Pancoast Tumor

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January 22, 2018 at 1:20 pm  #1293851    


My 85 year old mom has just been diagnosed with a non small cell pancoast tumor on her right lung. We are still waiting for pathology to complete their report. From everything I am reading a pancoast tumor is a difficult surgery. What are your thoughts?

January 22, 2018 at 2:18 pm  #1293852    
JimC Forum Moderator
JimC Forum Moderator

Hi vcr511,

I’m sorry to hear of your mom’s diagnosis. It is true that surgery for a pancoast tumor is complicated, and best left to surgeons with a great deal of expertise on this particular type of surgery. Thoracic surgeon Dr. Edward Vallieres discusses pancoast tumor treatment and surgery here.

Treatment choices for an 85 year old patient necessarily involve an assessment of the overall fitness for radiation, chemotherapy or surgery, as every patient of advanced age presents individual issues, and each cancer has features which make surgery or radiation more or less difficult. If your mother is deemed fit for surgery and wishes to proceed, then the best course would be to find a quality thoracic surgeon (one who specializes in chest/lung surgery rather than performing many different types of surgery). They can usually be found at cancer centers affiliated with leading medical schools.

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Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
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January 22, 2018 at 3:39 pm  #1293853    
catdander forum moderator
catdander forum moderator

Hello vcr511,

Welcome to Grace. I’m so sorry to hear about your mom. As Jim said surgery for a pancoast tumor is at best difficult and often too risky. Depending on where or what it’s infiltrated a team of surgeons involving neurosurgeon and orthopedic surgeons are often enlisted to participate in the surgery. If she is thinking about surgery an opinion from a dedicated thoracic surgeon is a must and one who does pancoast tumors regularly is best. Dr. Robert Cerfolio now in New York is one of the leading surgeons of pancoast tumors.

While my husband had surgery his was only to get a biopsy and not to resect the pancoast tumor which was invading ribs and encroaching on bracial plexus and spine. He was cured with radiation and chemo. Since it’s been impossible to accrue enough people in a trial to compare radiation and chemo to surgery for curative treatment in nsclc no one knows how much better surgery is than radiation and chemo or if it’s even better at all. So if she ends up not having surgery I hope she doesn’t feel like she’s not able to get the best treatment for it’s highly likely she will be able to have radiation and maybe even some type of radiation.

Keep us posted.
All best,

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