Thoracic Malignancy

Malignant 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, also known as mesothelioma, is cancer of the membranes or linings that surround the lungs and line the inside of the chest cavity. 

One or more of the following methods may be used to diagnose a thoracic malignancy:

  • 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.
  • 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 thoracoscopic surgery (VATS). 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 computed tomography (CT) scan. Scans in a spiral path to create detailed pictures of inside the body.
  • Endoscopic ultrasound and total body positron emission tomography (PET) scan. Takes pictures of the chest or other locations in the body to find cancer cells

Thoracic Malignancy Treatment

At the Indiana University Health Melvin & Bren Simon Cancer Center, our surgeons specifically treat thoracic malignancies. We have 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 that consider the stage of your tumor, your ability to carry on normal activities while living with cancer and your preference. Most patients can be evaluated at the IU Health Melvin & Bren Simon Cancer Center and receive treatment recommendations by our specialists within one week.

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 to other parts of the body). Our patients have access to the most advanced diagnostic, treatment and palliative care options. 

Our multidisciplinary team discusses and creates individualized treatment recommendations for each patient. We focus on total care, emphasizing pain management, rehabilitation, nutrition and your emotional, social and educational needs.

Healthcare for thoracic cancer patients can be extremely complex and often includes more than one type of treatment such as:

  • Chemotherapy. Medication that destroys cancer cells.
  • Radiation therapy. Uses high energy, penetrating waves or particles to destroy cancer cells or keep them from reproducing.
    • Three-dimensional conformal radiotherapy. Produces a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while protecting healthy tissue.
    • Gamma Knife radiosurgery. An advanced radiation technology that targets a tumor from many angles in a single treatment session.
    • Stereotactic body radiation. Special equipment that delivers a large radiation dose to a tumor without affecting healthy tissue.

Supportive care is also available through the CompleteLife Program, where staff provides compassionate support and education for patients, tending to their emotional, mental, social and spiritual needs.

Thoracic Malignancy 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 about the treatment of thoracic malignancies at national and international conferences.

We combine both clinical and laboratory expertise. Our leading edge laboratories 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, leading to new and improved patient care options. The IU Health Simon Cancer Center is at the forefront of these discoveries, and our patients are among the first to benefit from access to clinical trial options.

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