Thoracic Diseases

The Hartford HealthCare Cancer Institute’s Thoracic Diseases program provides care to patients with diseases of the chest, an area that includes the lungs, esophagus and thymus.

But lung cancer is, by a significant amount, the leading cause of cancer death in the United States among both men and women. An estimated in four cancer deaths are caused by lung cancer.

“The high-risk population are people between the ages of 55 and 75 who have smoked for 30 years at least one pack a day or more who could be current smokers or former smokers,” says Dr. Andrew Salner, the Hartford HealthCare Cancer Institute’s medical director.


Lung Cancer

Minimally invasive techniques allow us to deal with lung cancer in a manner that maximizes patient comfort and minimizes hospital stays. Superdimension navigational bronchoscopy uses GPS technology to pinpoint even small tumors deep in the lung. Endobronchial Ultrasound (EBUS) allows us to sample lymph nodes in the center of the chest without the need for incisions. Our experts can then employ either VATS or robotic lobectomies to remove the cancer through small incisions without spreading the ribs. Less than half of patients with lung cancer in the US have access to some of these advanced techniques.

Treatments for Lung Cancer

Personalized Therapy

Our specialists are advancing personalized treatments with fast-tracked “next-generation sequencing.” By identifying the specific genetic defects in each tumor, we select precisely targeted drugs to fight lung cancer. These personalized approaches can help improve the impact of therapy on the cancer while minimizing the toxicity of therapy. We can evaluate, on site, a 50-gene panel to help select therapy. More than 400 more genes can be compared through a larger trial with Memorial Sloan Kettering.

Clinical Trials

Our alliance with Memorial Sloan Kettering has allowed us to greatly expand the clinical trial offering available for lung cancer patients. Our goal is to allow patients access to cutting-edge trials at any point during their therapy.

Pioneering Medical Technologies

Endobronchial Ultrasound (EBUS) is a faster and far more accurate way to find and diagnose even hard-to-reach tumors. EBUS spares lung cancer patients from general anesthesia and any need for incisions, passing a thread-like ultrasound-guided device through the trachea to image tumors and biopsy lymph nodes. Pathologists can evaluate the biopsies immediately. Patients can usually go home right after the EBUS procedure.

The Cancer Institute is also a leader in robotic and video-assisted thoracic surgery (VATS), as well as brachytherapy that places radiation seeds directly into tumors. Some smaller lung cancer tumors can be treated in as few as five days with high-dose Stereotactic Body Radiation Therapy (SBRT). With this specialized technology, our Radiation Oncologists can deliver high doses of localized radiation with extreme precision. It’s an alternative to weeks of traditional radiation therapy for qualifying tumors.

We even have advanced devices that use GPS technology to pinpoint the smallest of tumors deep in the lung. Without this super-dimension navigational bronchoscopy, they would be unreachable.

Individualized Care Designed by Multidisciplinary Specialists

We navigate to the right oncologist faster. We use the latest technologies to detect even the smallest tumors. And we bring resources from our vast Hartford HealthCare system to each patient’s bedside. That’s how we became a major referral center for patients with lung cancer and other chest tumors.

Each patient’s best course of treatment is designed by a team of pulmonologists, thoracic surgeons, medical oncologists and radiation oncologists with unmatched expertise. Specialized experts from across every discipline at the Cancer Institute join forces against lung cancer cases. More answers, insights and treatment options are available through the Memorial Sloan Kettering Alliance. You get the most advanced cancer treatment available anywhere, with the added comfort of staying close to home.​


Esophageal Cancer

We are committed to providing compassionate care for every stage of esophageal cancer. Working hand-in-hand with a multidisciplinary team, we are involved in formulating an individualized care plan for each patient. Furthermore, we are one of the few centers in the region with expertise in minimally-invasive esophagectomy (MIE), an advanced technique that permits us to remove esophageal cancers through small incisions.

Cancer of the esophagus facts

  • Fastest growing cancer in the US
  • Seventh highest cause of cancer deaths
  • 1 new cancer diagnosed every 30 mins
  • 18,000 new cases expected in 2013
  • Early diagnosis leads to the best chance of cure

Risk factors

  • Age older than 65
  • Smoking
  • Heavy drinking
  • Diet
  • Obesity
  • Acid Reflux
  • Barrett's Esophagus

Reflux and cancer risk

  • Persistent reflux bathes the GE junction in acid
  • The esophagus compensates by trying to make its surface more acid resistant
  • Cells begin to change to a different type of lining
  • These changes are known as Barrett’s disease
  • Not all reflux leads to Barrett's!

Symptoms

  • No symptoms in the early stages
  • Food gets stuck, and may come back up
  • Pain when swallowing
  • Severe heartburn
  • Persistent pain in the lower chest or back
  • Unexplained weight loss

How is the diagnosis made?

  • Barium swallow
  • Endoscopy with biopsies

Cancer staging

(Staging helps the doctors decide the best treatment)

  • Stage I - barely penetrates the inner lining
  • Stage II and III - deeper penetration, may involve surrounding lymph nodes
  • Stage IV - chemotherapy

Cancer treatment options

  • Stage I - surgery
  • Stage II and III - chemotherapy and radiation followed by surgery
  • Stage IV - chemotherapy

Minimally Invasive Esophagectomy

  • Removing the cancer through small incisions
  • Pros: less pain, lower complication rates, decreased length of stay, same cancer survival
  • Cons: Need for specialized training and centers, so not widely available
  • Hartford Hospital is on of the few centers in the region to offer this advanced technique


Other Thoracic Diseases

We deal with a lot of complex esophageal and airway problems using endoscopic and laser interventions. We also offer evaluation and treatment for many other conditions within the neck, chest and upper abdomen, including:

  • Thymomas
  • Myasthenia Gravis
  • Carcinoids
  • Mediastinal cysts
  • Hyperhidrosis
  • Paraesophageal hernias
  • Esophageal (Zenker's) diverticula
  • GERD
  • Pectus deformities
  • Thoracic outlet syndrome

 

Meet our Thoracic Specialists:

Name Specialties Location
Flaherty, James Francis, MD
860.224.5011
  • Surgical Oncology
  • General Surgery
  • Thoracic Surgery
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  • New Britain
Gawish, Brianna, PA-C
860.696.4306
  • Thoracic Surgery
  • Hartford
  • Manchester
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Kachala, Stefan, MD
860.696.4923
  • Thoracic Surgery
  • General Surgery
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  • New Britain
  • Meriden
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Katigbak, Mario Winn, MD
860.696.4306
  • Thoracic Surgery
  • Hartford
  • Manchester
  • Norwich
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Kearney, Kristi, PA-C
860.696.4923
  • Thoracic Surgery
  • New Britain
  • Hartford
  • Meriden
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Khachane, Vasant B., MD
203.407.2500
  • Thoracic Surgery
  • Cardiac Surgery
  • General Surgery
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  • Hamden
McKelvey, Alicia Ann, MD, FACS, FCCP
860.696.4306
  • Thoracic Surgery
  • Cardiothoracic Surgery
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  • Hartford
O'Connor, Jeffrey Michael, PA-C
860.696.4306
  • Thoracic Surgery
  • Hartford
  • Norwich
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Rooney, Kevin P., PA-C
860.696.4306
  • Thoracic Surgery
  • Hartford

Thoracic Diseases at The Cancer Institute

Our Thoracic Diseases Locations:

Hartford HealthCare Cancer Institute