Pancoast Tumor Causes and Risk Factors

A Pancoast tumor, also called a superior pulmonary sulcus tumor, is a type of lung cancer that develops at the uppermost part (apex) of either lung. Most Pancoast tumors are non-small cell lung cancers. As the tumor grows, it may extend into nearby structures at the top of the chest, including the ribs, vertebrae, nerves, and blood vessels.

What Causes a Pancoast Tumor?

A Pancoast tumor develops when genetic changes cause cells in the upper part of the lung to grow and divide abnormally. Healthy cells normally follow genetic instructions that regulate their growth, division, and death. When those instructions are disrupted, abnormal cells may continue multiplying and eventually form a tumor.

It is rarely possible to identify the exact event that caused a particular person’s cancer to develop. Instead, physicians consider risk factors that may increase the likelihood of harmful cellular changes over time.

Risk Factors for Pancoast Tumors

Because Pancoast tumors are an uncommon form of non-small cell lung cancer, much of what we understand about their risk profile comes from broader lung cancer research. Recognizing risk factors is about understanding statistical probability rather than certainty; having multiple risk factors does not guarantee you will develop a Pancoast tumor, and conversely, individuals with no known risk history can still be diagnosed.

Modifiable Risk Factors (Factors You Can Control)

• Tobacco Smoke: Cigarette smoking is the leading risk factor for lung cancer, including the non-small cell cancers that make up most Pancoast tumors. Tobacco smoke contains carcinogens that repeatedly damage cells lining the lungs. Risk generally rises with the number of cigarettes smoked and the duration of use. Secondhand smoke also elevates risk, as inhaling exhaled smoke introduces many of the same harmful substances.
• Radon Exposure: Radon is a naturally occurring, odorless, radioactive gas that can enter homes and buildings from soil and rock. Testing is the only way to detect it. Long-term radon exposure is a primary cause of lung cancer in both smokers and non-smokers.
• Workplace & Industrial Carcinogens: Chronic workplace exposure to cancer-causing substances significantly increases lung cancer risk. High-risk substances include asbestos, arsenic, diesel exhaust, chromium, nickel, beryllium, cadmium, soot, and industrial tar. These exposures frequently occur in mining, construction, shipbuilding, manufacturing, transportation, and metal processing.
• Outdoor Environmental Pollution: Prolonged exposure to heavy air pollution and airborne industrial emissions can contribute to baseline lung cancer risk.

Non-Modifiable Risk Factors (Factors You Cannot Change)

• Prior Radiation Therapy: Having received radiation therapy to the chest area for a previous medical condition or cancer can increase the risk of developing lung cell mutations later in life.
• Family History & Genetics: A family history of lung cancer may be associated with increased risk, reflecting shared genetic susceptibility, shared environmental exposures, or a combination of both. However, no single inherited mutation is responsible for most Pancoast tumors.
• Age and Sex: Like most lung malignancies, Pancoast tumors are diagnosed most frequently in older adults (typically between ages 50 and 70) and occur somewhat more often in men, largely reflecting historical patterns of occupational exposure and smoking habits.

Can Pancoast Tumors Be Prevented?

While not every Pancoast tumor can be prevented, reducing exposure to established lung carcinogens can lower your overall risk.

• Avoid Tobacco: Avoiding tobacco or quitting smoking is the most important step a person can take to lower lung cancer risk. Minimizing exposure to secondhand smoke provides vital additional protection.
• Test Your Home for Radon: Radon testing is a simple, practical step to protect your household. If elevated radon levels are detected, a qualified professional can install mitigation systems to reduce gas entry.
• Adhere to Workplace Safety Protocols: Individuals working around asbestos, diesel exhaust, metals, dust, or industrial chemicals should strictly follow workplace safety procedures and wear required protective equipment (such as respirators). Employers should maintain appropriate ventilation and engineering controls to minimize airborne hazards.

Benefit from world-class care at Moffitt Cancer Center

The renowned team in the Thoracic Oncology Program at Moffitt offers the latest diagnostic and treatment options for all types of lung cancer, including rare and complex malignancies like Pancoast tumors. As a National Cancer Institute-designated Comprehensive Cancer Center, Moffitt is nationally recognized for its groundbreaking research. We also take a bench-to-bedside approach, quickly translating our notable discoveries into tangible benefits for our patients. 

If you would like to learn more about Pancoast tumor causes and risk factors, you can request an appointment with a lung cancer specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.