Division of Cardiothoracic Surgery
Thoracic Oncology Program - Providing a Multidisciplinary Approach to Care
The Thoracic Oncology Program is a specialized program of the Hollings Cancer Center. Dedicated to delivering the most innovative treatment options to patients with thoracic malignancies, the Thoracic Oncology Program is comprised of a multidisciplinary team of specialists, including thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, gastroenterologists, radiologists, pathologists, nurses, dietitians and social workers.
The Thoracic Oncology Program at the Hollings Cancer Center treats patients with:
- Lung cancer
- Esophageal cancer
- Chest wall tumors
- Tumors of the mediastinum, including thymoma and thymic carcinoma, germ cell tumors, and neurogenic tumors
- Tracheal cancer
- Tumors metastatic to the lungs, mediastinum, airways and chest wall
Thoracic Cancer Treatment at MUSC
MINIMALLY INVASIVE STATE-OF-THE-ART DIAGNOSTIC AND STAGING TOOLS
- Integrated PET-CT: Combining functional assessment and anatomic detail to better stage malignancies
- Endoscopic Ultrasonography with Fine-Needle Aspiration (EUS/FNA): Nationally renowned gastroenterologists use this technique to stage esophageal and lung cancer, biopsy mediastinal masses, and restage the mediastinum after chemo ± radiation
- Endoscopic Bronchial Ultrasonography with Fine-Needle Aspiration (EBUS/FNA): Pulmonologists and surgeons diagnose and stage lung cancer with this minimally invasive approach.
All new cases are seen in the multidisciplinary clinic and discussed at the Thoracic Tumor Board to develop a plan for each patient. The clinic offers evaluation and recommendations for:
- High risk lung cancer patients
- Complex cases requiring chest wall resection and reconstruction
- Patients who are potential candidates for thoracoscopic lobectomy
- Locally-advanced lung cancer needing induction therapy
- Second opinion patients
MUSC is the state’s high-volume provider for esophageal cancer. The program is led by Dr. Carolyn Reed, well-known for her contributions in the field. Esophageal cancer is a component of the Center of Excellence in GI Malignancy. Areas of focus include therapy, development of markers and molecular profiling, identification of therapeutic targets, technologies for screening and surveillance, and chemoprevention.
Working closely with the Digestive Disease Center (DDC), staging is considered key to treatment planning. Surgical options are discussed with each patient in view of tumor and patient characteristics. The surgeon coordinates preoperative therapy with referring physicians. Palliative options include stenting, laser, and photodynamic therapy.
The DDC has a special interest in Barrett’s esophagus (a change in the lining of the esophagus due to chronic gastroesophageal reflux). A surveillance clinic is in place. A variety of ablation techniques are available. For patients with high-grade dysplasia (a precancerous condition), individualized treatment options are discussed, including participation in cutting-edge ablation trials.
This program is led by Dr. John DeRosimo. Combined modality techniques that significantly extend the survival and improve the quality of life of patients with malignant pleural mesothelioma have been pioneered at Brigham and Women’s Hospital in Boston where Dr. DeRosimo has done a special fellowship. At MUSC, advanced surgical resection by extrapleural pneumonectomy in combination with chemotherapy and radiation therapy is offered to selected patients.
INNOVATIVE RADIATION ONCOLOGY
- PET-CT scan fusion for more accurate radiation planning
- 3D conformal radiation therapy
- IMRT for appropriate cancers
- Stereotactic radiosurgery for lung cancers metastatic to the brain
- Tomotherapy: A new cancer treatment that uses a CT scanner while receiving radiation
- High-dose radiation therapy for early-stage tumors in medically inoperable tumors.
- Use of novel agents with radiation therapy
Medical therapy at the Program includes:
- Induction therapy for certain locally advanced lung cancers
- Adjuvant therapy, including chemotherapy, after resection for stage II and IIIA lung cancer
- Targeted therapies for medical treatment of lung cancer, including epidermal growth factor receptor inhibitors
- Second opinions to help plan treatment closer to patient’s homes
- Access to clinical trials for small cell and non-small cell lung cancer
MINIMALLY INVASIVE THORACIC SURGERY
The Section of General Thoracic Surgery offers appropriate patients minimally invasive solutions and approaches that can reduce postoperative pain, cause less damage to tissues and promote faster recovery. Surgeons at MUSC perform thoracoscopy to:
- Diagnose, stage and treat lung cancer
- Evaluate interstitial lung disease or pulmonary fibrosis
- Treat pleural effusions
- Resect selected early-stage lung cancers
- Biopsy and resect abnormalities of the mediastinum, including thymectomy for myasthenia gravis
- Treat hyperhidrosis
- Treat recurrent pneumothorax
Laparoscopic procedures are used to treat:
- Achalasia: esophageal myotomy
- Gastroesophageal reflux disease (GERD)
- Giant hiatal (paraesophageal) hernia