Thoracic cancer is any cancer that develops inside your chest. Your chest houses your lungs, heart, esophagus, and other organs. It is protected by your ribcage on the front and sides and your spinal bones (vertebrae) on the back.

The most common type of chest cavity cancer is lung cancer. But cancer can also start in your:

• Esophagus (tube between your throat and stomach)
• Mesothelium (lining of your lungs, diaphragm and rib cage)
• Thymus (butterfly-shaped gland behind your sternum or breastplate)

Specialists typically divide lung cancer into two categories:

• Non-small cell lung cancer makes up about 80% of lung cancers in the U.S.
• Small cell lung cancer is less common but more aggressive than non-small cell lung cancer.

Thoracic cancer occurs when cells grow and divide too quickly, forming tumors. Changes (mutations) in genes can disrupt the normal signals that prevent cells from multiplying uncontrollably.

You may inherit abnormal genes, or genes can change or be damaged during your lifetime. Certain risk factors increase your chances of developing genetic changes that can lead to cancer, including:

At UC Davis Comprehensive Cancer Center, we focus on catching thoracic cancers as early as possible — when treatment is more effective. Our specialists use the latest tests to quickly find, diagnose and stage cancer. Staging is the process of determining how advanced your cancer is.

Your physician begins by reviewing your symptoms and medical history. It’s important to provide details about your smoking history and any other risks factors that could increase your chances of thoracic cancer.

Your physician may order tests if they suspect you have cancer or another problem in your chest cavity:  

• Bronchoscopy: We insert a thin tube with a video camera on one end (bronchoscope) through your mouth and down your throat to look at your lungs and airways. Your physician may do a bronchoscopy to check for lung or esophageal cancer, or to take a sample of tissue for a biopsy. At UC Davis Health, we specialize in robotic-assisted bronchoscopy. Robotic technology creates a 3D map of your lungs, allowing us to locate, biopsy and treat lung masses in a single procedure.
• Chest X-ray: A chest X-ray is useful for spotting large tumors, fluid build-up and thickened tissue in the lungs. A chest X-ray won’t show small lung tumors or nodules (abnormal growths).
• CT scan: A CT scan uses X-rays to create multidimensional views of your chest. It’s the most common test used to screen for and diagnose lung cancer and thymic cancers (thymoma and thymic carcinoma).
• Lung biopsy: A biopsy is the only way to confirm a diagnosis of thoracic cancer. During a biopsy, we take a tissue sample from a tumor or fluid from your lungs and examine it for signs of cancer. We get the sample using a needle, bronchoscope or through a very small incision in your chest.
• MRI: Your physician may recommend an MRI to find out if cancer in your chest has spread to other parts of your body, such as your lymph nodes or your brain. An MRI is rarely used on its own to diagnose lung or other thoracic cancers.
• PET scan: During a PET scan, we inject a small amount of a radioactive substance into a vein. Cancer cells absorb the substance, so fast-growing tumors show up clearly on scans. We often combine PET scans with CT.  

At UC Davis Comprehensive Cancer Center, we take a team approach to thoracic cancer care. Experts in medical oncology, pulmonary medicine, thoracic surgery, radiation oncology, pathology and radiology work together to customize your treatment. They draw on a wide range of leading-edge treatments, including clinical trials, to help you achieve the best possible outcome.

Our treatments for lung cancer and other thoracic cancers include:

Thoracic Surgery

For early-stage cancer in your lungs, thymus or esophagus, surgery may be the only treatment you need. For advanced cancer, we may shrink the tumor first with chemotherapy with or without radiation before surgery. Or we may do surgery to reduce the size of the tumor (debulking). We then may follow surgery with radiation therapy or chemotherapy.

Thoracic surgeries we offer to remove cancer include:

• Esophagectomy (all or part of your esophagus)
• Lobectomy (one lobe of your lung)
• Omentectomy (lining around your abdomen)
• Pleurectomy (lining of your lungs)
• Pneumonectomy (one entire lung)
• Segmentectomy or wedge (part of one lobe of your lung)
• Sleeve resection (part of one lung and part of your main airway, with reconstruction)

More common than not, we perform thoracic surgery using minimally invasive techniques. UC Davis Health leads the region in video-assisted thoracic surgery (VATS) and robotic lung surgery. As the only academic medical center in our region, we routinely use minimally invasive techniques to treat thoracic cancers.

Our expertise in robotic-assisted bronchoscopy means we can often locate lung nodules, biopsy them on-site and remove early-stage cancers in a single procedure. Patients receive immediate treatment, without the stress of waiting weeks or months for surgery.

Robotic surgery uses several small incisions and a high definition camera and a complex robot to operate on organs in your chest. This allows us to remove some tumors without opening your breastbone, resulting in: 

• Faster recovery
• Less pain
• Fewer visible scars
• Lower risk of complications
• Shorter hospitalization

Radiation Therapy

Radiation therapy uses high-powered X-rays or other forms of energy to shrink or destroy tumors. You may have radiation therapy alone or in combination with surgery.

The most common type of radiation for thoracic cancers is external beam radiation therapy (EBRT). In this procedure, a machine that doesn’t touch your body aims radiation directly at the tumor. Radiation therapy is less common for mesothelioma.

In some cases, we may use internal radiation therapy. Also called brachytherapy, this treatment implants a radioactive substance, such as a capsule, inside your body very close to the tumor. The implant releases high doses of radiation to a small area. Brachytherapy tends to have fewer side effects than EBRT.

Other Treatments for Thoracic Cancer

We also use medication to fight cancer in several ways, including:

• Chemotherapy, which uses drugs to destroy cancer cells
• Targeted therapy, which targets proteins and genes that allow cancer cells to grow and divide
• Immunotherapy, which harnesses your body’s own immune system to fight cancer

Lung and other thoracic cancers sometimes can be prevented. Not smoking and avoiding secondhand smoke are the best ways to reduce your risk.

To find out if you have risk factors for lung cancer, talk to your physician about screening. Screenings are tests that detect cancer or other diseases before symptoms develop.

A lung cancer screening uses low-dose CT scans (a type of imaging exam) to create detailed images of your lungs. To detect lung cancer, we look for tumors and other abnormal growths.

Your physician may recommend yearly screening if you:

• Are a current or former smoker between 50 and 80 years old
• Smoked the equivalent of at least one pack a day (20 cigarettes) for 20 years or more
• Or quit within the last 15 years