Mediastinal Tumor Treatment Planning
Following a diagnosis of a mediastinal mass, we work carefully to determine the best treatment options for you and to prepare a treatment plan personalized for your needs. We try to maximize treatment success while minimizing the impact that diagnosis and treatment can have on your life.
WHAT TO KNOW ABOUT TREATMENT PLANNING
1Getting Started In Your Care
2Getting Your Diagnosis
3Planning Your Treatment
Ìý
Considering Your Options
4Undergoing Treatment & Follow-Up
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Select your type of treatment below.
Assessment
Evaluating Options
Choosing Treatment
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Size and location of the tumor
- Type of tumor you haveÌý
- Your age and overall health
- There are a number of other consideration which may impact your treatment plan.
We discuss different types of treatment and how to combine them in a sequence that will best treat the tumor.
a.ÌýÌýÌýÌýÌýÌýÌý Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for mediastinal masses cancer
b.ÌýÌýÌýÌýÌýÌýÌý You may be able to choose alternative therapies, depending on your diagnosis
Choosing your treatment
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for lung cancer have different goals, such as:
- Slowing or stopping the growth of the tumor
- Destroying tumor cells
- Destroying any tumor cells that may have spread (metastasized) to other areas
- Delaying or preventing the tumor from coming back (recurrence)
- Managing symptoms of incurable disease
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing lung cancer treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Size and location of the tumor
- Type of tumor you haveÌý
- Your age and overall health
- There are a number of other consideration which may impact your treatment plan.
close Assessment
We discuss different types of treatment and how to combine them in a sequence that will best treat the tumor.
a.ÌýÌýÌýÌýÌýÌýÌý Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for mediastinal masses cancer
b.ÌýÌýÌýÌýÌýÌýÌý You may be able to choose alternative therapies, depending on your diagnosis
close Evaluating Options
Choosing your treatment
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for lung cancer have different goals, such as:
- Slowing or stopping the growth of the tumor
- Destroying tumor cells
- Destroying any tumor cells that may have spread (metastasized) to other areas
- Delaying or preventing the tumor from coming back (recurrence)
- Managing symptoms of incurable disease
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing lung cancer treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
close Choosing Treatment
Every diagnosis is different. The best treatment for one person might not be the best treatment for another. Your doctor will help you make an informed decision about which options may be right for you. Your treatment plan may consist of one or any combination of the following:
Surgery
Your care team may recommend surgery to diagnose, stage, or treat your condition:
- Diagnosis: Your doctor may recommend that you have a biopsy, to obtain tissue samples and determine a more precise diagnosis.
- Staging: Surgery can help determine the progression of disease, by showing the size of the tumor and other details.
- Treatment: Surgically removing the tumor may provide the best treatment for you.
Surgery Resources
Should surgery be part of your care plan, we are here to help guide you through the process.
If surgery provides a good treatment option, you will meet with a thoracic surgeon to develop a plan. Surgery is different for every patient. Your thoracic surgeon will work with you to determine the least invasive and most effective surgery for the type of cancer you have.
Combining surgery with other treatments
ÌýTo achieve the best possible outcome, your care team may recommend combining surgery with other treatments such as radiation therapy or chemotherapy. The additional treatment can be given 1 of 2 ways:
- Neoadjuvant therapy: This treatment occurs before surgery to make it easier and more effective. Undergoing chemotherapy before surgery, for example, may shrink a tumor and make removal more successful.
- Adjuvant therapy: This treatment occurs after surgery to reduce the risk of recurrence. Chemotherapy or radiation therapy after surgery can destroy remaining cells.
Drug Therapy (Medical Oncology)
Drug therapy, also called systemic or medical therapy, is treatment that works throughout the body to fight disease. These drugs slow the growth of cancer cells or destroy them.
You can receive drug therapy:
- By mouth (orally) as a pill
- Through the blood vessels (intravenously, or IV) as an injection or infusion
Chemotherapy Resources
Chemotherapy is a treatment option for most lung cancers. We are here to help you prepare and guide you through the process.
Types of Drug Therapy for Mediastinal Cancer
At Stanford, our medical oncologists use several types of drug therapy, including:
Chemotherapy: This group of medications stops the growth of rapidly dividing cells in the body, both cancerous and noncancerous. While powerful, chemotherapy can cause more side effects than other medication types. Chemotherapy is a treatment option for almost anyone with cancer.
Immunotherapy
These medications provoke your immune system to attack cancer cells. Immunotherapy treatments are the newest class of anti-cancer drugs. Some of these agents are FDA approved; many others are being tested in clinical trials.
The primary types of immunotherapy include:Ìý
- Antibodies: These are proteins that naturally occur in the immune system which may have been modified or selected for their anti- cancer effects. Antibodies can be designed to attack certain features on cancer cells that weaken the cells and cause them to die, or they can attach to and mark cancer cells for destruction by a patient’s own immune system.
Immunotherapy Resources
Should immunotherapy be part of your care plan, we are here to help you prepare and guide you through the process.
- Immune checkpoint inhibitors: These drugs remove immune system controls and free the immune system to recognize and attack cancer cells.
- Cancer vaccines: Vaccines prompt an immune response against certain diseases. We usually think of vaccines as medications prescribed to fight infections like measles or the flu. Some vaccines can help prevent or treat cancer.
- Cellular immunotherapy: These are immune cells from the patient or a donor which have been modified or activated specifically to attack cancer cells.
Targeted therapy
Medications that target certain features (including gene mutations) on cancer cells to block their growth, without harming nearby tissues.
For treatment to work, the cancer must have the specific markers a particular medication was designed to target. Some cancer cells have certain proteins on the cells that promote growth. These proteins cause cancer to grow quickly and spread. Our pathologists look for the presence of these proteins by examining samples of tissue taken during a biopsy.
Targeted Therapy Resources
Should targeted therapy be part of your care plan, we are here to help you prepare and guide you through the process.
Drug therapy scheduling
If your treatment plan involves drug therapy, you will have routine visits to have lab work done, see your doctor, and receive medication. You may need to come in once or twice per week. If you need an infusion, you will visit one of Stanford’s infusion treatment centers.
Drug therapy side effects
Side effects from drug therapies vary depending on the type of medication you receive. For example, chemotherapy may affect your hair and nails, because it slows their growth as it slows the growth of cancer cells. Fatigue is also possible. Ask your care team – we can help you manage or prevent many symptoms and side effects that can affect your everyday life.
Radiation Oncology
Radiation therapy is painless treatment that uses high-energy X-rays or other types of radiation to destroy cancer cells. Our radiation oncologists have years of experience safely and effectively treating lung cancer with radiation. Using the latest technology, we can precisely target tumors and minimize damage to nearby healthy tissue.
Radiation therapy may provide effective treatment for your condition. If so, your doctor will speak with you about the best options. The types of radiation therapy we use at Stanford include:
External radiation uses a machine called a linear accelerator (LINAC) to deliver radiation to the area of the esophageal where the tumor cells are found. Some of the types of external radiation we use include:
Radiation Therapy Resources
Should radiation therapy be part of your care plan, we are here to help you prepare and guide you through the process.
What to expect during external radiation therapy and how to prepare
- 3D (3-dimensional) conformal radiation therapy (3D-CRT)
With this method, 3D images help the doctor better target the tumor. The images are created using a special machine — a computed tomography (CT) or magnetic resonance imaging (MRI) machine. The radiation beams can be aimed from many different angles to match the exact shape of the cancer. - Intensity-modulated radiation therapy (IMRT)
This method is similar to the first method, but the doctor can adjust how much radiation you get from each beam. In certain situations, this enables the doctor to avoid nearby normal cells to reduce the risk for side effects.
For each treatment, most of your appointment will be spent getting your body positioned correctly. The actual treatment lasts just a few minutes.
Receiving radiation treatments
Radiation therapy does not cause pain, so you won’t feel anything during your treatments. Radiation does not make you radioactive, and you can safely be around other people, including children.
The exact number and timing of your radiation treatments depends on the type of lung cancer you have and the type of radiation therapy you need:
- Typically, you will be treated once a day, Monday through Friday, over a few weeks.
- Most treatment sessions take 15 to 30 minutes, but some may take up to 1 hour.
- We offer treatment sessions between 8 a.m. and 5 p.m. at our Cancer Centers in Palo Alto, Pleasanton, South Bay, and Turlock.
Radiation therapy side effects
Everyone has a different response to radiation therapy. It may cause short-term side effects during treatment or long-term side effects after treatment ends.
The side effects of treatment depend on the type of radiation you receive, the dose, and your overall health. Common side effects that you may experience after radiation treatment include:
- Fatigue
- Skin color changes, like a tan or sunburn
- Skin irritation
- Coughing
- Trouble swallowing
- Shortness of breath
No matter what you experience, your care team can help ease the side effects of treatment. At least once a week, your radiation oncology team will meet with you to discuss your progress and any side effects that you may have.
Clinical Trials
At Stanford, our doctors are always working to improve care for people with lung cancer. As an academic medical center, we conduct clinical trials to evaluate new medical techniques, devices, medications, and other treatments for safety and effectiveness.
We study new approaches to preventing, screening, detecting, diagnosing, and treating cancer. Some clinical trials look at new methods, while others evaluate new combinations of approved, existing approaches.
Depending on your individual circumstances, a clinical trial may provide a treatment option for you. Like any treatment, clinical trials have possible risks and benefits, including:
Possible benefits of joining a clinical trial:
- Access to a new treatment that isn’t widely available
- Expert care from our world-renowned cancer specialists and their teams
- Low- or no-cost treatment
- Participation in ÌÇÐÄ´«Ã½ that can save lives in the future
Possible risks of a clinical trial:
- Treatment that may not work for you
- Side effects that may be unexpected or worse than current standard-of-care treatments
- Additional doctor visits, meaning more time and travel
- Additional tests, which may be uncomfortable or time consuming
- Extra expenses if your health insurance does not cover all patient costs for a trial
To learn more about Stanford’s clinical trials for lung cancer, speak with your care team. We can help you decide if a clinical trial may be right for you.
We bring together the right experts to create a care plan tailored to your needs.Ìý Our doctors specialize in several different areas of cancer treatment and work together to create a coordinated and comprehensive plan. This group is known as a multidisciplinary team and includes:
- Thoracic Surgeons: Thoracic surgeons who remove tumors and perform biopsies (small tissue sample to test for cancer)
- Medical oncologists: Cancer doctors who treat cancer with medications such as chemotherapy and targeted therapy
- Radiation oncologists: Cancer doctors who treat cancer with radiation therapy
- Radiologists: Specialists who perform and read imaging tests, such as CT scans and MRI scans, to diagnose and treat cancer
Your treatment plan will address the following:
- Location, size, and stage of the cancer
- Treatment goals
- Treatment options, their possible side effects, and ways to minimize or relieve side effects
- Expected length of treatment
- Follow-up care after treatment
- Pathologists: ÌÇÐÄ´«Ã½ who specialize in reading laboratory tests and evaluating tissue samples to diagnose cancer
- Psychiatrist: Doctor who specializes in diagnosing and treating mental illness, with a background in cancer care
- Genetic counselor: Licensed health care professional with specialized training in cancer genetics, testing, and counseling
If you have metastatic cancer
Metastatic cancer means that cancer cells have spread from the mediastinum and nearby lymph nodes to other parts of the body.
Your appointment timing depends on your treatment goals:
- If you need treatment for a diagnosis of newly recurrent or metastatic cancer, you will see a medical oncologist for drug therapy within 7 days. Newly recurrent describes Ìýcancer that has come back and spread to another part of the body.
- If you are interested in clinical trials for metastatic disease, you will see a medical oncologist for drug therapy within 7 days.
- If you need a second opinion of a diagnosis, you will see a medical oncologist within 14 to 21 days.
If you want a second opinion
If you already have a diagnosis and want a second opinion about treatment options, we can usually schedule you within 14 days. Your reason for seeking a second opinion will help us determine which specialist(s) you should see:
- If you are still deciding where you will receive treatment, you will see a medical oncologist and a surgeon.
- If you need a second opinion about drug therapy, you will see a medical oncologist.
- If you need a second opinion about surgery, you will see our core doctors.