Lung Cancer Programs & Services

Our BIDMC thoracic surgeons are board-certified — an indicator for best quality outcomes. We perform a high volume of surgical procedures, with an emphasis on minimally invasive technique, to diagnose and treat lung, esophageal and other chest-related cancers.

Typically, surgery to treat cancer is most effective for early stage tumors, before the cancer has spread. Thoracic surgeons may use video-assisted thoracoscopic surgery (VATS) before surgery (to confirm cancer diagnosis or biopsy lymph nodes in the chest) or instead of an open procedure to remove a cancerous wedge of lung tissue (a segmentectomy) or an entire lung lobe (a lobectomy). Video-assisted thoracoscopic surgery uses a non-rib-spreading technique and smaller incisions compared to an open (or extended) procedure, and offers better pain control and faster recovery.

Minimally invasive esophagectomy (MIE) is another innovative surgical option for certain patients with esophageal cancer. Cancer can occur anywhere in the esophagus, but most typically in the distal region, where the esophagus joins the stomach. Our thoracic surgeons are exceptionally skilled and proficient at removing the cancer and reconstructing the esophagus using a portion of the stomach. This minimally invasive approach features small incisions — in the abdomen and chest — without rib spreading, for better pain control and easier recovery compared to an open procedure.

Chest Disease Center at BIDMC

Our thoracic medical oncology team is highly specialized and offers tumor genotyping, access to state-of-the-art clinical trials, and coordinated systemic (chemotherapy) cancer treatment. Your medical oncologist will help coordinate the care you need and talk with you and your family about treatment decisions.

Medical oncology uses chemotherapy and other systemic medicines, such as hormones and biological therapy, to treat cancer. Chemotherapy — either systemic (treating cancer wherever it is located in the body) or intra-arterial (delivering the chemotherapy through a catheter directly into the artery supplying the tumor) — travels through the bloodstream to kill cancer cells. BIDMC has a specialized outpatient medical oncology unit for outpatient oncology evaluation and treatment, and a specialized inpatient medical oncology floor for inpatient oncology care.

Medical Oncology at BIDMC

You may benefit from standard chemotherapy protocols (drugs and treatment guidelines) that improve the outcome of your particular cancer and symptoms. Or you may qualify for one of our extensive clinical trials — research studies that are designed to find better treatments for cancer patients based on the most updated information from around the country.

A subgroup of our patients may benefit from tumor genotyping with subsequent tailored treatments, a type of personalized cancer therapy designed to attack the genetic structure of an individual tumor. Most cancers are an accumulation of cellular defects — genes that have mutated or gone awry — that allow for unchecked cellular division and growth.

For non-small cell lung cancer, one of the more clinically relevant defects is a mutation in the EGFR (epidermal growth factor receptor) gene. The presence or absence of this EGFR alteration can help determine the timing and type of therapy you should have. BIDMC and the teaching hospitals in Boston do more of this type of genotyping than anywhere else in the country.

Cancer Clinical Trials at BIDMC

Our specialists in radiation oncology (doctors who treat cancer with radiation therapy) are among the most experienced in the Boston area in using the CyberKnife stereotactic radiosurgery system to treat chest cancers. Radiation therapy utilizes high-energy rays or particles to treat disease. High doses of radiation can kill cells or keep them from growing and dividing. Radiation therapy is a useful tool for treating cancer because cancer cells grow and divide more rapidly than many of the surrounding normal cells.

CyberKnife offers superior targeting accuracy with minimal exposure to surrounding healthy tissue. Its real-time, image-guided robotic technology continually tracks patient movement and confirms tumor location prior to beam delivery, making it especially effective at treating hard-to-reach tumors and tumors that move with respiration, such as lung tumors.

Our radiation oncologists also use intensity modulated radiation therapy (IMRT) to treat thoracic cancer. IMRT features radiation beams of different intensity that conform to tumor size, shape and location to kill cancer cells, while sparing nearby healthy tissue.

Radiation Oncology at BIDMC

A key distinction in our Lung Cancer Program is the unique partnership between our thoracic surgeons and interventional pulmonologists (physicians who use non-operative approaches to evaluate and treat airway disease). In most medical settings, non-surgical and surgical interventions occur on separate tracks, without close collaboration between these specialists. BIDMC is the only center in New England that offers complete and seamless integration between thoracic surgery and interventional pulmonology, and together we are advancing techniques and pioneering therapies.

Thoracic surgeons and interventionalists work jointly in our Complicated Airway Center to determine whether you are best served by endoscopic and/or surgical techniques. We use minimally invasive techniques and innovative equipment to reach previously inaccessible lung tumors, aid in tumor staging to determine the extent of your disease, guide surgical therapy, and treat complex endobronchial obstruction. We offer a number of interventional pulmonology procedures not generally available elsewhere in the Boston area including photodynamic therapy, tracheal and bronchial stenting, and endobronchial ultrasound (EBUS).

Interventional Pulmonology at BIDMC

BIDMC is widely regarded for our expertise in radiologic imaging and treatment, including using radiofrequency ablation (RFA) to treat lung and other chest cancers. We have vast and pioneering experience in RFA, a non-operative, minimally invasive therapy that employs radiofrequency energy to kill cancerous cells. RFA is also helpful in targeting and destroying abnormal cell growth in the esophagus, a precancerous condition known as Barrett's esophagus.

Radiologists use an array of imaging options to diagnose and stage chest cancers. Our BIDMC thoracic radiologists are among the finest in the field in performing examinations and evaluating results. Computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine modalities such as positron emission tomography (PET) and combined PET/CT, help classify tumors and abnormal cells, and guide surgical therapy and treatment planning.

Radiology at BIDMC

Pathologists have special training and expertise in diagnosing disease from biopsies, blood samples and other body fluids. Our pathologists are internationally regarded for their expertise in all types of cancer and benign diseases.

Pathology at BIDMC

Compassionate support is a hallmark of our thoracic oncology program, and our nurses receive high praise from patients and staff for the care and services they provide. Our nursing staff is here for you and your family, and together with your doctors and other healthcare professionals at BIDMC, will help you learn about:

• Your cancer diagnosis, the tests you will have, and any necessary preparations.
• The procedure or operation you will need.
• Your recovery period, medications, returning home, and much more.

We can help you and your family navigate your care, arrange appointments, and coordinate any additional resources you might need.