Bronchogenic carcinoma affects the lungs’ airways; it is among the most common cancers for males and females.
While reading this article, you will obtain a description of bronchogenic carcinomas, their symptoms, diagnosis, and treatments. Also, which are its causes and how smoking is in relation to this disease?
Please, continue reading this article to get the information you need to know to comprehend more about this common, preventable, and life-threatening disease straight from a professional in the area.
What is bronchogenic carcinoma?
Bronchogenic carcinoma is any type of cancer that begins in the tissues covering the airways of the lungs. Historically, doctors used it to describe cancers in the bronchus and bronchioles, the lung’s airways.
Today, it could refer to any lung cancer. Bronchogenic carcinoma is one of the most common cancer. The incidence (or new diagnosis) is estimated to be over 200,000 cases per year in the US, making it the second-most common malignancy after prostate cancer in males and breast cancer in females.
Are there types of Bronchogenic Carcinomas?
Scientists would classify Bronchogenic carcinoma into two main types, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
The name SCLC comes from the appearance and size of the cells seen by a microscope. Approximately 15% of people with lung cancer have small cell lung cancer. It is a central tumor, more common in smokers.
It is very aggressive and more likely to metastasize to distant organs at the time of presentation. When cancers metastasize (or migrate) to other body tissues means trouble. Besides, doctors also associate this cancer with paraneoplastic syndrome, an ectopic hormone secretion. That is to say, this cancer can produce hormones that alter the body’s function and cause other overt symptoms.
On the other hand, Non-Small Cell Lung Cancer (NSCLC) is the most common type of lung cancer since it represents approximately 80 to 85% of all lung cancers. Science further subdivides it into three main subtypes, adenocarcinoma, squamous cell carcinoma, and large-cell carcinoma.
Of all lung cancers, Adenocarcinoma is the most common subtype. Usually, it is more frequent in women and nonsmokers and arises in the lungs’ surroundings, and contains glands.
Moreover, Squamous cell carcinoma could be found in the middle of the lung. It has a strong association with tobacco smoking habits and squamous metaplasia. The latter term means a transformation of the normal cells in the airways to malignant ones because of the smoke.
By contrast, Large cell carcinoma can appear in the sidelines of the lung. In this subtype, cells do not have gland formation as in adenocarcinoma; neither keratinization nor the thickening of cell layers, as in squamous cell carcinoma. Sadly, this type has a poor prognosis or scarce possible good outcomes.
What causes bronchogenic carcinoma?
Bronchogenic carcinoma is more common in males than in females and patients with a family history of lung cancer. Still, certain factors can raise your risk of developing this disease.
The leading risk factor is tobacco smoking, which is responsible for about 90 percent of cases. The risk of bronchogenic carcinoma has a direct relationship to the duration and dose of tobacco smoking. Also, secondhand smoke, when we inhale the smoke exhaled by smokers, may similarly place us at higher risk.
The exposure to radon, a color, and odorless gas that can pass through the ground, enter and accumulate in buildings, is the second most common cause.
Furthermore, other causes include exposure to exhaust smoke and occupational exposure to carcinogens. It means direct contact with chemicals, such as arsenic, beryllium, polycyclic aromatic hydrocarbons, asbestos, and even wood dust.
Another factor that increases the risk of suffering lung cancer is exposure to ionizing radiation. This is a treatment that doctors use for diseases like breast cancer.
Which lung cancers are strongly associated with smoking?
Studies show an unquestionable role of tobacco smoke in lung cancer. Cigarette smoke contains high acrolein levels and other agents such as nitrogen oxides, acetaldehyde, and phenols, contributing to carcinogenicity or the possibility to cause cancer.
Tobacco use is involved in almost all cases of NSCLC. Importantly, Squamous cell carcinomas and small cell carcinomas (SCCs) both have a strong link to smoking. In spite of adenocarcinomas that also tend to occur in people who have never smoked.
In the same way, although small cell lung cancer (SCLC) is less common than NSCLC, it is almost always due to heavy smoking.
There has been a gradual change in the way cigarettes are done. The introduction of filter vents allows deeper inhalation than unfiltered cigarettes.
Inhalation transports carcinogens farther within the airways toward the bronchoalveolar junction where adenocarcinoma often arises. This generates an increase in adenocarcinoma subtypes cases. Therefore, currently, it is no surprise that they are more frequent than other types of lung cancer.
How does the bronchial carcinoma develop?
A different set of cells builds our lungs. Bronchial carcinoma usually begins in cells that line the airways. One of these is epithelial cells, which produce mucus to protect the lungs. Other important lung cells include structural cells, blood cells, and nerve cells.
Usually, the cells in our body have a specific growth and death cycle that keeps the number of cells in check. Bronchial carcinoma develops when a set of specific changes, called mutations, develops in a previously normal cell.
Mutations affect the natural cycles of growth and death, resulting in too many cells, cancer cells. Instead of dying, the malignancy cells continue to reproduce and form tumors.
Where do bronchial carcinomas arise?
Bronchial carcinomas could appear anywhere within the lung tissue. The most frequent site is the lung’s hilum, in the primary, secondary, and tertiary bronchi. A few will occur at the outer lung tissue from the alveolar cells of terminal bronchioles.
Bronchogenic carcinomas begin as a small focus of atypical epithelial cells within the bronchial mucosa. They grow into the bronchial airway, or the bronchial wall and nearby lung tissue. While the lesion progresses, the atypia becomes frankly malignant, and the tumor grows. It can spread to the pleural cavity and pleural fluid, or the pericardium (the membrane that covers the heart).
As the tumor grows, it may do metastasis, spread cancer from one part of the body to another. Tumor cells can spread to lymph nodes around the lungs. Or it can travel to more distant organs such as the liver, brain, or bones through the blood.
On the other hand, various types of cancer can grow in another organ and metastasize to the lungs. The most frequent are colon cancer, breast cancer, and bone sarcomas. That is not primary bronchogenic lung cancer though.
Therefore, when a mass that appears to be cancer occurs in the lung. It is core to define first if it is a primary lung cancer or metastasis because of cancer somewhere else that went through the blood and began to grow in the lung.
What is an early sign of bronchogenic carcinoma?
Patients with adenocarcinoma will often have no symptoms at the beginning. Early symptoms can be so mild that sometimes they aren’t noticeable until cancer has spread. Coughing is considered the first main symptom, but some other general signs include weight loss and shortness of breath.
As tumors begin to interfere with the lungs’ function and cause problems in the airways, symptoms start worsening. Some of the most common are cough with blood, wheezing, chest pain, hoarseness, frequent or persistent bronchitis, or pneumonia.
Importantly, other symptoms are significant because they can alert on the spread of lung cancer when appearing in association with the above symptoms. They may include hip or back pain, headache, seizures, yellowing of the eyes and skin, and more prominent lymph nodes.
Cancers that affect the upper lobe of the lungs are usually named Pancoast tumors. They can affect specific nerves to the eye and part of the face.
So, it causes a drooping one upper eyelid, a smaller pupil, and sometimes severe shoulder pain. Other symptoms like a fatty hump between the shoulders, a round face, and purple stretch marks could indicate Cushing’s syndrome. This is due to the excess of cortisol in the blood from the secretion of hormones by small cell lung cancer.
How is bronchogenic carcinoma diagnosed?
Doctors might want to screen for lung cancer if you have symptoms or even if you meet specific criteria. It may include age between 55 and 80 years, a history of smoking, or a family history of lung cancer.
There are several tests your doctor might use to help with the diagnosis of this disease, including imaging tests. They may find abnormalities on a chest x-ray and order other evaluations as a CT scan. It can provide more detail, possibly showing small lesions that an X-ray might miss.
When an abnormality is found, physicians often recommend a lung biopsy, a tissue sample taken from the suspicious area. Your doctor can get the sample using a tube passed down the throat to the lungs. Or they can also insert a needle through the chest wall into the lung.
Then, a pathologist will examine the sample under a microscope to determine if there are cancer cells. If cancer is detected, the pathologist will also identify which type of lung cancer it is.
To stage the disease, doctors could order additional tests. It may include a positron emission tomography scan, the most sensitive imaging test, and bone scans.
They will also indicate a complete blood count and blood tests to know if tumors also come with paraneoplastic syndromes. That means the secretion of hormones by the tumor.
What are the treatment options?
Frequently, patients need a combination of treatments. In order to do this, doctors take into account different factors, including the type and stage of cancer you are diagnosed with.
When cancer is confined to the lungs, surgical resection may be an option. If you have a small tumor, doctors may remove that section with the small margin leaning it. But, somethings doctors could remove a whole lobe. During the same surgery, they may cut some nearby lymph nodes for testing.
Also, they could suggest chemotherapy, a powerful drug treatment that destroys cancer cells throughout the body. Most of the time, chemotherapy is given directly through the vein and can last months.
Another option for doctors is to use radiation therapy, high-energy beams that target localized tumors. It is also used as a support to shrink tumors before surgery or kill cancer after surgery.
There are other options for treatment, as targeted drugs. This kind of drug acts only with a specific genetic mutation patients have that grows and damages healthy cells.
Which lung carcinoma is associated with finger clubbing?
The term finger clubbing refers to the bulging of the distal portion of the fingers. They are also known as watch-glass nails, drumstick fingers, and Hippocratic fingers/nails.
This sign is frequently associated with diseases that reduce the oxygen level in the blood. Among them, we find congenital heart defects and lung cancer. The latter represents the most common cause, responsible for about 80% of nail clubbing cases.
It is mainly due to overgrowth and accumulation of soft tissue in the nail area. This causes an acute angle between the nail, the cuticle, and the nails’ downward curvature.
Studies say that Adenocarcinoma is the most frequent subtype of lung cancer, causing clubbing, being small cell carcinoma the least.
Can lung nodules be cancerous?
A lung nodule is a small abnormal mass in the lung, usually smaller than 3 centimeters or 1.2 inches. They are found as round or oval white shadows during a chest x-ray or CT scan, surrounded by normal tissue.
These scans may be done as part of a lung cancer screening test or to examine your lungs for respiratory symptoms. Although most solitary pulmonary nodule is benign or noncancerous and appears as a result of old infections, they can be cancerous.
Lung nodules could be a manifestation of any type of primary lung cancer in an early stage. Sometimes, it also may indicate that cancer is spreading from another body part. This is why testing is often needed.
If your doctors find a new lung nodule, they may recommend further scans in a few months. It depends on how likely they think the nodule is cancer.
Doctors may consider the shape, size, and location of the nodule and its solid or fluid-filled appearance. When a repeated scan shows changes, your doctor may also order another type of imaging test or a tissue biopsy.
Are you a heavy tobacco smoker?
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