Lung Cancer

Lung cancer is the most common fatal cancer in the U.S. When possible, lung cancers are removed by surgery, often to be followed by 6 to 7 weeks of irradiation and/or chemotherapy, depending upon the findings at surgery. However, some lung cancers present with a size and degree of anatomical spread to lymph nodes, as seen by PET (positron emission tomography) scanning, that makes surgical resection impossible. And some patients have medical issues, such as cardio-pulmonary disease or diabetes, which may make thoracic surgery too dangerous to consider. Tomotherapy is an excellent technique for treating such tumors to high dose, while minimizing damage to adjacent lung or heart tissues.

For earlier-stage lung cancers in medically inoperable patients, tightly localized irradiation with Tomotherapy appears to be almost as effective as surgical resection. Such therapy is much gentler for medically frail patients, requiring only one week of treatment rather than the usual 6 to 7 weeks.

Some lung cancer patients have a type of tumor called Small Cell Lung Cancer (SCLC). When this cancer is detected at an early stage with a smaller size, it may be preferable to give radiation treatments twice daily (separated by 6 hours) to deliver 30 fractions of radiation over 15 treatment days. When the tumor volume is larger or intertwined with more sensitive structures, it may be safer to treat just once daily over a period of 6 weeks. Oftentimes, chemotherapy is recommended to be given in conjunction with the irradiation, given the propensity of SCLC to spread to other parts of the body. Metastasis to the brain is so common with SCLC, however, that 10 fractions of prophylactic brain irradiation is typically recommended to follow the conclusion of the chest treatment, even when the patient’s brain MRI scan does not show visible evidence of lesions.

Dr. Grado and his team of dedicated specialists make it a point to decrease the level of pain and anxiety in patients suffering from lung cancer. With the help of the qualified doctors with the latest medical expertise, we have often been able to detect the symptoms of lung cancer at the earliest stage, thereby helping us to devise the most-beneficial medical treatments for our patients.

We try to incorporate all the important details of the patient to provide effective treatment and post-cancer counseling. With a clear understanding of the patient’s physical requirements, we can provide the most effective treatment for our lung cancer patients. They are thereby better able to make informed decisions and manage their lives more efficiently after cancer therapy.


1. Rosen LR, Fischer-Valuck BW, Katz SR et al. “Helical image-guided stereotactic body radiotherapy (SBRT) for the treatment of early-stage lung cancer: a single-institution experience at the Willis-Knighton Cancer Center.” Tumori. 2014 Jan-Feb;100(1):42-8. doi: 10.1700/1430.15814.

2 Arcangeli S, Falcinelli L, Bracci S et al. “Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours.” Br J Radiol. 2017 Mar;90(1071):20160853. doi: 10.1259/bjr.20160853.

3 Minatel E, Trovo M, Polesel J et al. “Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant pleural mesothelioma. Final results with long-term follow-up.” Lung Cancer. 2014 Jan;83(1):78-82. doi: 10.1016/j.lungcan.2013.10.013.

4 Sole CV, Lopez Guerra JL, Matute R et al. “Stereotactic ablative radiotherapy delivered by image-guided helical tomotherapy for extracranial oligometastases.” Clin Transl Oncol. 2013 Jun;15(6):484-91. doi: 10.1007/s12094-012-0956-2.

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