Lung Cancer Guidelines

Our partnership with MD Anderson Cancer Center enhances your access to services that align with best practices in lung cancer care. MD Anderson’s lung cancer treatment guidelines (algorithms) reflect leading research on appropriate lung cancer diagnosis, treatment and follow-up care.

Important notes about lung cancer care guidelines

Experts at Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center, use lung cancer treatment algorithms to help guide care decisions. Our personalized approach means we also give careful consideration to your diagnosis, other medical problems and care preferences.

The care that’s right for you depends in part on your diagnosis. The two main types of lung cancer are:

• Small cell lung cancer: Fast-growing lung cancer that’s more likely to spread but occurs less often
• Non-small cell lung cancer: Group of common lung cancers that includes adenocarcinoma and squamous cell carcinoma

Read more about our:

• Lung Cancer Program
• Partnership with MD Anderson Cancer Center

Diagnosis and evaluation

Tests we use to evaluate lung cancer include:

• Chest X-ray to identify abnormal lung growths
• Computed tomography (CT) scan of the chest and upper abdomen for a more in-depth view
• Biopsy, which is a tissue sample that a specialist (pathologist) examines under a microscope
• Pathology review to evaluate the biopsy and determine the cancer stage, meaning how advanced it is
• Lab studies to check for signs of cancer (biomarkers) in your blood
• Electrocardiogram to rule out certain heart conditions

Additional tests to evaluate small cell lung cancer

If we suspect small cell lung cancer, you may also need:

• Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, an advanced imaging study to evaluate cancer cell activity
• Magnetic resonance imaging (MRI) of the brain or a head CT with a dye to detect cancer that has spread to the brain
• Bone scan if there’s a concern cancer has spread to the bones

Treatment planning

For small cell or non-small cell lung cancer, we may conduct additional tests to determine whether surgery is possible.

These tests may include:

• Bronchoscopy: We examine the insides of the airways using a long, thin tube (bronchoscope) inserted through the nose or mouth.
• Endobronchial ultrasound with fine needle aspiration (EBUS-FNA): We use a bronchoscope to perform imaging studies from inside the lungs. A thin needle makes it possible to take a tissue sample (biopsy).
• Mediastinoscopy: This procedure helps us check for cancer in the space between the lungs (mediastinum).
• Pulmonary function tests: We evaluate whether your lungs are healthy enough to continue working after cancer surgery. 

Surgery

Depending on the size, location and stage of cancer, you may be able to have surgery. We use a variety of techniques to remove the cancer and a section (margin) of nearby healthy tissue.

Lung cancer that spreads typically travels first to lymph nodes in the mediastinum. If there is a concern the cancer may have spread, we take a biopsy of the lymph nodes during surgery.

Other treatments

You may need additional treatments if you are:

• Not healthy enough for surgery or have a cancer that surgeons cannot remove
• Able to have surgery and there’s a concern that trace levels of cancer remain

Your care may include:

• Chemotherapy drugs and other substances that slow cancer cell growth
• Radiation oncology therapies that use energy to destroy cancer cells

Follow-up care after treatment is complete

After completing treatment, ongoing follow-up helps us detect the early signs of cancer that comes back. Your care may consist of:

• Physical exam
• Imaging studies including a low-dose chest X-ray or CT scan of the upper abdomen

The frequency of follow-up appointments depends on the stage of your original (primary) cancer. For more advanced cancers, you may need these services every few months.