Bronchial cancer is an oncological disease in which tumor cells grow from the epithelial cells (mucous membrane) of the bronchi. This is a serious pathology requiring urgent treatment. In the absence of proper therapy, the patient dies.
Features of the disease
According to medical terminology, bronchial cancer and lung cancer are united by one common concept - bronchogenic or bronchopulmonary cancer. This is explained by the fact that the vast majority of types of pulmonary tumors grow precisely from the bronchial walls. In other words, all parts of the lungs (including the bronchi) are involved in the pathological process.
The prevalence and frequency of this disease helps to establish statistics. Many countries have been leading it for several decades. According to these data, bronchogenic cancer in number of occurrence is one of the first places.
Around the world, about a million new cases of lung cancer are detected every year, hundreds of thousands of patients can not cope with this disease. The complexity of diagnosis and treatment is largely due to the asymptomatic course at the earliest stages. But it is during this period that patients have the highest chance of a full recovery.
Most patients with this diagnosis are representatives of the stronger sex, in men this disease is detected almost 10 times more often than in women. The first symptoms and signs of bronchial cancer in most patients are detected at the age of 40 to 60 years.
Causes of bronchogenic cancer
Doctors tend to divide all possible causes of tumor growth into 2 categories:
- external factors;
- chronic diseases of the respiratory system.
External factors include all adverse effects on the human respiratory system. One of them is smoking.
The appearance of negative effects from tobacco smoke is most often delayed. In other words, a person may be a smoker with 30 years of experience and not complain about health, but ultimately he will still have problems with the respiratory system. According to statistics, oncological diseases of the respiratory system (including bronchi) in 90% of cases are diagnosed in people who abuse tobacco.
This is explained by the fact that inhaled tobacco smoke contains radioactive components, soot, tar and other harmful substances. Over time, these particles settle on the epithelium of the bronchi and provoke pathological changes in the tissues.
Another negative external factor is considered harmful production. People significantly increase the risk of developing oncology of the respiratory system with prolonged contact with asbestos, arsenic, nickel, chromium, and heavy metals.
As for chronic diseases, the following diseases can provoke bronchogenic cancer:
- scarring;
- abscesses;
- bronchiectasis;
- advanced inflammatory diseases.
Types of bronchial tumors
A tumor arising from the epithelium of the bronchi is differentiated according to the characteristics of cancer cells. According to this characteristic, several types of cancer are distinguished.
- Squamous cell form - this type of oncology most often occurs in the bronchi and lungs. It is localized mainly in large-caliber bronchi.
- Small cell form. A special characteristic of such a tumor is high aggressiveness. Rapid growth and active metastasis (spread to other organs) provide not the most favorable prognosis of treatment.
- Tumor of the central bronchus (as well as segmental or lobar). In some cases, the tumor forms a kind of node that begins to grow in the lumen of the bronchus and partially closes it. Another option for the development of a disease of this form is tumor growth infiltratively. In other words, the neoplasm braids the bronchus from the outside and pulls it together, blocking the lumen.
Stages of bronchogenic cancer
Like all other types of cancer, the disease is differentiated according to the stages of development. This indicator is very important for doctors, because on the basis of these data they can develop the most effective course of treatment.
Stage 1 bronchial cancer. This is the very beginning of the development of the disease. Characteristic differences are the small diameter of the neoplasm - from 0.5 to 3 cm. In this case, only the upper layer of the epithelium is involved in the process, the tumor does not extend deeper.
2nd stage. The tumor can reach a size of 6 cm. Sometimes near lymph nodes can be involved in the process.
3rd stage. The size of the tumor already exceeds 6 cm, while it grows into the deep layers of the bronchus or closes its lumen. Cancer cells are present in the lymph nodes and parts of the lung.
4th stage. With bronchial cancer at this stage, malignant cells are not present in one lung (in which there was a primary focus), but spread to the second. The lymphatic system and distant organs are affected.
Coughing as the first sign of illness
The initial stage of bronchogenic cancer is usually asymptomatic. This is explained by the small size of the tumor and the fact that it does not yet affect neighboring tissues.
The first of all symptoms is a cough. In general, it is no different from a cough with a common cold, and patients do not pay much attention to such a symptom. A doctor without additional research will also not be able to make a diagnosis with 100% accuracy. To identify the oncological process, it is necessary to conduct tests and take tests.
Over time, coughing becomes more pronounced. At this time, you can somewhat differentiate the first symptoms and signs of bronchial cancer. Cough with bronchogenic cancer has several differences:
- other symptoms of flu and colds are not observed;
- antitussive drugs do not give an effect;
- attacks are worse at night and in the morning and almost do not appear during the day;
- the occurrence of pain during coughing.
Chest pain
Painful sensations appear during the growth and spread of the tumor. At first, pains are localized only on one side - it is in that lung that the primary focus is located. Gradually, the pain spreads to the entire sternum.
In some cases, hemoptysis occurs. At first, only a small admixture of blood is present in the sputum, but at stage 3-4 it becomes much larger.
One of the frequent signs of the rapid development of a cancerous tumor is the cancer patient's refusal to eat and a sharp decrease in body weight.
The mental status of a person changes, he becomes irritated, nervous.
Symptoms in children
Children under 16 rarely have this type of oncology. Most often, the cause of the development of the disease becomes a congenital pathology of the respiratory system or extreme living conditions.
In this case, the following symptoms of bronchial cancer are observed in young patients:
- severe cough that occurs “out of nowhere” (without other symptoms of a cold);
- severe shortness of breath;
- labored breathing;
- a sharp decrease in body weight;
- hemoptysis;
- headache;
- dizziness and loss of consciousness.
Diagnosis of bronchial cancer
The success of the entire campaign depends on how correctly the doctor diagnosed the patient. Only on the basis of clear diagnostic procedures can we choose the most effective approach to treatment, which means significantly increase the chances of a full recovery.
1. Initial examination of the patient. This procedure involves examining the patient, listening with a stethoscope, checking the lymph nodes for pain and the presence of an increase. In addition, it is extremely important to listen to the patient’s complaints and determine whether this is a respiratory illness or the first symptoms of bronchial cancer.
2. X-ray examination. For the diagnosis of diseases of the respiratory system, x-ray is one of the most effective and affordable methods. If pathologies are detected during the screening, then an additional study is prescribed by other methods. The effectiveness of x-rays is confirmed by medical statistics: even in the early stages, a tumor is detected in 75% of cancer patients.
3. CT (computed tomography). This method of hardware research makes it possible to visualize all the necessary structures. Thus, in the presence of a tumor, doctors receive data on its size, exact location and other structural features.
4. Bronchoscopy. Another test option that is prescribed for suspected symptoms of bronchial cancer. To obtain information, a special flexible tube with a micro-camera located at the end is introduced into the patient's respiratory system. The picture is transferred to a computer monitor, so the doctor receives information about the presence or absence of a tumor, its size, structure. At the same time, tumor samples are taken for further research.
5. Ultrasound of the internal organs. Ultrasound is used to study the condition of the heart, aorta, superior vena cava, and esophagus. In the presence of metastases, foci will be immediately identified.
6. Transthoracic biopsy. This procedure involves the use of a very long thin needle. With its help, the skin and other soft tissues are punctured in order to achieve a tumor and seize samples of its tissue. They resort to this method only in those cases if the sample cannot be taken using bronchoscopy.
Surgical treatment of a bronchial tumor
Despite the fact that the surgical operation is considered an old, classical method of eliminating the tumor, in terms of effectiveness, it is noticeably superior to all other methods of therapy. During this procedure, the surgeon removes the affected part of the lung. Depending on the size of the excised part, the following types of operations are distinguished:
- pulmonectomy - complete removal of the affected lung;
- resection - excision of a small area of lung tissue;
- lobectomy - removal of half of the lung.
Pulmonectomy is the most radical technique in which a lung with lymph nodes, as well as fiber, is removed. In cases of damage to the trachea or large vessels, removal of the aorta, inferior vena cava and part of the trachea may be required. Such operations are extremely rare, as the patient must be in good health, and the surgeon must have a high degree of preparation. In the list of contraindications:
- proliferation of a tumor in the vessels;
- the appearance of distant metastases (in this case, the elimination of the primary focus will be ineffective);
- general serious condition of the patient - general anesthesia will aggravate his condition.
When the first signs of bronchial cancer are detected, the choice is made in favor of partial excision. Recently, bronchoplasty operations have become more common, during which cancer foci are removed by circular or wedge-shaped resection. In the postoperative period, the patient is prescribed a course of certain antibiotics to prevent complications.
It is worth noting that surgery is most often combined with other methods of treatment to consolidate the result.
Radiation therapy
Such treatment is based on exposure to tumor tissue radiation. In the vast majority of cases, such procedures are carried out before or after surgery, which reduces the size of the neoplasm. However, in some cases, chemotherapy becomes the main and only way to treat bronchial cancer. What are these cases?
- Refusal of operation.
- Inoperable case.
- General serious condition of a cancer patient.
If there are such factors, doctors decide to use radiation for 6-7 weeks. The total dose can reach 70 gray. The disadvantage of this treatment option is the serious side effects (pain, nausea and vomiting, dizziness). An alternative was a cyber knife - a narrow directional beam of radiation, effectively replacing the surgeon's scalpel.
Chemotherapy
Chemotherapy refers to the use of potent drugs in the form of intravenous injections or tablets. These substances destroy the structure of cells, thereby blocking the growth and spread of the tumor.
The use of chemotherapy is possible in cases of the appearance of small cell cancer with sensitivity to drug treatment. They resort to this method in the case of inoperability of non-small cell forms of neoplasm.
Forecasts
The prognosis for the treatment of a bronchogenic tumor is optimistic only in the first or second stages. So, the correct complex therapy at the 1st stage gives 5-year survival in 80% of cases.
In the second stage, the chances of recovery reach 50%. The third stage, with good sensitivity of the tumor to treatment, allows to achieve 20% survival for 5 years. At stage 4, taking into account metastasis, the chances are reduced to 8-10%.