Lung Cancer

Cancer that begins in the lungs. Common terms used to describe the appearance of some lung cancer cells include:

  • Non-small cell lung cancer (NSCLC). Subtypes based on the cells from which the tumor develops include:
  • Adenocarcinoma. The most common subtype, usually develops at the edges of the lungs.
  • Squamous cell carcinoma. Formed from reserve cells (round cells that replaced injured or damaged cells in the lining of the bronchi, the lung’s major airways).
  • Large cell carcinoma. Often occurs in the outer regions of the lungs and tends to grow rapidly and spread more quickly than some other forms of non-small cell lung cancer.
  • Small cell lung cancer. Less common than non-small cell lung cancer and tends to be more aggressive. It is usually divided into limited stage or extensive stage categories.

Lung Cancer Diagnosis

One or more of the following methods may be used for a lung 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 lesions 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 approach using novel robotic technology.  
  • Video-assisted thoracic surgery (VATS) or thoracoscopy. Minimally invasive approach to thoracic surgery often used in lung and esophageal resections.
  • Transbronchial biopsy and transesophageal biopsy. Removes tissue through the wall of the bronchus or esophagus, for examination under a microscope.
  • Mediastinoscopy. Surgically removes tissue and lymph node samples from between the lungs to look for abnormalities.
  • Bronchoscopy. Uses a scope to look inside the trachea and large airways in the lung for abnormal areas and to remove tissues for examination under a microscope.
  • Exploratory thoracotomy. An open surgical operation to look inside the chest for abnormalities.

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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Lung Cancer Treatment 

Our thoracic oncology team specializes in the diagnosis and treatment of cancers of the chest, including lung, esophagus, pleura, chest wall, and mediastinum.  We provide unique expertise in thymoma, mediastinal germ cell tumors, and lung cancer.

Our surgeons specifically treat thoracic malignancies and we’ve practiced a multidisciplinary approach to care for the past 20 years. 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 lung 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 lung 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 lung cancer patients can be extremely complex and often includes more than one type of treatment:

  • Chemotherapy. Medication that destroys cancer cells.
  • Surgery. Frequently the primary treatment for non-small cell lung cancers involves removing the cancer and sometimes a portion of the lung. The IU Health Melvin and Bren Simon Cancer Center offers expertise in complicated surgeries such as pneumonectomies which is the removal of the entire lung.
  • 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.
    • Stereotactic body radiation. Special equipment is used to precisely deliver a large radiation dose to a tumor and not to normal tissue.

Palliative Care

At IU Health Simon Cancer Center, we offer excellent palliative care that brings you, your family and your doctors together to decide your best care plan. Palliative care is focused on providing patients with relief from the symptoms, pain and stress of a serious illness - whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.

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Lung Cancer Specialists

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

Mark Langer, M.D.

Thoracic Surgery

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

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Lung Cancer Research

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

The research that is carried out through our partnership with the Indiana University School of Medicine has set the standard for treatment of small cell lung cancer and stage III NSCLC and 2nd line NSCLC. In addition, we rank among the top in the world for treating inoperable stage I lung cancer with stereotactic radiotherapy (XRT). We combine both clinical and laboratory expertise, and 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 Simon Cancer Center and the IU School of Medicine are 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.

More information about cancer research can be found on the IU School of Medicine website

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