They often invade nerves and other structures nearby, sometimes spreading to the brain.

Pancoast tumor symptoms include arm and shoulder pain, and tingling and weakness in the hands.

This article discusses pancoast tumors, their causes, and how they are diagnosed and treated.

Types of Pancoast Tumors

Most pancoast tumors are a form ofnon-small cell lung cancer.

The most common types are:

Only about 5% of Pancoast tumors arise from small cell lung cancer.

The tumor is associated with a unique set of symptoms known as Pancoast syndrome, sometimes called Pancoast-Tobias syndrome.

Pancoast syndrome creates a constellation of symptoms that, taken together, help to inform a diagnosis.

Pain can also radiate into the armpit or shoulder blade.

Weakness in Hand Muscles

People may feel weakness in the muscles of the hand.

This weakness can easily be dismissed or misdiagnosed as a musculoskeletal condition of the joints and muscles.

In some cases, people also experience swelling in the hand.

Where Do Pancoast Tumors Spread?

Diagnosis of Pancoast tumors is frequently delayed.

As many as 25% of alllung cancers are missed on chest X-rays.

An MRI is important before surgery to look for nerve involvement.

Other tests, such as abronchoscopyto visualize the airway, may be done as well.

Many of these cancers are stage IIB non-small cell lung cancer.

Staging is often done with a combination positron emission tomography PET scan/CT.

APET scancan be important in planning treatment.

Currently, the preferred treatment includes a combination of chemotherapy and radiation therapy followed by surgery.

Chemotherapy

Pancoast tumor treatment usually begins withlung cancer chemotherapy, whether or not surgery is possible immediately.

This chemotherapy treatment before surgery is called “induction therapy.”

Targeted Therapies

Many Pancoast tumors have targetable mutations.

These are genetic abnormalities found through gene testing for which targeted therapies are available.

Targeted therapies are a form of precision medicine that are selected based on precise information about your specific disease.

Surgery

Surgery can often be done on Pancoast tumors.

It is usually performed after chemotherapy and/or targeted therapy plus radiation therapy to shrink the size of tumors.

Because this surgery can be challenging, it’s important to find an experienced surgeon familiar with this condition.

Radiation therapy may also be used along with chemotherapy to shrink a tumor before surgery.

Immunotherapy

Immunotherapyis a possible treatment for some non-small cell lung cancers.

This treatment uses your body’s own immune system to attack cancer.

Checkpoint proteins on immune cells are normally activated to start an immune response.

Cancer cells can deactivate these checkpoints to avoid being attacked by the immune system.

Drugs that target these proteins are called checkpoint inhibitors, and they allow the immune system to attack cancer.

A Word From Verywell

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