The patient is from Alaska and was diagnosed with a Pancoast tumor three months prior to his presentation at the University of Washington. He was in Seattle to visit family and presented at the emergency room with jaw pain. He reported that he had lost 30 pounds over the past year. A chest x-ray showed a 7 X 5 X 6cm posterior apical mass on the right. He had reportedly completed a course of carboplatin and Taxol therapy combined with radiation therapy. He also reported having difficulty swallowing, and choking on liquids. His past medical history also included hypertension, hyperlipidemia, and chronic back pain secondary to an industrial accident and two spinal surgeries.