The standard of care for people with a Pancoast tumor is chemotherapy and radiation followed by removal of the tumor and a portion of the the chest wall if it is affected or if its removal facilitates surgery. The purpose of the chemotherapy and radiation is to shrink the tumor and to block the cancer from spreading through lymph nodes. An interval of two to four weeks after the chemo and radiation allows the the procedures to reach their maximal effect. After four weeks, all patients are reassessed for surgery. If the cancer has not spread to distant areas of the body, surgery will likely be offered.