What is Cancer?

In our body normal cells multiply and divide to replace those lost or to repair areas of injury, then they stop dividing.   Sometimes cells will continue to multiply and divide when the body does not need them to.   Cancer is an abnormal, continual multiplying of cells.  The cells divide uncontrollably and may grow into adjacent tissue or spread to distant parts of the body.   The proliferation of cells will eventually become large enough to produce lumps, masses, or tumors that can be detected.  These lumps, masses, or tumors can be benign (non-cancerous) or malignant (cancerous).  Cancer can start in any part of the body, including organs, tissue or blood, but the type of cells that make up the cancer determine the progression of the disease and its treatment.

Because different types of cancer can behave very differently, for example lung cancer and breast cancer are very different diseases, they grow at different rates and respond to different treatments, it is important that the treatment be aimed at the specific cancer type.

In the Thoracic Oncology Program at Huntsman Cancer Institute and the University Health Care, we serve patients with cancers occurring in the chest.   The Thoracic Program's multi disciplinary team of specialists provides diagnostic and therapeutic services to treat patients with tumors involving the lungs, esophagus, chest wall, trachea, mediastinum, and heart.  A brief overview of the types of cancers this program is involved in treating are discussed below.

Lung Cancer

Lung cancer is currently the number one cancer killer of both men and women in the United States.  Lung cancers are generally divided into two types:  small cell and non-small cell.  Determining cancer type is important in the development of the treatment plan.   Another important factor in determining the treatment is the location of the tumor in the lung and any other adjacent chest structures such as the:

• trachea,
• bronchi,
• pleura,
• esophagus, and/or
• lymph nodes.

To find out more specifics about lung cancer types, treatments, symptoms and risk factors please click on anyone of the following:

http://www.cancer.gov/
http://www.huntsmancancer.org/

Mesothelioma

Mesothelial cells are a layer of specialized cells that line the chest cavity.  The tissue formed by these cells is called mesothelium.  Its purpose is to help protect your lungs by producing a special lubricating fluid that allows them to move or slide, for example making it easier for the lungs to move inside the chest during breathing.  The mesothelium of the chest is called the pleura.   Mesothelioma is a cancer arising from this lining of the chest and lung or pleura.

Mesothelioma can be benign (noncancerous) or malignant (cancerous).  A malignant tumor of the mesothelium is called a malignant mesothelioma.  Because most mesothelial tumors are cancerous, malignant mesothelioma is often referred to as mesothelioma.

The incidence of mesothelioma has increased over the past 20 years however it is still considered a relatively rare cancer.   A majority of people with mesothelioma have been exposed to asbestos particles.

Diagnosis and treatment of malignant mesotheliomas requires an aggressive multi disciplinary approach.  Research of this particular cancer and treatment modalities has become more intensified over the past several years and continues to grow.

Mediastinal Tumors

Mediastinal tumors in the chest can signal several different disease processes and require a thorough evaluation.   Like most tumors, a mass in the mediastinum or center of the chest between the lungs can be benign (noncancerous) or malignant (cancerous).   Evaluation of any mediastinal mass requires blood tests and a radiologic evaluation including a chest x-ray (CXR) and computed tomography (CT) or Positron Emission Tomography (PET) scan prior to surgical intervention.  

Findings from these procedures can then assist your health care specialists in determining the next steps.   Those steps may include:

• Magnetic Resonance Imaging (MRI)
• Nuclear imaging
• Barium studies
• Ultrasound
• Minimally invasive surgery

It is the close collaboration amongst the oncologist, radiologist, thoracic surgeon, pathologist, hematologist and other health care providers that is crucial for appropriately managing mediastinal tumors.

Esophageal Cancer

The esophagus is a hollow, muscular tube like structure that allows food and liquid to move into your stomach. Cancer of the esophagus generally arises from the lining of the esophagus and may occur anywhere along its length. The two most common forms of esophageal cancer are adenocarcinoma and squamous cell carcinoma.

Adenocarcinomas most frequently develop in the lower part of the esophagus, near the stomach.
Barrett's esophagus, which is a condition that occurs as result of frequent irritation of the esophageal lining due to gastric reflux, is considered a risk factor for the development of adenocarcinoma.

Squamous cell carcinoma is found most frequently in the upper to middle portions of the esophagus, but it may occur at any point.

Symptoms associated with esophageal cancer often occur late in the cancer's development. Difficulty swallowing, weight loss, hoarseness, frequent indigestion and heartburn are potential signs that require medical attention.

Treatment options and prognosis depend on numerous factors including the stage of the cancer, the size of the tumor and the individual's overall health. The different types of treatment include:

• surgery
• radiation
• chemotherapy
• laser therapy

Often multiple types of treatment will be recommended in a specific sequence to provide the most optimal therapy. Development of an esophageal cancer treatment plan requires the expertise of the multiple specialties involved in the Thoracic Oncology Program.  For more information on esophageal cancer click on:

"What You Need to Know About Cancer of the Esophagus" by the NCI
http://www.cancer.gov/
http://www.huntsmancancer.org/