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    A Pancoast Tumor is a tumor of the apex of the lung, named after radiologist Henry Pancoast. A Pancoast Tumor is defined primarily by its location at the very top of either lung. Also, most of these tumors are a form of non-small cell lung cancer.

    Pancoast Tumors are particularly difficult to diagnose and treat due to their location. The Pancoast Tumor often grows near and around blood vessels, nerves, lymph nodes, ribs, and the spine. When the tumor compresses and invades these areas, it creates health problems outside the usual symptoms of lung cancer.

    While Pancoast Tumors only account for 3 to 5% of lung cancers, their challenging location and symptoms have medical professionals worldwide striving to understand the illness and how to treat it.

    What Are the Risk Factors of Pancoast Tumors?

    X-ray of a patient with a Pancoast Tumor Oncologists and medical professionals do not know the exact cause of a Pancoast tumor. However, there are known risk factors, which include:

    • Smoking
    • Exposure to smoking (also known as secondhand smoke and passive smoking)
    • Exposure to asbestos
    • Exposure to certain industrial elements

    Furthermore, according to the study ‘Pancoast tumors: characteristics and preoperative assessment,’ in the Journal of Thoracic Disease, this tumor affects men more than women, with the average age at diagnosis being sixty years old. If a person falls under these risk factors, especially working around asbestos for a prolonged period, they should get a screening to check their lungs.

    Common Symptoms of a Pancoast Tumor

    Due to its location in the apex of the lung and its ability to compress and invade other tissues, nerves, and lymph nodes, common symptoms of a Pancoast tumor differ from that of other lung cancers. Additionally, symptoms can vary from person to person, depending on the specific area the mass grows.

    Still, common symptoms tend to be present in Pancoast tumor patients, such as:

    • Shoulder Pain

      When the tumor invades the brachial plexus, it can cause shoulder pain. Pain in this area is the most common symptom in Pancoast tumor patients. The pain is often constant and debilitating and can spread to other areas such as the arm, armpit, and shoulder blade. Patients may also experience tingling and muscle weakness in their hands or arm.

    • Horner’s Syndrome

      Horner’s syndrome is another common symptom of a Pancoast tumor and occurs when the growth disrupts the sympathetic nerves. This syndrome can cause ptosis (droopy eyelids), miosis (constricted pupils), and anhidrosis (inability to sweat) on one side of the face. Plus, patients might also experience facial flushing.

    • Lower Body Paralysis

      Between 10 to 15% of patients experience compression of the spinal cord and paraplegia, which paralyzes the lower part of the body. This symptom can happen when the tumor metastasizes the vertebral bodies.

      These symptoms are often debilitating and may severely impact a patient’s life. It can take some time to diagnose the tumor in the first place, however, as oncologists do not always correlate these symptoms with lung cancer.

    The Diagnosis and Treatment of Pancoast Tumors

    Because of the challenging location and sometimes unusual symptoms of a Pancoast Tumor, it is not easy to diagnose and treat the condition. Often, medical professionals diagnose this type of tumor at a later stage than other forms of lung cancer.

    Oncologists often use a chest x-ray or a CT scan to diagnose a Pancoast tumor. If these yield unclear results, they may also do an MRI scan of the lung, which provides more detailed pictures of the area, making it easier for doctors to detect abnormal tissue. Oncologists also perform a biopsy to determine the type of cells in the tissue growth.

    Unfortunately, while there is no cure for a Pancoast tumor, it is treatable. The treatment depends on several factors, including the tumor’s stage, where it grows and invades, and the patient’s overall health.

    Generally, these are the most common types of Pancoast tumor treatments:

    • Radiation Therapy and Chemotherapy Before Surgery

      Known as a combination treatment, a patient may undergo radiation therapy and chemotherapy before surgery. This pre-surgery step reduces the amount of tissue that requires surgically removing.

    • Radiation Therapy

      Not all patients can get surgery for Pancoast tumors. Doctors use radiation therapy treatments to kill cancer cells if surgery is unavailable.

    • Pain Relief

      As the pain from this kind of tumor can be extreme in some cases, doctors may prescribe Opioids to manage the ongoing and severe pain and discomfort. Surgeries can help with pain relief, too, including a CT-guided cordotomy or decompression laminectomy.

    What Is the Outlook for Pancoast Tumor Patients?

    In the past, this tumor was considered untreatable; however, medical research has come a long way to ensure that today’s patients have access to treatments targeting the growth itself and the pain it causes.

    The five-year survival rate is 26.6% for all patients, with the survival rate higher for patients with operable tumors. Over time, these survival rates have increased due to new research and technologies, and the outlook can only improve as studies into Pancoast tumors continue.

    The Key Researchers of Pancoast Tumors

    Key researchers are leading the way with Pancoast Tumor research and developments. These trusted professionals are formulating new ideas for diagnosis and treatment options, ensuring the outlook for patients is even more promising.

    Below are some of the leading voices on Pancoast Tumors today:

    • Paul Zarogoulidis

      Dr. Paul Zarogoulidis is a pulmonary physician specializing in interventional pulmonology and lung cancer treatment. He works in the Pulmonary Department-Oncology Unit at G. Papanikolaou General Hospital, Aristotle University of Thessaloniki in Greece. Alongside his post, he is the president of The Society for Diagnosis and Lung Cancer Treatment. He has also produced hundreds of publications and informative work on Pancoast Tumors.

    • Abdulaziz Sebiany

      Dr. Sebiany at the College of Medicine at King Faisal University in Saudi Arabia contributes to understanding the relationship between pain and Pancoast tumor patients. In his published article ‘Pancoast Tumor: The Overlooked Etiology of Shoulder Pain in Smokers,’ he dives into shoulder pain and how it can be a common symptom of lung cancer. He suggests that elderly patients and smokers suffering from shoulder pain should get chest X-rays to rule out or diagnose lung cancer.

    • Felicitas Oberndorfer

      Dr. Felicitas Oberndorfer of the Medical University of Vienna is a gastroenterological and molecular pathology specialist and was coauthor of the publication; an atypical Pancoast tumor case. Works like these help to pave the way for Pancoast tumor diagnosis and treatment in patients.

    • Wolfgang Grisold

      Prof. Wolfgang Grisold​, a neurologist from Vienna, Austria, was elected president of the World Federation of Neurology (WFN) in 2021. In addition to his many other publications throughout his long career, he was also coauthor of the atypical Pancoast tumor case, alongside Dr. Oberndorfer (above).

    Among many others, these researchers are at the forefront of diagnosis and treatment developments for Pancoast Tumors. Leading the way, these key opinion leaders use research, clinical studies, new technologies, and collaboration to expand their knowledge and improve the outlook on Pancoast tumors and their treatments.

    With their research, medical professionals can learn more about this challenging tumor, which means they can effectively diagnose and treat patients.

     

Recent articles about Pancoast Tumor

Therapeutic Modalities For Pancoast Tumors.

[ PUBLICATION ] ... Pancoast tumor, also called a pulmonary sulcus tumor or superior sulcus tumor, is a tumor of the pulmonary apex. It is a type of lung cancer defined primarily by its location situated at ...
Known for
Pancoast Tumors | Therapeutic Modalities | Lung Cancer | Subclavian Artery

Pancoast Tumor Approach Through Oesophagus

[ PUBLICATION ] ... with Pancoast Tumor usually present in advanced stage of the disease which requires chemotherapy and radiotherapy as options of treatment. Histologic confirmation is a key for further ...
Known for
Pancoast Tumor | Computed Tomography | Left Lung | Upper Lobe

Combined Radiosurgical Treatment Of Pancoast Tumor

[ PUBLICATION ] ... with Pancoast tumor treated with combined radiosurgical treatment were evaluated. External radiation therapy was administered preoperatively in a dose of 30 Gy in 50 patients. Operation ...
Known for
Pancoast Tumor | Combined Radiosurgical | Subclavian Artery | 7 Months

Ultrasonography Of Pancoast Tumor

[ PUBLICATION ] ... with Pancoast tumor, who failed to yield diagnostic materials by conventional sputum cytology and fiberoptic bronchoscopy, were studied by real-time linear-array and sector ...
Known for
Pancoast Tumor | Ultrasound Guidance | Diagnostic Materials | Pathologic Confirmation

Pancoast Tumor As The Initial Presentation Of A Metastatic Colon Adenocarcinoma

[ PUBLICATION ] ... Pancoast tumor is a rare condition, representing 3% to 5% of all lung cancers. The particular location of these lesions leads to the invasion of structures in the thoracic inlet, causing a ...
Known for
Pancoast Tumor | Colon Adenocarcinoma | Initial Presentation | Lung Cancers

Cervicobrachialgia And Pancoast Tumor: Value Of Standard Anteroposterior Cervical...

[ PUBLICATION ] ... with Pancoast tumor were studied retrospectively. The definitive diagnosis was made between 2 and 24 months after the onset of pain. Pain localization was hard to pinpoint; some patients ...
Known for
Pancoast Tumor | Cervical Radiographs | Early Diagnosis | Neck Pain

Hepatoid Pancoast Tumor. A Case Report And Review Of The Literature

[ PUBLICATION ] ... a Pancoast tumor of the right lung and a serum alpha-fetoprotein (αFP) at 39,000 ng/ml. Alpha-fetoprotein is a tumor marker found elevated in patients with hepatocellular carcinoma (HCC), ...
Known for
Pancoast Tumor | Rare Cancers | Hepatocellular Carcinoma | Hepatoid Differentiation

Pancoast Tumor Presenting As Cervical Radiculopathy.

[ PUBLICATION ] ... of Pancoast tumor presenting as cervical radiculopathy is reported, including the clinical, EMG, and radiologic findings. A 64-year-old man with a two-month history of left shoulder pain ...
Known for
Pancoast Tumor | Cervical Radiculopathy | Brachial Plexopathy | Nerve Roots

An Unusual Cause Of Acute Headache: Subarachnoid Free Air Secondary To...

[ PUBLICATION ] ... a Pancoast tumor treated with palliative chemoradiation who developed symptomatic spinal and intracranial air caused by spontaneous bronchopleurodurosubarachnoid fistula secondary to ...
Known for
Pancoast Tumor | Spontaneous Bronchopleurodurosubarachnoid Fistula | Acute Headache | Subarachnoid Free Air

Pancoast Tumor: Radiation Therapy Alone Versus Preoperative Radiation Therapy And Surgery

[ PUBLICATION ] ... a Pancoast tumor. All patients were treated with curative intent between October 1964 and September 1987 (minimum follow-up 2 years). The treatment plan consisted of preoperative radiation ...
Known for
Radiation Therapy | Pancoast Tumor | Curative Intent | 4500 Cgy

 

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