Pancost cancer is an oncological disease that is localized in the upper groove of the lung. In its symptoms, it is similar to tuberculosis, abscess, echinococcus, pneumonia, benign tumors and other pathologies.
The Pancost tumor was named after the radiologist Henry C. Pankost. He was the first of his colleagues who described the disease in detail. This happened in 1924.
In addition to malignant pathology, some inflammatory and oncological diseases, also localized in the upper part of the lung, can cause similar symptoms. This phenomenon is called Pancost syndrome.
The relevance of the Pancost cancer problem lies in the difficulty of its early diagnosis in view of the specific location of the tumor, closed bone structure. Even with the help of fluorography performed in the most modern cancer clinics, it is far from always possible to quickly detect the disease in the early stages.
Causes of Upper Lung Cancer
In general, the development of Pancost cancer is influenced by the same causes as other types of lung cancer . What is this? The main reason for its manifestation is smoking: active or passive. An important role is played by the number of cigarettes smoked per day, the quality of the tobacco used, as well as the overall smoking experience. It is worth noting that when abandoning addiction, a person leaves the risk zone only after ten years.
People who do not have a passion for smoking can also be exposed to this disease. The percentage of pancreatic cancer lesions of passive smokers rises 1.7-2 times. Children and adolescents whose parents regularly smoke in their presence also fall into the risk group. Tobacco smoking in 85% of cases causes the appearance of lung cancer.
In addition to smoking, environmental and industrial factors can cause Pankost cancer. Contact with substances such as pesticides, asbestos, heavy metals, arsenic, nickel or chromium also increases the percentage of people with Pancost cancer.
The role of various pulmonary diseases in history is also great: tuberculosis, previous pneumonia and bronchiectatic diseases - all this increases the chance of a Pancost tumor in a person.
This disease of men affects five times more often than women, and it manifests itself after 50 years. It has been proven that a predisposition to Pancost cancer is also transmitted at the gene level.
In general, there are several key factors that influence the occurrence of Pancost cancer:
- age;
- smoking;
- ecological situation in the area;
- professional activity in the construction or chemical industry;
- heredity.
Cancer symptoms
Often the patient seeks help with an advanced stage of the disease. This problem is associated with the absence of symptoms in the early stages: the patient has no cough, hemoptysis and, most importantly, visible physical defects in the form of cones on the body. Pain in oncology of the early stages, as a rule, does not appear.
The only alarming symptoms at the 1st and 2nd stages of cancer are general weakness, constant fatigue, weight loss.
Pancost and Horner Syndromes
With the further course of the disease, there is a manifestation of Pankost and Horner syndromes, both individually and in combination with each other. You need to know about this.
Pancost syndrome is manifested by several of the following symptoms:
- severe debilitating pain on the side of the tumor localization - in the shoulder area, along the ulnar nerve and under the shoulder blade;
- weakness of the muscles of the hand on the affected side of the body, paresthesia, numbness of the fingers, atrophy of the muscles of the limb;
- voice change - the appearance of hoarseness, cough.
When a tumor acts on sympathetic fibers, Horner's syndrome manifests itself:
- prolapse of the upper eyelid (ptosis) ;
- anhidrosis of the upper limb and part of the face with an affected side tumor;
- narrowing of the pupil (miosis) and retraction of the eyeball (ethnophthalmos).
Quite often, Pancost cancer is accompanied by superior vena cava syndrome with tumor pressure on it. This syndrome is accompanied by the following symptoms:
- chest pain;
- cough;
- labored breathing;
- headache and increased drowsiness;
- whistling while breathing.
Diagnosis of lung cancer
As mentioned above, the diagnosis of the disease is quite difficult, because in the early stages, Pancost cancer can not always detect even an X-ray examination due to the fact that the tumor is not visible at its location.
As a rule, patients turn to a neurologist or surgeon first of all with complaints of pain in the upper limbs and only after that they get an appointment with oncologists.
Given that the Pancost tumor in its symptoms is similar to other diseases of the bronchopulmonary system, its diagnosis should be comprehensive and include the following types of examinations:
- Radiography - determines the presence of a tumor in the later stages due to thickening of the pleura and the appearance of blackouts.
- Computed tomography and MRI - determine the degree of involvement of vessels, ribs, lymph nodes, vertebrae in the process. The results of these studies are among the most important. They show the possibility of surgery.
- Lymph node biopsy - allows you to determine the stage of development of the pathology.
- Blood test - determines the condition of the body as a whole.
Also, as additional examinations, bronchoscopy (determines the condition of the bronchi and trachea close to the affected area), an arteriogram and phlebogram (assess the condition of veins and arteries in the clavicle area).
Lung cancer treatment
Pancost cancer treatment occurs only in specialized oncology clinics, while the complexity of the therapy is a fundamental factor. According to statistics, Pancost cancer is detected most often in the 3rd stage, when the pains of oncology of this kind become unbearable. In this case, treatment should be started with the administration of painkillers, up to narcotic analgesics.
The main methods of treating a Pancost tumor are:
- chemotherapy;
- radiation therapy;
- surgical intervention.
Preoperative therapy
Therapy of the disease takes place in several stages: preoperative and postoperative treatment, surgical intervention.
Preoperative therapy is a complex of chemotherapy and radiation, necessary to reduce the tumor and prevent the spread of metastases in the lymph nodes. This allows an operation that was not possible prior to such treatment.
Radiation therapy can also be used as an independent method of treatment when surgery is not possible. Irradiation in this case reduces the pain in the patient, but does not affect the life expectancy.
Both radiation and chemotherapy are carried out in several stages, with breaks between them in 2-3 weeks. After radiotherapy and chemotherapy, the patient is assigned a second examination, according to the results of which they conclude that surgical intervention is possible.
The relevance of surgery in the treatment of lung cancer
Surgical treatment is far from being carried out in all cases: if there is no full guarantee that the patient’s capabilities will allow him to undergo the operation, or if numerous areas of the body that are far from the lesion site are affected, it is pointless to carry out the intervention. The percentage of survival in this neglected state of the patient is minimal.
In other cases, when the operation is possible, there are several options for its implementation:
- Pneumoectomy - removal of the entire volume of the affected lung.
- Resection of a part of the lung.
With a significant growth of the tumor, it is possible to remove several ribs and vertebrae, blood vessels, chest wall, brachial plexus. In rare cases, the patient must have an amputation of the upper limbs.
After the operation, radiation and chemotherapy are also performed to "finish off" the tumor cells in order to avoid relapse.
Prognosis for upper lung cancer
The survival rate of patients who have undergone Pankost cancer directly depends on the stage at which the disease was detected.
In patients diagnosed with stage 1 disease, the survival threshold is about 60%, stage 2 is no more than 40%, and when diagnosed with stage 3 cancer, only 20% of patients overcome the five-year threshold.
At the 4th stage, Pancost cancer is practically incurable: in 98% of cases, death occurs within 6-7 months after the treatment.