Our Approach to Lung Cancer

The lung cancer team at the Siteman Cancer Center provides nationally recognized expertise in the diagnosis and treatment of lung cancer and other chest cancers. Our physicians treat approximately 900 new lung cancer cases each year – far more than other facilities in the region. Our programs (pulmonary medicine and cancer therapy) are ranked among the best in the country by U.S. News & World Report. This experience in the treatment of chest cancers means we are able to offer the latest in diagnostic tests and cutting-edge treatments.

Lung cancer is the leading cause of cancer death in the United States; deaths that could potentially be prevented by early detection. Learn more about our lung cancer screening program.

Patients who come to the Siteman Cancer Center for treatment of lung cancer are seen by a team of Washington University Physicians – surgeons, medical oncologists and radiation oncologists who only treat lung and esophageal cancers, often during the same visit. A health psychologist is also available.  Experienced nurses spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses offer patient literature on your condition, chemotherapy, radiation therapy, surgery and other related issues. Dietitians can help you deal with any nutritional issues. A multidisciplinary group of different specialists meet weekly to look at patient cases and personalize the treatment approach for difficult cases. As a unique feature of your care, we also offer the services of a palliative care specialist who can help you fit treatment into your own special circumstances.

There are two main types of lung cancer:

  1. Non-small cell lung cancer: most lung cancers fall into this category.
  2. Small-cell lung cancer: About 10-15 percent of lung cancers fall into this category.

Each classification has different subtypes, depending on the appearance of cells that are cancerous. Different types grow and spread in different ways. Small-cell and non-small cell lung cancers are treated differently.

Non-small cell lung cancer:

  • Adenocarcinoma: This cancer begins in the cells that line the lung’s air sacs (alveoli) and make substances such as mucus. This type accounts for most of non-small cell lung cancers seen at Siteman.
  • Squamous cell carcinoma: Cancer begins in squamous cells, which are cells that create linings, such as the skin and the inside of the mouth. Squamous cells are not typically found in a healthy lung, but result from smoking-related changes to the bronchial tube lining. This is also called epidermoid carcinoma.
  • Others: Less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, salivary gland carcinoma and unclassified carcinoma.

Small-cell Lung Cancer:

  • Small cell carcinoma, previously called “oat cell” cancer, makes up the majority of small-cell cancer.

The types of treatment used for lung cancer depend on the type and sub-type of the cancer and the stage at which it is diagnosed. Treatment may include: surgery to remove the diseased section of the lung when technically feasible, radiation, systemic therapy (including chemotherapy), molecularly targeted or personalized therapy and immunotherapy. Our multidisciplinary approach means your doctors talk to each other, and you are treated by experts who collaborate for your benefit.

Clinical trials are in place now to bring promising advances into routine clinical areas. Washington University Physicians at Siteman are actively involved in and develop new therapies and clinical trials that investigate promising new approaches to manage the disease. Having your cancer treated at Siteman, either by standard therapy or as part of a trial, gives you access to the newest therapies that are at least as good as – or potentially better than – current standard therapies available elsewhere.