Thoracic Oncology

A Guide for Esophageal and Lung Cancer Patients

The comprehensive thoracic oncology program at Virginia Mason is dedicated to achieving superior outcomes for patients with cancers of the lung, esophagus and other areas of the chest. We are an integrated team of thoracic surgeons, medical and radiation oncologists, pulmonologists, radiologists, pathologists, nurses and technicians working to provide every patient the highest level of evaluation, treatment and individual support available anywhere.

The Floyd and Delores Jones Cancer Institute at Virginia Mason offers state-of-the-art equipment and techniques to detect thoracic cancers in the earliest stages:

Comprehensive Lung Cancer Care

  • Video-assisted thoracic surgery (VATS) —  The VATS technique allows the surgeon to operate on the lungs through small incisions using a small video camera.

  • Lobectomy and segmentectomy — Lobectomy, or the removal of one lobe of lung tissue, remains our gold standard for treating early-stage lung cancer. Segmentectomy involves removing the smallest anatomic piece of lung tissue (less than an entire lobe) to provide a safe treatment option for patients who would otherwise not be surgery candidates.

  • Sleeve resection/lobectomy — This highly specialized procedure allows the removal of part of the airway with or without adjoining lung tissue, followed by reattachment of the healthy tissue.

  • Intraoperative brachytherapy — Our center was one of the first in the region to introduce intraoperative brachytherapy, a treatment that places tiny cancer-killing radioactive "seeds" at the tumor site.

Radiation Therapy: More Powerful, More Precise
Patients who receive radiation therapy at Virginia Mason as part of their lung cancer treatment plan undergo an extensive treatment-planning process. All members of the radiation oncology team, including physicians, dosimetrists, physicists and technicians, work collaboratively to determine the precise dose and delivery method to best treat the cancer.

  • Today three-dimensional imaging technologies are used to "conform" radiation to the tumor size, avoiding healthy tissues and minimizing side effects for patients.

  • Internal beam radiation with radioactive seed placement (brachytherapy) is another advanced way to administer radiation, by way of catheters placed surgically or by a bronchoscope.

Treatment for Esophageal Cancer

  • Endoscopic Ultrasound — Advanced high-resolution endoscopes better visualize abnormal tissues while increasing the precision of needle biopsy if needed.

  • Barrett's Esophagus and Early-Stage Cancer — Endoscopists at Virginia Mason use nonsurgical procedures to ablate superficial and obstructive cancers, as well as high-grade dysplasia (a precancerous condition) associated with reflux disease and Barrett's esophagus. Some procedures are effective for managing inoperable conditions, aimed at maintaining comfort and relieving symptoms:

    • Photodynamic therapy (PDT) — A sensitizing drug delivered intravenously concentrates in precancerous or malignant tissues. The drug reacts to applied laser light, destroying the sensitized tissue.

    • Radiofrequency ablation — Controlled radiofrequency energy delivered by endoscope destroys a thin layer of surface tissue containing the problem cells.

    • Esophageal stents — A variety of permanent and removable stents are available to treat difficulty swallowing dur to malignant, as well as benign esophageal obstructions and perforations.

    • Endoscopic mucosal resection (EMR) — A promising new therapy in which a diseased portion of esophageal lining is lifted by injecting fluid or applying suction, then removed.

Education, Counseling and Support
At the Floyd and Delores Jones Cancer Institute, we believe the patient is the key decision-making member of the care team. Focus is given to providing our patients with comprehensive information about their condition and treatment options. A patient navigator — as well as other specially trained Virginia Mason nurses, dietitians, social workers and others — are all a part of a support system for you and your family.

Classes such as Appearance and Cancer help patients adjust to cancer-related changes in their physical appearance. Virginia Mason also offers Free and Clear, a program to help people stop smoking.

Research, and the Latest in Care
Thoracic cancer patients often benefit from the newest advances in diagnosis and treatment because of Virginia Mason’s strong focus on teaching and research. At the internationally recognized Benaroya Research Institute at Virginia Mason, for example, scientists are working on the causes and cures for cancer. In the clinic setting, our thoracic cancer physicians participate in new research studies and national lung cancer trials, all of which provide the latest treatment options for patients.

We also have begun a new approach for treating esophageal cancer to continue to improve patients’ outcomes, including long-term survival rates.

A Recognized Cancer Program
The Floyd & Delores Jones Cancer Institute at Virginia Mason is accredited by the Commission on Cancer of the American College of Surgeons (ACoS). The ACoS recognizes only those cancer centers that provide patients with a full range of diagnostic, treatment and supportive services. Every three years, the ACoS evaluates the scope, organization and performance of our program so thoracic cancer patients at Virginia Mason can be confident that they are receiving the best care possible.