Are you worried you may have lung cancer?
There is a lung cancer team at UAMS that helps to figure out what you have and how to approach it. The team includes several physicians and a lung cancer coordinator. We offer a full range of services from diagnosis to supportive care.
Everything usually starts with an abnormality found on a chest x-ray. This could have been done because you had symptoms, or maybe an abnormality was discovered while your doctors were looking for something else. If an abnormality was found, you need to see a diagnostic Pulmonologist. Dr. Bartter heads this team. He will examine you, study your films, and help decide whether you need a biopsy. If you do, he will offer you the best available approach – he may do a procedure himself or he may ask other professionals to get involved. There are several options:
- Bronchoscopy – a look into the airways for abnormalities. Sometimes X-ray is used during the procedure.
- Endobronchial or esophageal ultrasound – UAMS is one of only 2 sites in the state which offer this special technique. A special scope with an ultrasound at its tip is used to look through the walls of the airway or esophagus and guide a biopsy.
- CT-guided biopsy – Some lesions are better approached through the chest wall with CT guidance. When this is the case, a specialist in Interventional Radiology will help with your diagnosis.
- PET scanning – A PET scan does NOT tell you whether or not you have cancer, but it can help us to understand different types of abnormality and where they are in the body. Sometimes a PET helps guide us to the best biopsy area.
- Other options are available when called for.
Have you been diagnosed with lung cancer? If so, what are your options?
Before we know your options, we have to know the stage of your cancer. This may involve further studies, such as the diagnostic studies listed above. Once we know the stage, there are several possibilities for treatment:
Should I have surgery? Can I have surgery?
This question is important and sometimes can be complicated. The discussions about you and what should be done are an important part of the work of the lung cancer team. If you have a cancer which can be safely completely removed, surgery should be considered. Dr. Matthew Steliga is a thoracic surgeon with special training and expertise in lung cancer surgery. But in order to decide whether he should operate, we need to ask several questions.
First is the type of cancer. For example, if you have small cell cancer surgery almost never helps and is very unlikely to be recommended.
The second is the stage.
The third question is about your overall health and lung function. If the cancer could be taken out but the risks are too high, then you should not have surgery.
If you do need surgery, you may be a candidate for “VATS”, or Thoracoscopic Lobectomy. This is a minimally invasive approach to the chest for which Dr. Steliga has special training. It is not available in most of Arkansas.
What about chemotherapy and radiation therapy?
These two treatments are listed together because they are often used together to get the best possible outcome. When an operation is not what is best for you (or sometimes even when it is), the team will discuss the possibility of treatment with chemotherapy and/or radiation. At UAMS, Drs. Konstantinos Arnaoutakis and Imran Ahmad are the main doctors for chemotherapy of lung cancer, while Dr. Jose Penagaricano is the main doctor for radiation therapy of lung cancer. All three are at the forefront of advances in the treatment of lung cancer.
I need something not mentioned here. What should I do?
You should ask. There are other possible treatments available at UAMS. One example is Radiofrequency Ablation (RFA), a way to destroy tumor tissue with radio waves. UAMS has one of very few radiology departments in the country that offer RFA for lung tumors.
What about second opinions?
Our multidisciplinary team of experts welcomes patients with lung cancer who may be seeking a second opinion. This is an important role of an academic lung cancer center. Our team includes pulmonary, surgery, oncology, pathology, radiology, radiation therapy, and palliative care physicians.
Cancer therapy is not working for my family member. Can you help?
Yes we can help. In two ways. First, we can offer a second opinion, as mentioned above. If there is more that we can do, we can offer that. Second, if we agree that there is no more to be done to fight the cancer, we can ask the Palliative Care Team to see your family member. Palliative care doctors try to relieve pain, improve function, and improve the quality of life for patients no matter what disease they have or how serious it is.
In conclusion, if you think you might have lung cancer or know that you do, UAMS doctors can work with you to form a personalized diagnostic or treatment plan. Because we are the state’s cancer center and the only academic hospital, we have many advanced therapies which are not available elsewhere in the state. A member of our lung cancer team can be reached through the number listed above. If you wish to e-mail the lung cancer coordinator, Teka Bartter, APN can be reached at BartterTekaM@uams.edu.