The primary malignant diseases of the chest are lung carcinoma (lung cancer). With an estimated number of 55,000 new cases each year in Germany, it is the fourth most common cause of death and the most common cause of death from cancer.

There are no distinctively characteristic (pathognomonic) symptoms of bronchial carcinoma. Besides a dry cough, breathlessness and the coughing up of bloody phlegm, chest pain symptoms may be indicative; furthermore, metastases can cause the following symptoms: impairment of brain function or headaches (brain metastasis), fatigue or tiredness (metastasis in the liver or in other organs), bone pain (bone metastasis).

By taking a tissue sample (biopsy) from the tumor, the diagnosis of lung cancer can be made reliably. In accordance with pathological tissue diagnostics, differentiation is made between small cell and non-small cell bronchial carcinoma (squamous cell carcinoma, adenocarcinoma, ...), differing fundamentally in prognosis and therapy.

For non-metastatic non-small cell lung cancer, surgery as a local therapy is one of the main pillars of therapy.

If metastases develop or if small cell lung cancer is more aggressive, chemotherapy is necessary. Oftentimes, a combination of different forms of treatment (surgery, chemo / immunotherapy, radiation therapy) is performed.

Additionally, so-called molecular diversification is gaining importance (for example, EGF-receptor mutations; EML4-ALK translocation; and–in a study context–mutations of K-RAS, DDR2, B-RAF; and ROS-1 translocation). Therapeutic approaches developed from this can have a positive influence on the course of the disease and treatment of lung cancer.

An overview of the available treatment modalities for lung cancer:

• Surgery
• Radiation therapy
• Interventional tumor ablation (e.g. radio frequency ablation, microwave ablation)
• Chemotherapy
• Targeted therapy (e.g. tyrosine kinase inhibitors, antibody therapy ...)
• Immunotherapy
• Combination therapies as part of studies

Due to its collaboration with the Thoraxklinik Heidelberg, the NCT Heidelberg has a direct connection to one of the first certified lung cancer centers in Germany. Here all necessary current measures for the diagnosis and therapy of lung cancer are carried out and structured at the current level. In daily interdisciplinary case conferences (tumor boards), patient-specific therapy concepts are determined by all decision-makers involved in the process of treatment (surgery, oncology, internal medicine, radiation therapy, radiology, pathology). Other collaborations, e.g. with the German Cancer Research Center (DKFZ) and other innovative diagnostic and therapeutic options available through Heidelberg University Hospital enable analysis of the patient's tumor tissue that goes beyond the standard. For instance, a comprehensive examination for molecular changes in the tumor can be carried out as part of the “Heidelberg Center for Personalized Oncology (HIPO)”. In the following, a result-specific, molecular tumor board is used to provide a therapy recommendation that is “tailored” to the individual case.

The ultimate goal of our measures is to cure the disease. If this is not possible despite all efforts, then we aim to achieve the best possible quality of life and stabilization of the disease. Here again, we offer you a comprehensive concept for treatment, consultation, and care.  Whenever it may be helpful, stress-relieving and advisable, we integrate components of palliative medicine or even comprehensive palliative medical care (outpatient/inpatient) in our treatment concept.

In addition to lung cancer therapy, our focus is also on the treatment of other primary thoracic malignancies (e.g. pleural mesothelioma, thymoma and thymus carcinoma, mediastinal germ cell tumors ...), but also includes the entire spectrum in the care of pulmonary metastases in cancers with primary manifestations outside the chest (e.g. sarcomas, renal cell carcinoma, gastrointestinal tumors, breast carcinoma). Specific advice is given in special outpatient clinics, taking into account the underlying disease and the tumor involvement in the chest cavity.