The Duke Lung program combines the expertise of world-class patient treatment teams with exciting advances in research for patients diagnosed with non-small cell lung cancer, small cell lung cancer, or mesothelioma. For many lung cancer patients, the individualized care offered by Duke presents the best chances of survival and a better chance for a higher quality of life during and after treatment. As noted by the list of program members, cancer care at Duke means the added benefit of specialists from every necessary medical field, working together daily in multidisciplinary clinics and meeting weekly in tumor boards and research conference, all of which are Thoracic Oncology specific.

Currently the Thoracic Oncology Program is conducting more than two dozen clinical trials employing multimodality protocols, innovative surgical approaches, high dose conformal radiotherapy techniques, combinations of chemotherapeutic and targeted agents, and cytokines that salvage bone marrow activity to treat non-small cell and small cell lung cancers as well as mesotheliomas and other thoracic malignancies.

In addition to the therapeutic trials, studies also focus on supportive care of the lung cancer patient from diagnosis through all phases of treatment, with special concern given to pain issues, taste alterations, overall nutrition, maintenance of functional status, and quality of life. Lung cancer patients have options of support groups, individual counseling, and educational resources.

Basic research opportunities include laboratories working to identify the genes responsible for a genetic predisposition to lung cancer so patients at risk can be targeted for prevention, early detection, and intervention. Members are also tracking down the molecular markers that indicate which cancers are likely to recur after surgery. The role of tumor hypoxia is under study in conjunction in the laboratory and in translational studies in surgical patients.

Another critical focus area is prevention. Nicotine addiction is being studied both in the laboratory and in clinical epidemiology and international studies. Trials with novel chemopreventative agents including COX-2 inhibitors and Iressa are underway in high-risk patients.

Duke has become a world leader in PET (positron emission tomography) scanning for lung cancer. This progressive imaging technique allows physicians to pinpoint "hot spots" of lung cancer that may have spread through the body and helps them distinguish benign from malignant tumors.

Radiation oncologists use three-dimensional radiotherapy and image registration to improve tumor targeting while minimizing normal tissue toxicity.

Duke physicians have achieved excellent results by using a combination of chemotherapy, radiation therapy, and surgery to treat patients for whom, in earlier days, only surgery was available. The new photodynamic therapy (PDT), a highly specific light laser which targets tumor cells, is available by the Duke thoracic surgeons. The recent recruitment of an interventional pulmonologist working in our multidisciplinary clinic has further expanded the diagnostic and therapeutic capabilities of the group.