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Bronchial Tumour

The bronchial tumour is a condition where the tumours are formed in the bronchial tubes. The occurrence of bronchial tumours is strongly associated with cigarette smoking (both active and passive).

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Overview

The bronchial tumour is a condition where the tumours are formed in the bronchial tubes. Bronchial tubes connect the windpipe to the lungs and let the air in and out of the lungs. Bronchial tumours cause breathing difficulties and start spreading to nearby organs as the disease progresses.

The occurrence of bronchial tumours is strongly associated with cigarette smoking (both active and passive).

Types

Following are the different types of bronchial tumours:

  • 1. Endobronchial Tumours: Up to 80% of the bronchial tumours among children are endobronchial tumours.
  • 2. Hemangiomas: Rare form of bronchial tumours that could be benign and malignant.
  • 3. Papillomas: Less common benign tumours that grow in nipple-like or finger-like fronds.
  • 4. Inflammatory Pseudotumours: Usually benign, inflammatory pseudotumours mimic the neoplasms and are of rare occurrence.
  • 5. Leiomyomas: Also called fibroids, leiomyomas form from the smooth muscle tissues that line the bronchi. These are of rare occurrence too.
  • 6. Mucous Gland Tumours: Arise from the bronchial mucus glands and are benign in most cases. Mucous gland tumours are rare.
  • 7. Glomus Tumours: These tumours are the neoplasms that start in glomus cells. These are mostly benign and are of rare occurrence.
  • 8. Bronchial Adenomas: These arise from the mucous glands and ducts of the lung, windpipe and salivary glands. Bronchial adenomas can be cancerous and can spread to other parts of the body.
  • 9. Neuroendocrine Tumours: These are the neuroendocrine neoplasms of the lung, which are slow-growing and uncommon.

Symptoms

Early symptoms of bronchial tumours are mild and are often associated with less severe health conditions. Following are the symptoms of bronchial tumours:

  • Blood in cough
  • Persistent coughing
  • Breathing difficulties
  • Chest Pain
  • Wheezing
  • Sweating
  • Facial flush (redness and warmth)
  • Fever
  • Fast heartbeat
  • Weight loss and weakness
  • Diarrhoea
  • Hyperpigmentation
  • Increased facial and body hair

Causes

There are several factors that are associated with an increased risk of bronchial tumour development. Following are the risk factors for bronchial tumour:

  • Smoking (Active/Passive): Tobacco or cigarette comprises at least 60 carcinogenic chemicals that increase the risk of multiple cancer types. Both active and passive smoking are observed to increase the risk of bronchial tumours.
  • Exposure to Harmful Chemicals and Radioactive Components: Exposure to asbestos, sulphate aerosols, coal smoke and other harmful chemicals increase the risk of bronchial tumours. Radon exposure is also considered a risk factor for this disease.
  • Family history of Bronchial Tumours: It is reported that about 8-14% of bronchial tumours are genetically inherited. 

Diagnosis

There are multiple tests to detect and diagnose bronchial tumours:

a. Sputum Cytology: If a bronchial tumour is suspected, sputum cytology may be recommended where the sputum or phlegm is examined.

b. Blood Tests: Blood tests are carried to detect tumour markers that are specific to bronchial tumours. Blood tests also help specialists in understanding the overall health of the patient before recommending treatment plans.

c. Imaging Tests: Imaging tests such as CT scan, MRI scan and chest X-ray help in tumour detection. These tests also help specialists with details, such as the exact location, shape and size of the tumour, which are necessary for treatment planning.

d. Bronchoscopy: During bronchoscopy, a fibre optic viewing tube (bronchoscope) is inserted through the throat into the windpipe and the airways of the lungs to find signs of tumour growth.

d. Biopsy: Biopsy is necessary for a definitive diagnosis as it not only helps in confirming the diagnosis but also helps with additional details, such as the nature of the tumour. Biopsy for bronchial tumours is done in the following ways:

  • Trans-bronchial fine-needle biopsy: This is a procedure where a small sample of tissue is excised during the bronchoscopy and examined under the microscope.
  • Transthoracic needle biopsy: This procedure is performed if the tumour is hard to access or is located in the organ periphery. During the procedure, a long needle is inserted between the ribs for the tissue sample collection.
  • Thoracotomy: During this procedure, an incision in the chest wall is made to access and inspect the organs present in the chest cavity. This procedure may be performed in rare cases where neither fine-needle biopsy nor transthoracic needle biopsy can provide detailed information on the disease.

Treatment

Multiple factors such as the type of the tumour, the stage, the grade, the patient’s age and the overall condition of the patient are taken into consideration before recommending treatment options for bronchial tumours. In most cases, bronchial tumours are classified as benign, and therefore, surgery is the main line of treatment.

a. Surgery: Surgery removes the tumour and a small portion of healthy tissues surrounding it. Various surgical management options available for bronchial tumours include:

  • Sleeve resection: This is a procedure that involves the removal of the airway containing the tumour.
  • Segmental resection: This involves the removal of the segment of the lung with tumour.
  • Wedge resection: This procedure removes the small wedge of the lung where the tumour growth is found.
  • Lobectomy: This procedure involves the removal of the lobe of the lung where tumour growth is observed.
  • Endoscopic tumour ablation using laser: This is a minimally-invasive procedure during which the tumour is removed using laser technology with the help of a bronchoscope.

b. Radiation Therapy: Radiation therapy uses high-dose radiation beams to destroy the tumours. Through advanced technology, specialists can now reduce the damage to the surrounding healthy tissues today. Radiation therapy is often combined with surgery and chemotherapy for better clinical outcomes.

c. Chemotherapy: Chemotherapy is also one of the treatment options for bronchial tumours. Chemotherapy may be administered orally or intravenously to destroy the tumour cells. Just like radiation therapy, chemotherapy is often combined with other treatment modalities to increase the overall efficacy of the treatment given.

Frequently Asked Questions

1. Are bronchial tumours treatable?

Bronchial tumours are treatable. There are various treatment options available for bronchial tumours.

Nevertheless, early detection is crucial. Early detection of bronchial tumours not only increases the chances of positive clinical outcomes but also positively impacts the quality of life after the treatment.

2. What are the side effects associated with the treatment of bronchial tumours?

The potential side effects that a patient may encounter depends on his/her treatment plan(surgery/chemotherapy/radiation therapy) and the stage at which the disease is detected and treated.

Potential side effects of bronchial tumour treatment include fatigue, pain, cough, breathing difficulties, blood clots, bleeding, nausea, vomiting, loss of appetite, mouth sores, skin irritations, etc.

As mentioned before, the side effects may vary from patient to patient. Therefore, it is important for patients to talk to their doctor to know the potential side effects of the treatment and ways to manage them.

3. How long does it take for me to recover from bronchial tumour treatment?

The recovery period varies from patient to patient as each patient is treated with a different treatment plan. Some may need surgery alone, whereas a few may need surgery and chemotherapy sessions.

Therefore, it is best to talk to your doctor, who will help you understand the treatment protocols, time for recovery and the measures that you can take to speed up the overall recovery process.

4. Does smoking cause bronchial tumours?

Yes, smoking is one of the biggest risk factors for bronchial tumours. Studies have found that both active and passive (second-hand) smoking can cause bronchial tumours.

5. How to reduce the risk of bronchial tumours?

Some ways that can help you reduce your risk of developing bronchial tumours include quitting smoking and reducing your exposure to harmful chemicals and radioactive substances.

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