An Inoperable Tumor in Your Lung

We think about treatments in two or three main areas. One is if the patient's tumor has not spread far beyond where it started but is encroaching on the neighboring structures, we use what's called a combined modality treatment. And that involves using radiation and chemotherapy together to try and attack the tumor.

And once patients complete the radiation and chemotherapy, we now use immunotherapy to try and extend the benefits of the chemotherapy and radiation. When the cancer has metastasized, which is what we call the Stage IV disease, we look at -- what's the molecular makeup of the tumor?

We do sequencing of the patient's tumor to see what are the main genes that are turned on that we can actually use medications to interrupt the effects of the gene that's turned on. So we call them driver genes. So we look for these driver mutations. And for patients who have these driver mutations, we can actually give them pills which we call targeted therapies that specifically shrink their tumors and provide relief from their symptoms.

The other group of patients are patients where we use immunotherapy. And immunotherapy is a new, exciting advance in lung cancer. This is the way we get medications to turn on the patient's own immune system, and then let the immune system go and attack the cancer. And that approach has provided some very exciting results.

For some patients, we will use immunotherapy by itself. For some patients, we use immunotherapy in combination with chemotherapy. But really, we're using either targeted therapy for some patients. For others, it may be immunotherapy. For another group of patients, it may be immunotherapy and chemotherapy. We're able to provide benefits and longer-term survival that was not even imaginable a few years ago.