Chest Wall Cancer

Malignant chest wall tumors. Chest wall tumors can be lung cancers that grow into the chest wall (the most common scenario); or they can be primary tumors of the chest wall (a sarcoma).

Pleural cancer. Cancer of the membranes or linings that surround the lungs and line the inside of the chest cavity. Mesothelioma is cancer in the pleural tissue.

Chest Wall Cancer Diagnosis

One or more of the following methods may aid a chest wall or pleura cancer diagnosis:

  • Fine needle biopsy. Removes a lump, suspicious tissue or fluid using a small needle for examination under a microscope.
  • Endoscopic ultrasound (EUS) with biopsy. Allows for biopsy of lymph nodes once too small to be identified.
  • Navigational bronchoscopy. Minimally invasive technology that allows tissue samples to be taken earlier and is potentially safer than traditional bronchoscopy.
  • Robotic-assisted surgery. Minimally invasive surgery that allows surgeons to perform complex procedures with more precision, flexibility and control than standard surgical techniques.
  • Mediastinoscopy. Surgically removes tissue and lymph node samples from between the lungs to look for abnormalities.
  • Video-assisted thoracoscopy (VATS surgery). Uses a thin, lighted tube to examine the inside of the chest.
  • Exploratory thoracotomy. An open surgical operation to look inside the chest for abnormalities.
  • Thoracocentesis.  Malignant fluid is drained to comfort patients and diagnose the cancer.

Imaging services may also aid diagnosis:

  • Spiral CT scan. Scans in a spiral path to create detailed pictures of inside the body.
  • Nuclear medicine. Uses a small amount of radioactive material to create an image of the inside of the body.
  • Endoscopic ultrasound and total body PET scanning. Takes pictures of the chest or other locations in the body to find cancer cells.

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Chest Wall Cancer Treatment

Our surgeons specifically treat thoracic malignancies, and we’ve practiced a multidisciplinary approach to care for the past 20 years. Our thoracic oncology team specializes in the diagnosis and treatment of cancers of the chest, including lung, esophagus, pleura, chest wall, and mediastinum.

Our multidisciplinary teams of specialists in thoracic surgery, radiation oncology, pulmonology, medical oncology, dietetics, psychology, social work and nursing are leaders in diagnosing and treating patients with thoracic cancer. We offer advanced medical and surgical approaches for patients, which are individualized and based on the stage of your tumor, your ability to carry on normal activities while living with cancer and your preference. Most patients can be completely evaluated by our specialists and receive treatment recommendations within one week at the Indiana University Health Melvin and Bren Simon Cancer Center.

Once cancer has been diagnosed, your doctor will want to determine the stage or extent of the disease – how large the tumor is and whether the cancer has spread or metastasized to other parts of the body. Our patients have access to the most advanced diagnostic, treatment, and palliative care options available. 
Our multidisciplinary team discusses and creates individualized treatment recommendations for each patient. Our team focuses on total care, emphasizing pain management, rehabilitation, nutrition and your emotional, social and educational needs.
The care of thoracic cancer patients can be extremely complex and often includes more than one type of treatment:

  • Chemotherapy. Medication that destroys cancer cells.
  • Radiation therapy. Uses high energy, penetrating waves or particles to destroy cancer cells or keep them from reproducing. Treatments include:
    • Three-dimensional conformal radiotherapy. Guided by a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while sparing the normal tissue as much as possible.
    • Gamma-knife radiosurgery. Specialized equipment aimed at a tumor from many angles in a single treatment session.
    • Stereotactic body radiation. Special equipment is used to precisely deliver a large radiation dose to a tumor and not to normal tissue.

Supportive care is also available through the CompleteLife Program whose staff compassionately support and educate our patients and tend to their emotional, mental, social and spiritual needs.

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Chest Wall Cancer Specialists

Medical Oncology

Lawrence H. Einhorn, M.D.
Nasser H. Hanna, M.D.
Paul R. Helft, M.D.
Shadia Jalal, M.D.
Patrick J. Loehrer, M.D.

Radiation Oncology

Robert Bryan Barriger, M.D.

Thoracic Surgery

Thomas J. Birdas, M.D.
Duykhanh (Mimi) P. Ceppa, M.D.
Kenneth A. Kesler, M.D.
Karen Rieger, M.D.

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Chest Wall Cancer Research

Our team members write and serve as chairpersons for Eastern Cooperative Oncology Group (ECOG) trials, Hoosier Oncology Group (HOG) trials, and investigator-initiated trials. We provide advice to companies on drug development, serve on boards, advise on National Cancer Institute (NCI) grants and teach other physicians on the treatment of thoracic malignancies at national and international conferences.

We combine both clinical and laboratory expertise. We maintain leading-edge laboratories where we use advanced molecular biology to better understand the biology of tumors and improve patient care. Promising scientific discoveries undergo rigorous testing in the laboratory and clinic and help lead to new and improved patient care options. IU Health Melvin and Bren Simon Cancer Center is at the forefront of these discoveries and our patients are among the first to benefit, having unique access to both standard of care and clinical trial options.

Additional research at IU Health Simon Cancer Center has studied the role of certain therapies that produce promising anti-cancer activity by targeting key mechanisms involved in cancer cell growth.

More information about cancer research can be found on the Indiana University School of Medicine website.

Clinical Trials

We currently host multiple clinical trials into the nature, treatment and prevention of esophageal cancer, lung cancer (non-small cell and small cell), mediastinal tumors, and pleural cancer.

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