Probable Pancoast tumour

Hi app.92,  Welcome to Grace.  I'm sorry this is late getting to you. And more sorry your mum is going through this.  It's possible this isn't a pancoast tumor even though it does sound like it's very possible.  A biopsy will confirm if this is cancer.  

My husband had a pancoast tumor diagnosed in 2009.  As is fairly common with pancoast tumors his was not resectable.  He had chemo and radiation and more chemo.  He has pain from tumor or radiation or surgery, though probably a combination of it all but he is doing quite well today and the pain is no where near what it was before radiation. 

The thing I learned that I would say to anyone over and over is that if she has any kind of surgery in the area of the tumor it should be done by a "dedicated" thoracic surgeon.  They only do surgery on lungs and the chest wall.  A cardio/thoracic surgeon does mostly heart surgery and occasionally thoracic surgery.  Surgery on a pancoast tumor is very complicated and should only be done by a dedicated thoracic surgeon or better yet a surgeon who specializes in pancoast tumors.  Often the thoracic surgeon is accompanied by a neurosurgeon and and orthopedic surgeon.  It's complicated.

Depending on the individual's circumstances there are many possible ways to treat.  If it's cancer and it has not metastasized possibilities often include systemic therapy like chemo or immunotherapy and radiation to shrink the tumor as much as possible, then surgery, then more chemo and or immunotherapy.  All of this is very agressive and that perosn would need to be strong enough to endure.  If the tumor is unresectable like my husband's then systemic therapy like chemo and or immunotherapy and radiation maybe followed by more chemo and or immunotherapy to kill any wandering cancer cells.  

Before any treatment genetic testing is normally done.  But since your mom is in tremendous pain and if she has squamous cell nsclc and has a smoking history treatment may not wait until genetic testing results are in.  That's because people with a smoking history, squamous cell, and pancoast tumor probably don't have a targetable treatment for their cancer and very possibly will benefit from immunotherapy.  And since she is in tremendous pain it's important to get her pain under control which radiation may do in a matter of days or weeks.  

That's a lot.  I have a lot to say about these tumors.  Let us know your mum's biopsy results and any questions you have.  I hope you will keep us posted.

Take care,

Janine