Wake Forest Baptist Approach
Thoracic Oncology Program
The Thoracic Oncology Program, the region’s only multidisciplinary thoracic oncology clinic, consolidates the services of a team of physicians and other health care professionals involved in care of patients with malignancies of the chest, including lung cancer, mesothelioma, carcinoid tumor and thymoma. The Program’s primary goal is to facilitate communication between physicians to provide the highest level of care for patients with these common and uncommon chest malignancies.
Evaluating treatment options and determining a course of action as quickly as possible is of great importance. In most cases, patients need to come to the clinic only once to see appropriate specialists and receive a treatment plan for their care.
The team includes cancer specialists in pulmonary medicine, medical oncology, cardiothoracic surgery, radiation oncology, radiology and pathology. The members of the team meet weekly to discuss new cases and develop the most effective treatment plan for each patient. The patient sees the specialists in the morning, his/her case is discussed at a noon conference, and in the afternoon the patient leaves with an initial treatment plan in place.
As a comprehensive cancer center, we offer our patients access to the best diagnostic tools and the latest advances in treatment, including interventional pulmonary procedures, surgical techniques, radiation techniques and chemotherapy.
The team is involved in clinical trials testing novel therapies including combinations of surgery, radiation and chemotherapy. Research protocols are available to study new approaches in each of these areas.
Wake Forest Baptist is the lead site for a clinical trial evaluating the use of dose-dense chemotherapy as front-line treatment for patients with advanced non-small cell lung cancer. This clinical trial involves intensive chemotherapy with the support of growth factors to stimulate the production of red blood cells and white blood cells which should minimize symptoms such as fatigue, weakness, fever, and infections. Half of the patients will also be assigned to receive an investigational medicine that may reduce side-effects on the peripheral nervous system such as numbness and tingling in the hands and feet. This research study is sponsored by the Cancer and Leukemia Group B (CALGB), a national cooperative cancer research group.
Making cutting-edge research and treatments available to lung cancer patients is the only way real progress will be made in improving both quantity and quality of life.
3D Conformal and Intensity Modulated Radiation Therapy
Among the newer treatment options for cancer of the prostate, brain, lung, and head and neck are two methods of focusing radiation on the tumor and surrounding at-risk tissues while optimally sparing nearby normal tissues, 3-dimensional (3D) conformal radiation therapy, and intensity modulated radiation therapy (IMRT). This approach uses anatomic computed tomogrphic and/or magnetic resonance images of the patient, computer-generated radiation dose calculations, and a computer-controlled linear accelerator to conform or “paint” the radiation dose very precisely to match the shape of the tumor to be treated, avoiding critical structures that may be only millimeters away.
When the linear accelerator radiation beam intensity is varied, or modulated, over space and time during the patient’s treatment, hence the term “Intensity Modulated” radiation therapy. In combination with advanced imaging techniques like magnetic resonance spectroscopy and positron emission tomography that image both tumor anatomy and biology, IMRT holds great promise for improving local tumor control and survival, even in the most resistant and aggressive human cancers.