Facts About Pancoast Tumors

by | Oct 28, 2023 | CyberKnife for Lung Cancer Treatment, Pancoast Lung Tumor

Lung cancer can form in any part of the lungs. When lung tumors grow in the upper portion of the lung, above the first rib, they’re called Pancoast tumors, after Henry Pancoast, M.D., the radiologist who first described them in the early 1900s. They’re also sometimes referred to as superior sulcus tumors, based on the location where they’re found.

Pancoast tumors are quite rare, accounting for only 3% to 5% of lung cancers.

Here Are 3 Facts You Should Know About Pancoast Tumors: 

1. Pancoast tumors only occur in the upper portion of the lung.

The difference between Pancoast tumors and other lung tumors is their location. These tumors occur in the uppermost portion of the lung known as the apex.

Even if a tumor is near the upper portion of the lung, it’s not a Pancoast tumor if it’s below the first rib.

They may also spread into the ribs at the top of the chest and affect important areas at the base of the neck, like nerves and blood vessels.

It’s not clear why tumors develop here, though cigarette smoking is often a factor. Exposure to certain harmful chemicals, radon gas and asbestos may also cause these tumors.

2. Pancoast tumors have specific and unique symptoms.

Because of their unique location, Pancoast tumor symptoms are specific to the area where they’re found. Shoulder pain and upper back pain are common symptoms, especially if the tumor is impacting the ribs, spine or nerves of the brachial plexus. Patients may feel neck, back, arm or chest pain on the affected side.

In some cases, these tumors may involve the nerves of the brachial plexus, which provide sensory and motor supply to the arm and hand. When that happens, symptoms may include arm pain and loss of function of the small muscles of the hand.

Additionally, the tumor may involve the sympathetic nerve, leading to Horner’s syndrome. These symptoms include the same side drooping of the eyelid, lack of facial sweating and constriction of the pupil. The combination of severe arm and shoulder pain, Horner’s syndrome, and atrophy of the small muscles of the hand is called “Pancoast syndrome.”

In rare cases, tumors can grow so large that they block vessels that drain blood from the arms or face. This can lead to extreme swelling or may invade the spinal canal, leading to paralysis.

Pancoast tumors are often found during a chest X-ray, CT scan or MRI prescribed to identify the cause of these symptoms. Once a diagnosis is made, PET imaging and an MRI brain scan are also required to exclude the possibility of distant metastasis.

3. Treatment for Pancoast tumors requires multidisciplinary care.

Unfortunately, by the time Pancoast tumors are diagnosed, they’re usually at a locally advanced stage and may have invaded the chest wall or wrapped around blood vessels or nerves.

Treating Pancoast tumors often requires multiple approach. Patients may need a combination of chemotherapy, radiation and surgery. That’s why patients should seek treatment from a cancer center like CyberKnife Miami which has experience treating complex tumors like these.

In general, chemotherapy and radiation are considered standard treatments. In patients without extensive involvement of the brachial plexus or spinal canal and nodal metastases, surgery is often beneficial. Typically, this occurs following preoperative chemotherapy or chemoradiation.

Should radiation be required, at CyberKnife Miami we use the most up-to-date technology available today called SBRT or Stereotactic Body Radiation Therapy. It is very precise radiation, delivering high doses of radiation directly at the tumor site, killing the cancer on target, but not causing damage to surrounding tissue or nearby organs.

The CyberKnife’s special quality is that it tracks tumor movement whether from breathing or other patient motion. Its beam delivery arm reacts with minute precision to real-time images of the tumor. No radiation is sent out when the tumor moves out of the beam, protecting healthy tissue.

You should know, CyberKnife is not a knife at all. In fact it’s a robot that uses A.I. and missile guided technology to treat patients. It is a noninvasive procedure, so patients simply lie down on the CyberKnife table in your clothes, for about 45 minutes while the machine does its work and you take a nap. No cutting or anesthesia is needed. Its inventor, Dr. John Adler at Stanford University called it a knife because it cuts the cancer out by destroying tumors and killing cancer cells. When your treatment is over, you get up and get on with your day. Most patients require one-to-five treatments. Once treated with the CyberKnife, the tumor begins to shrivel up to nothing. The process begins immediatly but it will take weeks before the tumor disappears completely.

Although Pancoast tumors are rare, the highly experienced cancer experts at CyberKnife Miami are not afraid to take them on. The team will work with your doctors to make sure you achieve the best possible results. Plus our promise is to provide you and your family with personalized care. Our goal is to get you treated as quickly as possible, cutting through all the red tape that can come with cancer treatment. We will make the process as easy for you as possible. We are a center of excellence, a boutique cancer center if you will, not a medical maze.

Request an appointment at the CyberKnife Center of Miami online or by calling 305-279-2900.