A bronchial tumor refers to an abnormal mass that forms in the bronchus, the large tubes that carry air from the trachea (windpipe) to the lungs. At times, the bronchial tumor is also referred to as lung cancer, as it is a general term for all cancers that arise from the different parts of the lungs, namely the bronchi, bronchioles, and alveoli.
These tumors can either be benign or malignant. Benign tumors do not spread to other parts of the body, whereas malignant tumors spread to other parts of the body.
Bronchial tumors are rare, accounting for only 0.6% of all pulmonary tumors. A few reports suggest that the incidence of this condition may be underestimated as its symptoms overlap with those of other respiratory conditions.
Although rare, these tumors pose a significant health burden, especially in developing countries where there is a lack of awareness and limited access to modern healthcare facilities.
Bronchial tumors can arise from different cell types and tissues present in the bronchial wall, which lines the air passages of the lungs. The following are the different types of bronchial cancer or tumor:
Endobronchial tumors arise from the bronchial wall lining, including squamous cell carcinoma, adenocarcinoma, and carcinoid tumors. This is one of the types of bronchial cancer that is malignant. Smoking is an important risk factor; however, genetic factors also play an important role. Early diagnosis and timely treatment help in the effective management of endobronchial tumors.
Hemangiomas are formed from the blood vessels present in the airways. In most cases, hemangiomas are caused by congenital abnormal vascular growth. These tumors are benign. However, these may cause complications like bleeding or airway obstruction if left untreated.
Papillomas are benign and are characterized by a wart-like appearance. Papillomas are associated with human papillomavirus (HPV) infection. These tumors cause respiratory obstruction. Repeated tumor debulking is required for their effective management, as recurrence is a significant challenge with papillomas.
Staging is an important phase of bronchial tumor management. Staging helps specialists understand the extent of the disease’s spread. The staging of bronchial cancer plays a pivotal role in treatment planning.
The TNM system is the most common system employed for cancer staging. TNM stands for tumor (T), node or lymph nodes (N), and metastasis (M). TNM staging is the standardized way to describe the extent of tumor growth, lymph node involvement, and distant metastasis. Based on the information from TNM staging, bronchial tumors are categorized under stages 0, 1, 2, 3, and 4.
Stage 0 is when the tumor is in situ or present only in the innermost lining of the bronchus.
In stage 1, the size of the tumor is less than 4 cm, and the disease has not spread to any lymph nodes or any distant organs.
Stage 2 is categorized into 2a and 2b. In stage 2a, the tumor size is about 4-5 cm or has spread to the main bronchus. However, the disease has not spread to distant organs.
In stage 2b, the tumor size is 5-6 cm and may have spread to nearby lymph nodes.
In stage 3, the tumor size is about 7 cm across, or the tumor may be of any size but has spread to nearby tissue inside the lung, or the tumor has spread to nearby lymph nodes. The disease, however, has not spread to distant organs.
The tumor can be of any size, but the disease has spread to distant lymph nodes and organs.
Not all patients experience all or the same bronchial tumor symptoms. Both benign and malignant bronchial tumors exhibit symptoms. Some patients may experience early symptoms, while others don’t. The symptoms of bronchial cancer often overlap with those of various respiratory conditions. It is important to know different bronchial tumor symptoms for early detection and effective management of bronchial tumors.
Bronchial tumors can affect anyone. However, certain individuals have a higher risk of developing this condition than others. Those who smoke tobacco, those who have occupational exposure to hazardous chemicals, those who have radon exposure, those who have prolonged exposure to polluted air, and those with chronic lung diseases are more likely to develop bronchial tumors. Also, having a family history of bronchial tumors increases one’s chances of developing this condition.
These people, who are identified as “high-risk individuals,” should be aware of different signs of bronchial cancer and see a doctor when persistent respiratory symptoms are observed.
The symptoms of bronchial cancer may vary from one patient to another. The symptoms experienced may depend on the type of bronchial tumor, its stage, its grade, the patient’s overall health condition, etc. The following are the different symptoms of bronchial cancer:
One of the most common bronchial tumor symptoms is persistent coughing, which may worsen over time. When the tumor irritates the airways, it leads to coughing.
Shortness of breath, or difficulty breathing, is another important symptom of bronchial tumors. When the tumor obstructs the airways, patients start experiencing breathlessness; this is more pronounced during physical activities.
A dull pain or discomfort in the chest is also one of the bronchial tumor symptoms. Tumors growing in the bronchus can cause pressure or irritation, and this causes pain in the chest region.
Bronchial tumors can lead to constricted airways, which in turn lead to a high-pitched whistling sound while breathing.
Bronchial tumors close to the vocal cord may lead to changes in voice or hoarseness.
Unintended weight loss is one of the most important bronchial tumor symptoms. Bronchial tumors cause weight loss due to tumor-induced metabolic demand, reduced appetite, problems associated with nutrient absorption, increased energy expenditure, and systemic inflammation.
Fatigue or extreme tiredness is also one of the bronchial tumor symptoms. Tumors growing in the bronchi need a significant amount of energy for growth. This need for energy may cause significant changes in the energy metabolism, and patients may experience extreme tiredness.
Tumor growth weakens the immune system, and this in turn makes patients susceptible to respiratory infections.
Bronchial tumors can cause reduced oxygen levels in the blood, which may cause enlargement of the fingertips and nails curving around them. This is one of the advanced bronchial tumor symptoms.
Inflammation and infection caused by bronchial tumors may lead to fever. Fever is one of the most important bronchial tumor symptoms, and it should not be ignored.
Endobronchial tumors cause chest pain, coughing, wheezing, recurrent infections, bleeding, and weight loss.
Hemangiomas cause pain and impaired vital functions.
Hoarseness, difficulty speaking/breathing, and wheezing are the common symptoms of papillomas.
Common symptoms of inflammatory pseudotumors include coughing, shortness of breath, chest pain, hemoptysis, fever, extreme tiredness, unintended weight loss, and pneumonia.
Leiomyomas rarely form in the bronchus. Although asymptomatic, they cause symptoms like chest pain, tiredness, and other respiratory disorders over time.
Persistent coughing, wheezing, breathlessness, and chest pain are the commonly observed symptoms of mucous gland tumors.
Chest pain, cough, and shortness of breath are the commonly observed symptoms of glomus tumors.
Breathing difficulties, chest pain, wheezing, and persistent coughing are commonly observed in patients with bronchial adenomas.
Cough, chest pain, and breathlessness are commonly observed in patients with neuroendocrine tumors.
The exact cause of bronchial carcinoma is unknown. However, it is understood that certain factors may increase the risk of bronchial carcinoma. The following are the different risk factors or possible causes of bronchial tumors:
Smoking is considered one of the possible bronchial carcinoma causes. The harmful carcinogens present in tobacco can damage the DNA of bronchial cells, weaken the immune system, and affect DNA repair mechanisms. All these factors contribute to increased bronchial tumor risk.
Secondhand smoking, or passive smoking, is as dangerous as active smoking. Those who inhale secondhand smoke are exposed to the harmful carcinogens present in tobacco just as much as active smokers. Therefore, passive smoking is also considered one of the possible bronchial carcinoma causes.
Workers in mining, construction, and manufacturing are exposed to asbestos, arsenic, and other hazardous chemicals. The carcinogens present in these chemicals can increase the risk of bronchial tumors.
Exposure to radon gas is one of the most important bronchial carcinoma causes. Radon is a radioactive gas present in old homes, especially those with basements. Inhaling this gas for prolonged periods can increase bronchial tumor risk.
A positive family history of bronchial tumors is also one of the bronchial carcinoma causes. Those with family members diagnosed with lung cancer or respiratory disorders are more likely to develop bronchial tumors.
Long-term exposure to harmful air pollutants can increase one’s bronchial tumor risk.
Pre-existing lung conditions, such as chronic obstructive pulmonary disease (COPD) and interstitial lung diseases, can also serve as possible bronchial carcinoma causes.
Increasing age is one of the possible bronchial carcinoma causes. Older individuals have a higher chance of developing bronchial tumors.
It is important to see a pulmonologist when one starts experiencing persistent respiratory symptoms. Any respiratory symptom that lasts for more than 2 weeks and does not go away with medication should not be ignored. A proper evaluation by a specialist is necessary in such cases.
Doctors recommend multiple tests for an accurate bronchial cancer diagnosis. Along with helping specialists arrive at a conclusive diagnosis, these tests also help in personalized treatment planning, treatment response monitoring, and relapse evaluation. Once the disease is diagnosed and staged, a personalized treatment plan is devised, which may be unimodal or multimodal. Surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy are commonly recommended for bronchial tumor treatment.
One of the first steps in bronchial cancer diagnosis is obtaining detailed information about the patient's medical history and conducting a physical examination to assess symptoms and potential risk factors. If the observations indicate bronchial cancer, further tests will be recommended for a conclusive diagnosis.
Imaging tests help specialists obtain detailed images of the internal structures and determine various tumor parameters, such as the size of the tumor, its shape, and its exact location, along with the extent of its spread. This information can help specialists in the staging of bronchial cancer, treatment planning, response monitoring, and relapse evaluation. The following are the different imaging tests recommended for bronchial cancer diagnosis.
A chest X-ray scan helps specialists gain initial insights into the presence of anomalies in the lungs.
A CT scan helps obtain detailed cross-sectional images, aiding in locating and assessing tumors.
A PET scan helps study the metabolic activity in lung tissues and thereby assists in tumor detection, staging, and treatment planning.
An MRI scan is recommended for more detailed imaging, particularly when assessing soft tissues.
Bronchoscopy is a form of endoscopic procedure recommended for bronchial cancer diagnosis. During this procedure, a thin, flexible tube with a light and camera (bronchoscope) is inserted through the nose or mouth into the airways, allowing visualization of the bronchial passages.
A biopsy is recommended for a conclusive bronchial cancer diagnosis. Various biopsy techniques may be employed to obtain tissue samples for examination and confirmation of malignancy.
A needle biopsy involves using a thin needle to extract tissue for analysis.
A bronchial biopsy involves collecting the tissue sample through a bronchoscope. A bronchoscope carries specialized tools to collect the tissue sample for analysis.
A surgical biopsy involves removing a larger tissue sample through surgery. Further, this sample is analyzed for the presence of cancer cells.
Sputum cytology is one of the most important tests recommended as part of bronchial cancer diagnosis. This procedure involves the analysis of coughed-up mucus for the presence of cancerous cells.
Blood samples may be analyzed to detect certain molecular markers associated with lung cancer. Also, blood tests may be recommended to assess the liver and kidney functions and the levels of various blood cells.
Lung function tests are recommended to assess lung capacity and function to understand the impact of tumor growth on respiratory health.
Genetic testing involves examining the DNA structure of cancer cells to look for specific mutations or gene alterations that may have led to the formation of bronchial tumors. This information helps in personalized treatment planning, assessing familial risk, and understanding the disease prognosis.
Bronchial tumor treatment will often require a comprehensive and multidisciplinary approach wherein specialists from different disciplines go through the case information carefully before creating a treatment plan. Specialists consider various factors, such as the tumor type, stage and grade of the tumor, the patient’s age, and the patient’s overall health condition, before starting the treatment. The following are various options available for bronchial tumor treatment:
Surgery is the first-line treatment in bronchial tumor management, particularly in cases where the tumor is localized or is in its early stages. Depending on the tumor stage, location, and overall health of the patient, different types of surgery may be recommended:
This surgical procedure involves the removal of a lobe of the lung. This procedure is recommended when the tumor is confined to a specific lung lobe. This is a type of organ preservation surgery that removes the cancer-affected portion while preserving lung function.
This procedure involves the removal of the entire lung, and it is recommended if the tumor growth has affected the entire organ.
This bronchial tumor surgery involves the removal of a portion or segment of a lobe. This procedure is recommended for early-stage tumors, and it preserves lung function. Segmentectomy is a relatively more conservative approach than lobectomy.
During a wedge resection, the surgeon removes a wedge-shaped lung portion that contains the tumor. It is usually recommended for small, peripheral tumors.
This surgery is recommended when the tumor is located within the bronchus. The surgeon removes a portion of the bronchus and reattaches the disconnected ends.
This is a minimally invasive surgery wherein tiny incisions are made in the chest to insert specialized surgical tools, a tiny camera, and a light source. VATS is often recommended for wedge resection, lobectomy, and lymph node removal. This surgical procedure benefits patients with shorter hospital stays, reduced blood loss and pain, and a faster recovery.
Chemotherapy is one of the commonly recommended bronchial tumor treatment options. This treatment approach involves the administration of powerful drugs that attack cancer cells or slow down cancer growth. It is commonly used for bronchial tumors that have spread outside the lungs. It may be recommended in combination with other treatments, such as surgery and radiation therapy.
Chemotherapy for bronchial tumors may be administered orally or intravenously.
Radiation therapy is a non-invasive form of bronchial tumor treatment that involves the usage of high-intensity radiation beams to target and destroy cancer cells. Radiation therapy helps in shrinking the tumor, destroying residual cancer cells, and alleviating symptoms associated with advanced-stage cancers. Radiation therapy for bronchial tumors can be administered in two ways: external beam radiation therapy and internal beam radiation therapy.
During external beam radiation therapy, the radiation is delivered from an external radiation source, which is a linear accelerator. During internal beam radiation therapy, or brachytherapy, the radiation source (radioactive material) is placed inside or very close to the tumor. This source emits radiation that destroys cancer cells in the bronchus.
Targeted therapy is a new-age treatment for bronchial cancer management. This treatment approach specifically identifies molecules and cellular pathways involved in tumor growth and administers drugs to disrupt them and control cancer growth. As the name says, this treatment only targets the cancer cells, not the normal ones. The information from the patient’s genetic and molecular profiling is used to chart their targeted therapy.
Targeted therapy is highly recommended in cases where the tumor expresses specific tumor markers or molecular markers.
Immunotherapy is another latest bronchial tumor treatment approach. It involves re-engineering the immune system and stimulating it to identify and attack cancer cells. Different drugs administered as a part of immunotherapy include checkpoint inhibitors and cytokines. Immunotherapy is often administered along with other treatments.
As one of the leading cancer treatment hospitals in India, HCG is equipped with all modern diagnostic and treatment facilities to support effective bronchial tumor management. Supported by a robust team comprising globally-trained specialists and caring and compassionate nursing and administrative staff, HCG offers value-based and patient-centric care to patients diagnosed with bronchial cancer and helps them recover and return to the best state of health possible.
Bronchial tumors can affect anyone. However, it is associated with certain risk factors, and having those risk factors can increase one’s risk of developing bronchial tumors. Since the exact cause of the bronchial tumor is unknown, it cannot be prevented completely. Nonetheless, following certain preventive measures can help reduce the risk of bronchial tumors.
The development of bronchial tumors may be influenced by multiple factors. It is crucial to understand these factors, as it helps identify the individuals who have a higher chance of developing tumors in the bronchus. The following are the most common bronchial tumor risk factors:
Smoking is one of the most important bronchial tumor risk factors. The harmful carcinogens present in tobacco lead to tumor formation by causing inflammation, weakening the immune system, and causing damage to the DNA structure of bronchial cells.
Second-hand smoke, or passive smoking, is as detrimental as active smoking. Inhaling smoke from other’s cigarettes can negatively impact lung health and increase the risk of bronchial tumors.
Radon is a colorless and odorless radioactive gas. Like other radioactive substances, radon decays to emit high-energy particles, which can cause damage to bronchial tissues. Prolonged exposure to these particles can increase the risk of bronchial tumors.
Asbestos is a naturally occurring mineral that is in the form of thin, long fibers. Prolonged exposure to asbestos leads to the accumulation of asbestos in the lungs and bronchi. This will further lead to chronic inflammation and DNA damage, which will eventually lead to bronchial tumor formation. Therefore, asbestos exposure is one of the most important bronchial tumor risk factors.
Those working in the construction and shipbuilding sectors are exposed to asbestos frequently and have a higher bronchial tumor risk. They need to take appropriate preventive measures to reduce their exposure to this mineral.
Occupational exposure to certain harmful chemicals or carcinogens can also increase one’s bronchial tumor risk. According to studies, exposure to arsenic, chromium, nickel, diesel exhaust, vinyl chloride, formaldehyde, mustard gas, and aromatic hydrocarbons can lead to an increased risk of bronchial tumor formation.
Those working with these chemicals must take extra precautions to reduce their bronchial cancer risk.
Those with a family history of lung cancer have a higher chance of developing bronchial tumors. Shared genetic and environmental factors make family history an important bronchial tumor risk factor.
Certain gene mutations increase the risk of bronchial tumors by causing uncontrolled cell division. The following are the different genetic mutations that contribute to increased bronchial tumor risk:
Increasing age is an important risk factor for bronchial cancer. Older individuals have a higher risk of developing bronchial tumors.
Bronchial tumors are observed to be more common among certain ethnic groups. Studies have shown that African Americans have a higher risk of developing lung cancer, including bronchial tumors, when compared to other ethnicities.
There are no known ways to prevent bronchial tumors completely. Certain preventive measures, however, can help reduce the risk of bronchial tumors. The following are the different bronchial tumor prevention measures:
Quitting tobacco and avoiding exposure to secondhand smoke is the most effective bronchial tumor prevention measure. This will also have a positive impact on overall lung health.
Being mindful of your surroundings and limiting exposure to harmful chemicals helps increase the chances of bronchial tumor prevention.
Living spaces must have excellent ventilation. One may use air purifiers to ensure that the indoor air quality is good. Minimizing exposure to harmful pollutants can help one reduce their bronchial tumor risk.
Having a balanced diet that comprises healthy carbohydrates, proteins, healthy fats, fibers, antioxidants, and other essential nutrients may positively impact lung health and reduce the risk of bronchial tumors.
Regular exercise contributes to better lung health and thereby helps in bronchial tumor prevention.
Limiting alcohol consumption is another important measure that can help reduce bronchial tumor risk.
Adequate hydration is extremely important for optimum lung health and bronchial tumor prevention.
Certain infections can hamper respiratory functions and lung health, which may eventually lead to an increased risk of bronchial tumors. Taking appropriate shots for infections, such as influenza, pneumonia, etc., can help one reduce their bronchial tumor risk.
The bronchial tumor affects the lungs, or the bronchus, to be more specific. Bronchial tumors can either be benign or malignant. Depending on this, these tumors are classified into various types. Based on the severity of the disease, bronchial cancer is categorized under stages 0, 1, 2, 3, and 4. Stages 0 and 1 refer to the early stages, and stage 4 refers to the advanced stage. The key to the effective management of bronchial tumors lies in early detection and timely treatment.
