Facts About Pancoast Tumors: Lung cancer can form in any part of the lungs. When lung tumors grow in the upper portion of the lung, above the first rib, they’re called Pancoast tumors, after Dr. Henry Pancoast, the radiologist who first described them in the early 1900s. They’re also sometimes referred to as superior sulcus tumors, based on the location where they’re found.“Pancoast tumors are quite rare, accounting for only 3% to 5% of lung cancers,” says Dr. David Rice, a thoracic and cardiovascular surgeon. “But there are treatment options available for patients.”
1. Pancoast tumors only occur in the upper portion of the lung.
The difference between Pancoast tumors and other lung tumors is their location. These tumors occur in the uppermost portion of the lung known as the apex.
Even if a tumor is near the upper portion of the lung, it’s not a Pancoast tumor if it’s below the first rib.
They may also spread into the ribs at the top of the chest and affect important areas at the base of the neck, like nerves and blood vessels.
It’s not clear why tumors develop here, though cigarette smoking is often a factor. Exposure to certain harmful chemicals, radon gas and asbestos may also cause these tumors.
2. Pancoast tumors have unique symptoms.
Because of their unique location, Pancoast tumor symptoms are specific to the area where they’re found. Shoulder pain and upper back pain are common symptoms, especially if the tumor is impacting the ribs, spine or nerves of the brachial plexus. Patients may feel neck, back, arm or chest pain on the affected side.
In some cases, these tumors may involve the nerves of the brachial plexus, which provide sensory and motor supply to the arm and hand. When that happens, symptoms may include arm pain and loss of function of the small muscles of the hand.
Additionally, the tumor may involve the sympathetic nerve, leading to Horner’s syndrome. These symptoms include the same side drooping of the eyelid, lack of facial sweating and constriction of the pupil. The combination of severe arm and shoulder pain, Horner’s syndrome, and atrophy of the small muscles of the hand is called “Pancoast syndrome.”
In rare cases, tumors can grow so large that they block vessels that drain blood from the arms or face. This can lead to extreme swelling or may invade the spinal canal, leading to paralysis.
Pancoast tumors are often found during a chest X-ray, CT scan or MRI prescribed to identify the cause of these symptoms. Once a diagnosis is made, PET imaging and an MRI brain scan are also required to exclude the possibility of distant metastases.
3. Treatment for Pancoast tumors requires multidisciplinary care.
Unfortunately, by the time Pancoast tumors are diagnosed, they’re usually at a locally advanced stage and may have invaded the chest wall or wrapped around blood vessels or nerves.
Treating Pancoast tumors requires a team approach. Patients may require a combination of chemotherapy, radiation and surgery.
In general, chemotherapy and radiation are considered standard treatments.
In patients without extensive involvement of the brachial plexus or spinal canal and nodal metastases, surgery is often beneficial.
Typically, this occurs following preoperative chemotherapy or chemoradiation.
If radiation is recommended after surgery, consider CyberKnife radiation therapy because it is extremely targeted radiation, meaning it only hits the tumor site, sparing damage to healthy tissue and vital organs nearby.
Due to the location of the tumors and the structures they may invade, treatment is complex and requires a team of experts, like those at the Cyberknife Center of Miami – The Beam Of Life
While many cancer centers may turn these patients away, telling them nothing more can be done for them, that is not our attitude. We feel most often something can be done, and it certainly worth a try. You have nothing to lose and everything to gain.
CyberKnife is a painless procedure, done on an outpatient basis. It does not effect a patients quality of life, and most often, at the very least can extend life.
At CyberKnife Miami we provide patients personalized treatment, for your specific needs to achieve the best possible results. Call us to set up a consultation at 305-279-2900.