s defense system. Our researchers have identified a compound in shiitake mushrooms called beta-glucans that can enhance immune system activity, and City of Hope is conducting a trial to see if it can slow or halt tumor growth in lung cancer patients.
  • Because lung cancer patients are often present with advanced disease that compromises their quality of life, City of Hope researchers are continually investigating and implementing interventions that can support patients and their families through supportive and palliative care.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 

Living with Lung Cancer

While our primary goal is to cure or control the disease, another top priority is relieving suffering and discomfort for lung cancer patients undergoing cancer treatments.
 
In addition to curative treatments, City of Hope lung cancer patients have access to the broad range of services offered by our Department of Supportive Care Medicine. The department’s staff of professionals can help patients and loved ones with a variety of care and wellness issues including:
 
  • Managing side effects
  • Pain management
  • Pulmonary rehabilitation to improve breathing
  • Smoking cessation
  • Navigation through the health care system
  • Coping and maintaining emotional/social/spiritual well-being
  • Staying healthy and active during/after treatment
  • Guidance on eating and cooking well
  • Healing arts
  • Building caregivers’ skills  
 
 
The Sheri & Les Biller Patient and Family Resource Center is the heart of the Department of Supportive Care Medicine, integrating City of Hope's support services under one umbrella. The Biller Resource Center provides a warm and welcoming space where patients, families and caregivers can access the resources, education and support they need to strengthen and empower themselves, before, during and after treatment.

Our team of supportive care experts includes clinical social workers; pain and palliative care physicians and nurses; psychologists, psychiatrists; patient navigators; health educators; spiritual care chaplains; child life specialists and more. The Biller Resource Center staff may be reached at 626-256-4673, ext. 32273 (3CARE).
 
Tips, tools and online resources to help cancer patients and their families with issues that arise during cancer treatment.
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 

Support this program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Rick Leonard
Associate Vice President
Direct: 213-241-7218
Email: rleonard@coh.org

 
 

Lung Cancer

Lung Cancer

Each year, 220,000 Americans are diagnosed with lung cancer, making it one of the most common cancers in the United States. However, with timely diagnosis and
 
Download and reproduce our lung cancer infographic for lung health and education purposes.
appropriate therapies, the disease can be effectively treated with minimal impact to quality of life.
 
City of Hope's lung cancer program is comprised of a world-class, multidisciplinary team of experts is dedicated to using the most innovative approaches to screen, diagnose and treat lung cancers. Our lung cancer physicians and scientists collaborate across a wide spectrum of research, from basic biological studies to developing and testing new patient therapies. This “bench to bedside” collaborative effort allows us to quickly translate new discoveries into promising tests and therapies to better detect and treat the disease.
 
 
As one of a handful of institutes to attain the elite designation of Nationally Ranked Cancer Center , City of Hope is acknowledged as a leader in the research and treatment of lung cancer. With our decades of experience, specialized therapy protocols and extensive program of clinical trials, newly diagnosed or relapsed patients can find a treatment regimen that is tailored to their needs and gives them the best chance for survival. U.S.News & World Report also named City of Hope as one of the top cancer hospitals in the country for the 11th year.
 
 
City of Hope’s lung cancer program is comprised of a multidisciplinary team of surgeons, medical and radiation oncologists, nurses, therapists, social workers and supportive care professionals. Together, they provide coordinated, compassionate care tailored to the individual patient.
 
Highlights of our lung cancer treatment program include:
 
  • Our surgeons are trained in minimally invasive and robotically-assisted surgical techniques that are as effective as traditional open surgeries, but are less painful and allow for faster recovery
  • Helical TomoTherapy , which sculpts radiation precise at the tumor and minimizes radiation exposure to surrounding healthy tissues.
  • Chemotherapy and targeted therapy drugs that can be used alone or in conjunction with other therapies to treat lung cancer. In addition to FDA-approved drugs, patients may be eligible for clinical trials investigating promising new therapies.
  • Supportive and palliative care to help boost and maintain quality of life during and after treatment.
  • Genomic testing that can identify lung cancer subtypes and the most effective treatments against them.
 
In collaboration with other departments and cancer centers, City of Hope’s lung cancer program has an active portfolio of lung cancer clinical trials studying novel treatments, including trials of new surgery, radiation and drug therapy regimens that are more effective against the disease and/or less harmful to the patient. Many of these promising therapies are only available to patients being treated at the City of Hope.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 

Lung Cancer Team

Lung Cancer Team

About Lung Cancer

About Lung Cancer

Lung cancer is typically classified by their different cell structures when examined under a microscope.
 
  • Non-small cell lung cancer: is the most common type of lung cancer, representing approximately 85% of lung cancers. Non-small cell lung cancer has three main subtypes:
    • Adenocarcinoma: Adenocarcinoma, which begins in cells that line the alveoli, is the most common type of lung cancer. While this type of lung cancer occurs mainly in current or former smokers, it also is the most common type of lung cancer seen in non-smokers. It is more prevalent in women than in men and is more likely than other types of cancer to occur in younger people.
    • Squamous cell (epidermoid) carcinoma: Representing approximately 25 to 30 percent of all lung cancers, squamous cell carcinoma begins in thin, flat cells that line the bronchial tubes in the center of the lungs, near a bronchus. It is most often caused by tobacco smoking.
    • Large cell (undifferentiated) carcinoma: Large cell carcinoma, which can start anywhere in the lungs, is almost always associated with smoking.
    • Other subtypes: Other forms of non-small cell lung cancer are rarer and include adenosquamous carcinoma, carcinoid (well-differentiated neuroendocrine tumor) and sarcomatoid carcinoma.
  • Small cell (oat cell) lung cancer: This type of lung cancer makes up about 15% of lung cancers and almost always is caused by tobacco smoking. It tends to grow quickly and spread widely to other parts of the body fairly early in the course of the disease, but often responds well to chemotherapy.
  • Pulmonary metastases: Sometimes tumors found in the lungs are not lung cancer at all, but a cancer from another organ that have spread to the lungs. These are identified by their primary cancer type. The most common cancers resulting in pulmonary metastases include breast, colorectal and kidney cancers.
 
Each type of lung cancer grows and is treated in different ways. Your City of Hope team of lung cancer experts will carefully study your individual case and work with you to determine the best treatment plan for you. Learn more about our approach to diagnosis and staging.
 
Signs and Symptoms of Lung Cancer
 
Symptoms of lung cancer can include:
 
  • a cough that worsens or does not go away
  • breathing trouble, such as shortness of breath
  • constant chest pain, worsened by deep breathing, coughing or laughing
  • coughing up blood or rust-colored spit
  • persistent hoarseness
  • frequent lung infections, such as pneumonia or bronchitis
  • swelling of the neck and face
  • arm or shoulder pain
  • ongoing fatigue
  • loss of appetite or unexplained weight loss

Early lung cancer detection is critical to successful treatment, so if you or a loved experience any of the above symptoms, please contact a doctor for further evaluation.
 
Lung Cancer Risk Factors
 
  • Smoking: Tobacco smoking is by far the most important risk factor for lung cancer, causing 90 percent of cases in men and about 80 percent of cases in women. Cigarette, pipe and cigar smoking all add to the risk of lung cancer. Low tar or nicotine cigarettes do not lower that risk.
  • Secondhand smoke: People exposed to secondhand tobacco smoke are also at a higher risk of developing lung cancer. People who breathe in the smoke exhaled by smokers are exposed to cancer-causing agents.
  • Radon exposure: Exposure to radon, a radioactive gas, can increase the risk of lung cancer. A product of uranium breakdown, radon can come up through the ground and leak into buildings. Of nonsmokers killed by lung cancer, about 30 percent had been exposed to radon.
  • Family history: A person with a family member who has had lung cancer may be at an increased risk of developing the disease.
  • Exposure to other substances: Exposure to substances such as asbestos, arsenic, diesel exhaust and some forms of chromium are linked to a higher lung cancer risk.
 
If you suspect that you or a loved one may have an elevated risk of lung cancer, please consult with a doctor on preventive and early detection measures that are available.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about  becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society, National Cancer Institute and Centers for Disease Control and Prevention
 

Lung Cancer Screening

Lung Cancer Screening

Why Screen for Lung Cancer ?

Screening increases the chance of diagnosing lung cancer at an early stage when it is more treatable. Screening can also lead to identification of other treatable tobacco-related disease such as emphysema and heart disease.

How is Lung Cancer Screening Performed?
The only screening test proven to effectively reduce death from lung cancer is a high resolution computed tomography (CT) scan of the chest. The scan captures images of the entire chest cavity during a single breath.

What are the Risks of Radiation?
The ultra low-dose CT scan used at City of Hope for lung cancer screening uses far less radiation than standard CT scans, and is slightly higher than the radiation dose used in a standard mammogram. We use some of the most advanced equipment and techniques to enable the lowest radiation dose for your CT scan. For those at high risk for lung cancer, the value of screening far outweighs the minimal risks of radiation.
 
Who is Eligible for Screening?
 
Individuals aged 55-80 who are current or former smokers with a history of at least 30 pack years of smoking. A pack year is considered the equivalent of smoking a pack a day for a year, so 30 pack years can equal someone with a pack-a-day habit for 30 years, two-pack-a-day habit for 15 years, three-pack-a-day habit for 10 years and so forth.
 
What if the screening comes out with a positive finding?
Approximately 15 percent of all lung cancer screens will identify a lung nodule that requires followup, but 90 percent of those will be benign and will not require treatment. If the screen is positive, an appointment will be made with the program nurse practitioner, under the supervision of a thoracic or pulmonary physician, to discuss the findings and any additional testing that may be necessary.
 
What if screening is negative?
If the screen is negative, a repeat scan should be repeated in one year.
 
Where Should I be Screened?
Screening should be performed as part of a multidisciplinary program in order to minimize unnecessary tests and maximize patient safety.  The Lung Cancer Alliance designates Screening Centers of Excellence.
 
Is Lung Cancer Screening Covered by Insurance?
Currently, most insurance companies do not cover lung cancer screening. Our team of financial services specialists will work with you to identify your coverage and discuss payment plans.
 
Current patients should ask their primary physician for a referral to the Lung Cancer Screening Program, or call 626-218-9410 to speak with someone from the Lung Cancer Screening Program.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 

Diagnosing Lung Cancer

Lung Cancer Diagnosis and Staging

If you have lung cancer, it is important to get an accurate diagnosis as early as possible so your medical team can plan the best treatment options for you.
 
The process starts with a thorough physical examination, during which your doctor will ask about your general health, symptoms, family history, lifestyle – including smoking habits and possible exposure to cancer-causing substances.

If lung cancer is suspected following the physical exam, your doctor will order additional tests, which include:
 
  • Imaging Tests: This can include computed axial tomography (CT or CAT), magnetic resnonance imaging (MRI) and/or positron emission tomography (PET) scans, all of which take images of your lungs to determine presence and location of lung cancer.
  • Needle biopsy: CT scan images guide a needle through the skin into the lung tissue to collect cells. A biopsy sample may also be taken from lymph nodes or other areas in the body where cancer has spread.
  • Endobronchial Ultrasound (EBUS): This minimally invasive technique uses a thin, flexible camera with an ultrasound probe to examine and biopsy structures near the windpipe and its branches. At City of Hope, this has largely replaced mediastinoscopy, which is a procedure that gives the same information but requires an incision in the neck and passage of surgical tools to take tissue samples from lymph nodes.
  • Navigational Bronchoscopy: A special computer creates a three-dimensional map of the lungs and helps guide a thin, flexible tube down the mouth, through the windpipe, and directly to the tumor. This allows the doctor to take biopsies or place markers for other treatments much more accurately than with traditional methods.
  • Thoracentesis: Fluid from around the lungs is drawn out with a needle and looked at under a microscope.
 
In addition to the above tests, City of Hope is on the forefront of genomic testing, a revolutionary diagnostic tool that can classify lung cancer beyond its physical characteristics. By looking at the cancer’s molecular and genetic characteristics, our physicians can determine whether the disease is sensitive or resistant to specific therapies—allowing them to plan a treatment regimen that is more effective.
 
Staging
 
To properly plan for treatment, lung cancer patients are staged in accordance to how advanced the disorder is. This is primarily done by taking a number of factors into consideration, including:
 
  • Size of the tumor
  • If the tumor have grown into the chest wall, diaphragm, main brochus or tissue surrounding the heart
  • Whether the cancer has spread to nearby lymph nodes and how many lymph nodes are affected
  • If the cancer has metastasized to distant organs, such as the bone, liver or brain
 
Based on these factors, patients are staged according to their risk level, with higher risk patients typically requiring more intensive treatments.
 
More information on lung cancer staging criteria is available on the American Lung Association’s website.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Treatments

Lung Cancer Treatment Approaches

Our multidisciplinary lung cancer team provides compassionate, leading-edge, personalized care. Treatment options include surgery, radiation therapy, drug therapy or a combination of these treatments. Our clinicians and researchers are also constantly working to develop novel treatments that are more effective against lung cancer with fewer side effects for the patient.

Additionally, our supportive care and long-term follow-up programs to help patients and their families manage the process of treatment and recovery.

Surgery

For early stage lung cancers, surgical removal of the tumor can often by the only treatment needed. For most patients, a lobectomy (removing the entire lobe of the lung) is recommended, but more limited surgery may be suggested for patients with very small tumors or limited lung function.
 
Our surgeons specialize in  minimally invasive, robotically-assisted procedures using the da Vinci Surgical System. Robotic lobectomy is done through small incisions and is associated with less pain and quicker recovery compared with more traditional forms of lung surgery, with most staying in the hospital for only two days after the procedure.
 
For patients with advanced lung cancer, surgery is still a viable treatment option in combination with other therapies. We offer complex procedures including airway surgery, chest wall resection and spine resection that can improve outcomes and quality of life, and City of Hope surgeons have helped patients overcome lung cancer that other health professionals had considered inoperable.
 

Radiation Therapy

Radiation therapy may be used to treat lung cancer alone or in tandem with other therapies. For early stage lung cancer patients, stereotactic body radiation therapy (SBRT), which uses small beams of high-dose radiation, may be used to treat early stage lung cancer when surgery isn’t an option. This can be due to the patient’s health, diminished lung function, tumor location or other factors.
 
City of Hope also offers Helical TomoTherapy, which focuses radiation on to the tumor from all directions by using hundreds of beams rotating around the tumor. The radiation can be “sculpted” to fit the exact shape of the tumor, resulting in less radiation exposure in adjacent normal tissue and fewer complications.
 
For late stage lung cancer patients, radiation may also be used to palliatively to treat pain and other symptoms associated with the disease.
 

Drug Therapy

Chemotherapy and targeted therapy drugs can fight lung cancer throughout the body and can enhance other therapies by shrinking tumors beforehand, making them easier to target, or reducing likelihood of recurrence afterwards.
 
By looking at the cancer's biological or genetic profile, City of Hope clinicians can determine whether a cancer is vulnerable or resistant to specific drugs. This enables them to plan a treatment regimen that is more effective against the cancer and/or less toxic for the patient.
 
City of Hope doctors are also on the forefront of developing and studying new drugs, or new combinations of existing drugs, that can better treat lung cancer with fewer side effects for the patient. Many of these promising therapies are available to our patients through our clinical trials program.
 

Become a Patient

If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

Research

Lung Cancer Research

There is extensive collaboration between lung cancer clinicians and researchers develop and evaluate new therapies designed to improve survival and quality of life outcomes. City of Hope patients have access to a wide variety of clinical trials ranging from new chemotherapy and targeted therapies, hormone therapies, novel surgical techniques and new radiation approaches — all focused on enhancing lung cancer treatment, detection and prevention.
 
Some of our current research projects include:
 
  • Our researchers are currently studying markers of metastatic potential within lymph nodes of patients with completely resected non-small cell lung cancer (NSCLC). This allows them to better understand how the tumor and the immune system interact to facilitate cancer spread. By understanding these mechanisms, targeted molecules can then be developed to block tumor metastasis and improve survival.
  • As we gain knowledge into the biology of lung cancer, our clinicians have also incorporated the evaluation of biomarkers into our trials to better tailor therapies to our patients, particularly those with advanced disease.
  • The signaling pathway cyclooxygenase-2 (COX-2) plays a key role in lung tumor growth, spread and therapy resistance, so our researchers developed a drug trial to see if the COX-2 inhibitor, celecoxib, can improve outcomes by enhancing the effectiveness of another lung cancer drug.
  • Patients with advanced lung cancer frequently have immune system abnormalities, including depletion of the B cells and T cells, which make up the body’s defense system. Our researchers have identified a compound in shiitake mushrooms called beta-glucans that can enhance immune system activity, and City of Hope is conducting a trial to see if it can slow or halt tumor growth in lung cancer patients.
  • Because lung cancer patients are often present with advanced disease that compromises their quality of life, City of Hope researchers are continually investigating and implementing interventions that can support patients and their families through supportive and palliative care.
 
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 

Living with Lung Cancer

Living with Lung Cancer

While our primary goal is to cure or control the disease, another top priority is relieving suffering and discomfort for lung cancer patients undergoing cancer treatments.
 
In addition to curative treatments, City of Hope lung cancer patients have access to the broad range of services offered by our Department of Supportive Care Medicine. The department’s staff of professionals can help patients and loved ones with a variety of care and wellness issues including:
 
  • Managing side effects
  • Pain management
  • Pulmonary rehabilitation to improve breathing
  • Smoking cessation
  • Navigation through the health care system
  • Coping and maintaining emotional/social/spiritual well-being
  • Staying healthy and active during/after treatment
  • Guidance on eating and cooking well
  • Healing arts
  • Building caregivers’ skills  
 
 
The Sheri & Les Biller Patient and Family Resource Center is the heart of the Department of Supportive Care Medicine, integrating City of Hope's support services under one umbrella. The Biller Resource Center provides a warm and welcoming space where patients, families and caregivers can access the resources, education and support they need to strengthen and empower themselves, before, during and after treatment.

Our team of supportive care experts includes clinical social workers; pain and palliative care physicians and nurses; psychologists, psychiatrists; patient navigators; health educators; spiritual care chaplains; child life specialists and more. The Biller Resource Center staff may be reached at 626-256-4673, ext. 32273 (3CARE).
 
Tips, tools and online resources to help cancer patients and their families with issues that arise during cancer treatment.
 
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 

Support This Program

Support this program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Rick Leonard
Associate Vice President
Direct: 213-241-7218
Email: rleonard@coh.org

 
 
Quick Links
About the Lung Cancer Program


Karen Reckamp, M.D., M.S., co-director of the Lung Cancer and Thoracic Oncology Program, discusses lung cancer treatment and research at City of Hope.
What’s in cigarette smoke?
Did you know that there are more than 7,000 chemicals in tobacco smoke? Hundreds are toxic and at least 70 are known to cause cancer.
 
 
Lung Cancer Videos
 
Already a breast cancer survivor, Susan was shocked to learn she'd been diagnosed with lung cancer, though she had never smoked. But she didn't give up hope. Watch Susan's story »
 
Learn more about City of Hope's lung cancer treatments and research by watching the Lung Cancer YouTube playlist »
 
Medical Minute
 
 
 


NEWS & UPDATES
  • Are you thinking about switching from traditional cigarettes to e-cigarettes for the Great American Smokeout? Are you thinking that might be a better option than the traditional quit-smoking route? Think again. For lung expert Brian Tiep, M.D., the dislike and distrust he feels for e-cigs comes down to this: Th...
  • Hematologist Robert Chen, M.D., is boosting scientific discovery at City of Hope and, by extension, across the nation. Just ask the National Cancer Institute. The institution recently awarded Chen the much-sought-after Clinical Investigator Team Leadership Award for boosting scientific discovery at City of Hope...
  • Great strides have been made in treating cancer – including lung cancer – but by the time people show symptoms of the disease, the cancer has usually advanced. That’s because, at early stages, lung cancer has no symptoms. Only recently has lung cancer screening become an option. (Read more about the risks...
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  • Cancer is a couple’s disease. It affects not just the person diagnosed, but his or her partner as well. It also affects the ability of both people to communicate effectively. The Couples Coping with Cancer Together program at City of Hope teaches couples how to communicate and solve problems as a unit. He...
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  • Former smokers age 55 to 74 who rely on Medicare for health care services have just received a long-hoped-for announcement. Under a proposed decision from the Centers for Medicare and Medicaid Services, they’ll now have access to lung cancer screening with a low-dose CT scan. The proposed decision, announ...
  • City of Hope has a longstanding commitment to combating diabetes, a leading national and global health threat. Already, it’s scored some successes, from research that led to the development of synthetic human insulin – still used by millions of patients – to potentially lifesaving islet cell transplants. Diabet...
  • Dee Hunt never smoked. Neither did her five sisters and brothers. They didn’t have exposure to radon or asbestos, either. That didn’t prevent every one of them from being diagnosed with lung cancer. Their parents were smokers, but they’d all left home more than 30 years before any of them were diagn...
  • They may not talk about it, but women with cancers in the pelvic region, such as cervical cancer, bladder cancer and uterine cancer, often have problems controlling their urine, bowel or flatus. Although they may feel isolated, they’re far from alone. Many other women have such problems, too. In fact, nea...
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  • A new study suggests that the colorectal cancer outlook is more grim than many thought, with the number of cases among young adults actually rising. But the study, which made headlines around the country, might not have the obvious message many consumers think. Donald David, M.D., chief of gastroenterology at C...
  • Patients faced with a cancer diagnosis have a lot to take in. It’s no surprise that many need help airing their concerns to their care teams. That’s why a City of Hope team developed SupportScreen, to enable patients to communicate their needs better. Last week, the tablet-based app hit an important milestone, ...