Cancer of the bronchi is an oncological disease in which tumor cells grow from the epithelial cells (mucosa) of the bronchi. This is a serious pathology that requires 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 lung 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 incidence of this disease helps to establish statistics. It has been conducted by many countries for several decades. According to these data, bronchogenic cancer occupies one of the first places in terms of the number of occurrence.
Worldwide, about a million new cases of lung cancer are detected every year, hundreds of thousands of patients do 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 mosthigh chance of full recovery.
Most patients with this diagnosis are the 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 between the ages of 40 and 60.
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 the negative effects of tobacco smoke is most often delayed in time. In other words, a person can be a smoker for 30 years and not complain about his he alth, but in the end, he will still have problems with the respiratory system. According to statistics, oncological diseases of the respiratory system (including the 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 hazardous production. People have a significantly increased risk of developing oncology of the respiratory system with prolonged contact with asbestos, arsenic, nickel, chromium, heavy metals.
As for chronic diseases, provokebronchogenic cancer can the following diseases:
- scars;
- abscesses;
- bronchiectasis;
- advanced inflammatory diseases.
Types of bronchial tumors
A tumor arising from the bronchial epithelium is differentiated taking into account the characteristics of cancer cells. According to this characteristic, several types of cancer are distinguished.
- Squamous form - it is this type of oncology that most often occurs in the bronchi and lungs. It is localized mainly in the bronchi of large caliber.
- Small cell form. A special characteristic of such a tumor is considered to be high aggressiveness. Rapid growth and active metastasis (spread to other organs) do not provide the most favorable treatment prognosis.
- Tumor of the central bronchus (as well as segmental or lobar). In some cases, the tumor forms a kind of knot that begins to grow into the lumen of the bronchus and partially closes it. Another option for the development of the disease of this form is the growth of the tumor infiltratively. In other words, the neoplasm braids the bronchus from the outside and tightens it, blocking the lumen.
Stages of bronchogenic cancer
Like all other types of cancer, the disease is differentiated by stages of development. This indicator is very important for doctors, because based on this data they can develop the most effective course of treatment.
1st stage of bronchial cancer. This is the very beginning of the development of the disease. The characteristic difference is the small diameterneoplasms - 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 spread deep into.
2nd stage. The tumor can reach a size of 6 cm. Sometimes the process may involve nearby lymph nodes.
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.
Cough 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 the cough of 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, the cough becomes more pronounced. At this time, the first symptoms and signs of bronchial cancer can be somewhat differentiated. Cough in bronchogenic cancer has several differences:
- no other flu or cold symptoms;
- Antitussive drugs do not giveeffect;
- attacks intensify at night and in the morning and almost do not appear during the day;
- pain when coughing.
Chest pain
Painful sensations appear during the growth and spread of the tumor. At first, the 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 stages 3-4 it becomes much more.
One of the frequent signs of the rapid development of a cancerous tumor is the refusal of a cancer patient 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 get this type of cancer. Most often, the cause of the development of the disease is 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 comes out of nowhere (no other cold symptoms);
- severe shortness of breath;
- shortness of breath;
- drastic weight loss;
- hemoptysis;
- headaches;
- dizziness and loss of consciousness.
Diagnosis of bronchial cancer
The success of the entire campaign largely depends on how correctly the doctor diagnosed the patient. Just onBased on clear diagnostic procedures, you can choose the most effective approach in treatment, which means that you can 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 tenderness and enlargement. In addition, it is extremely important to listen to the patient's complaints and determine whether this is really a respiratory disease, or whether these are the first symptoms of bronchial cancer.
2. X-ray examination. For the diagnosis of diseases of the respiratory system, x-rays are one of the most effective and affordable methods. If pathologies are detected during the screening, then an additional study by other methods is prescribed. 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 localization and other structural features.
4. Bronchoscopy. Another examination option, which is prescribed for suspected symptoms of bronchial cancer. To obtain information, a special flexible tube with a micro-camera located at the end is inserted into the patient's respiratory system. The image is transmitted to a computer monitor, thanks to which the doctor receives information about the presence or absence of a tumor, its size, and structure. At the same time, the fencetumor samples for further study.
5. Ultrasound of internal organs. Ultrasound is used to study the condition of the heart, aorta, superior vena cava, esophagus. In the presence of metastases, foci will be immediately identified.
6. Biopsy transthoracic. This procedure involves the use of a very long, thin needle. With its help, the skin and other soft tissues are pierced in order to reach the tumor and remove samples of its tissue. Use this method only if the sample cannot be taken using bronchoscopy.
Surgical treatment of bronchial tumors
Despite the fact that surgery is considered an old, classic method of removing a tumor, it is noticeably more effective than 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 the lung is removed with lymph nodes, as well as fiber. In cases of damage to the trachea or large vessels, it may be necessary to remove the aorta, inferior vena cava and part of the trachea. Such operations are extremely rare, since the patient must be in good he alth, and the surgeon must have a high degree of training. Listedcontraindications:
- growth 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, bronchoplastic surgeries have been used more often, during which cancerous 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 treatments to consolidate the result.
Radiation therapy
Such treatment is based on exposure to radioactive radiation of tumor tissues. In the vast majority of cases, such procedures are performed 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?
- Cancellation of the operation.
- Inoperable case.
- General serious condition of the cancer patient.
In the presence of such factors, doctors decide to use radiation for 6-7 weeks. The total dose can reach 70 Gy. The disadvantage of this treatment option is severe side effects (pain, nausea and vomiting, dizziness). An alternative was a cyber-knife - a narrow directional beamradiation, effectively replacing the surgeon's scalpel.
Chemotherapy
Chemotherapy refers to the use of powerful drugs in the form of intravenous injections or tablets. These substances destroy cell structures, thereby blocking the growth and spread of the tumor.
The use of chemotherapy is possible in cases of small cell cancer with sensitivity to drug treatment. This method is also used in case of inoperability of non-small cell forms of the neoplasm.
Forecasts
Prognosis of treatment of bronchogenic tumors is optimistic only at the first or second stages. So, the correct complex therapy at stage 1 gives a 5-year survival rate 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, makes it possible to achieve a 20% survival rate for 5 years. At stage 4, taking into account metastasis, the chances are reduced to 8-10%.
