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types of cancer

Bronchial Tumor

Overview

Bronchial tumour affects the bronchial tubes that connect the windpipe to the lungs. This results in difficulty in breathing. The tumour starts at the bronchi and can spread to other areas of the body making affected areas incapable of functioning. Bronchial tumour is said to affect smokers (especially passive smokers). It is a recurrent form of cancer that can come back even after treatment. One of the common tumours include the endobronchial tumour which constitute 80% of bronchial tumours in children. The various types within it include benign lesions such as: Hemangiomas – a red nodule of extra blood vessels Pappillomas – benign epithelial tumour growing in nipple-like and often finger-like fronds Inflammatory pseudotumours – It is an inflammatory cell tumour forming in the lung. Leiomyomas -also known as fibroids. It is a benign smooth muscle tumour that very rarely becomes cancer Mucus gland tumours – an extremely rare benign lung tumour presumed to arise from the bronchial mucus glands. Some of the rare types of bronchial tumour include Glomus tumours present in the dermis and subcutaneous tissue. Another type is Bronchial adenoma which is a rare type of cancer that starts in the mucous glands, ducts of the lung, windpipe and in the salivary glands. Another type is Neuroendocrine tumours which may develop throughout the human body with the majority being found in the gastrointestinal tract and bronchopulmonary segment.

Symptoms

Bronchial tumours are detected purely by accident especially when routine chest x-rays are done for unrelated medical problems. When symptoms do appear, they usually include:

  • Persistent coughing
  • Blood in cough
  • Chest pain
  • Difficulty in breathing
  • Wheezing
  • Fever
  • Facial flushing (redness and warmness that may last hours to days)
  • Sweating
  • Diarrhoea
  • Fast heartbeat
  • Weight loss and weakness
  • Increased facial and body hair
  • Increased skin pigmentation
  • Causes

    Bronchial tumours can be caused by a variety of factors including: Cigarette smoking – Cigarette smokers form the highest number of bronchial tumour cases by far. Cigarette smoke contains over 60 known cancer causing chemical substances. Researchers have found that nicotine reduces immunity to cancerous growths in exposed tissue. Passive smoking – A passive smoker is someone who inhales smoke exhaled by another smoker. This causes bronchial tumours in non-smokers. Passive smokers are said to be at a higher risk since they are likely to inhale side-stream smoke (smoke that burns off the end of the cigarette). Radon gas – Radon is a colourless and odourless gas generated by the breakdown of radioactive radium. This causes bronchial tumours in non-smokers. The radiation present in this gas causes cancers by affecting the genetic make-up. Asbestos – Asbestos can cause a variety of lung diseases, including bronchial tumours. Tobacco smoking and asbestos both facilitate the formation of lung cancer. Air pollution – Fine particulates and sulphate aerosols, which may be released in traffic exhaust fumes, can slightly increase the risk of bronchial tumours. Women who are exposed to indoor coal smoke have about twice the risk as people who are not. Genetics – It is estimated that 8-14% of bronchial tumours are inherited genetically. If a person has a relative who suffers from lung cancer, the risk of contracting the disease increases by 2.4 times.

    Diagnosis

    There are multiple ways through which bronchial tumours can be diagnosed: Blood tests: If a patient is suspected of having the tumour, he or she may be advised to undergo some blood and urine tests to understand the concentration of cancer cells. Chest x-ray: 75% of patients with bronchial tumours show signs of it on their chest x-ray. The signs can either be in the form of the tumour itself or reveal an indirect evidence of its presence CT scan: Some carcinoid lung tumours are too minute to be detected or are located behind organs that obstruct the chest x-ray. In some of these cases, the specialists ask patients to undergo a CT scan. CT scans help highlight nodules, masses, or suspicious changes found on a chest x-ray. Magnetic Resonance Imaging (MRI): MRI generally provides information similar to that of CT scans, while also helping to differentiate small tumours from adjacent blood vessels Biopsy: While x-rays and scans can determine the presence of a tumour, it is necessary to conduct a biopsy to understand the nature of the tumour. The various ways of doing biopsy includes:

  • Bronchoscopy: A procedure which involves inserting a fibre optic viewing tube called a bronchoscope into the windpipe and the airways of the lungs through the throat.
  • Trans-bronchial fine-needle biopsy: If the tumour is small, a fine-needle biopsy of the tumour may be performed through the bronchoscope.
  • Transthoracic needle biopsy: If a tumour is inaccessible, or is located in the periphery of the lung, it is accessed using a long needle inserted between the ribs.
  • Thoracotomy (surgically opening the chest cavity): In the rare event that neither a bronchoscopic biopsy nor a transthoracic needle biopsy can provide enough tissue to identify the type of tumour, a thoracotomy may be necessary to obtain a biopsy and determine subsequent treatment
  • Treatment

    One of the effective ways to treat bronchial tumour is the resection of the primary tumour via surgery. Most tumours end up being classified as benign (which requires only a surgery). There are various surgical options available to the specialists for bronchial tumours:

  • Sleeve resection: a procedure where a section of the airway containing the tumour is removed.
  • Segmental resection: a procedure where the segment of the lung containing the tumour is removed.
  • Wedge resection: a procedure where a small wedge of the lung containing the tumour is removed.
  • Lobectomy: a procedure where a lobe of the lung containing the tumour is removed
  • Endoscopic tumour ablation using laser: This is a surgical technique that involves a removal of the tumour through the bronchoscope using laser technology.
  • Chemotherapy and Radiation therapy are used when the tumours spread to other parts of the body. If this is a solitary mass, it may be treated with chemotherapy directed at the hepatic artery connected to the location of the tumour.

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