Tracheal cancer

synonym

Tracheal carcinoma, tracheal carcinoma

definition

Tracheal cancer is a tumor in the field of windpipe (Trachea) and is one of the head-, neck- tumors. A tumor is generally understood to be a unhindered growth of the fabric to one tumor (Neoplasm, neoplasm). This process can also take place without growth-triggering factors. One then speaks of one autonomous tissue formation. It will benign (benign) Tumors and malicious (malignant) Differentiated tumors. The subdivision takes place according to the growth characteristics of the new formation and is decisive for the selection of the appropriate therapy.

The benign tumors grow slowly and displaced, which means that they are not invasive into the surrounding cell structures. This new formation can usually be clearly distinguished from normal tissue with the naked eye and has very good chances of recovery. The malignant tumor, which grows rapidly and destructively (invasively destructive) into the adjacent tissue, must be distinguished from this. It can hardly be distinguished from normal tissue. In addition, these tumor cells can spread and trigger further tumors in other regions of the body. This is known as metastasis.

Classification

Epithelial tumors go from Plate or gland cell associations from what is also in the Trachea is available. As Papillomas become benign tumors of the Squamous epithelium referred to in Skin and mucous membrane occur as well as in Tissue of the urinary bladder (Urothelium). Adenomas are more benign tumors and go from Glandular epithelium out. These cell associations are called malignant tumors Carcinomas and make up about 90% of malignant tumors.

Mesenchymal tumors are generally tumors caused by muscle-, Connective or supporting tissue go out. Since the windpipe out Cartilage braces exists, tumors can also develop from this material. It also includes tumors of the Vascular tissue and the Blood cells. Under mesenchymal one understands cells that are still in one Precursor stage are located. Many different benign and malignant tumors of these are also known.

causes

As the main cause of the Tracheal cancer will the massive consumption of tobacco and their carcinogenic (carcinogenic) ingredients. Even the excessive Supply of high percentage alcohol is one of the main risk factors.

Other harmful substances are Asbestos, arsenic, vehicle exhaust fumes or radioactive substances. These can through constant contact in everyday working life cancer trigger. Also genetic factors such as a hereditary disposition or certain sensitivity (predisposition) or the accumulation of cancer in the family are generally among the causes. Tumors in the windpipe can also through Spread from other primary tumors have arisen.

The process of developing a Tumor takes place at the molecular level and is used in medicine Carcinogenesis called. By a Change (mutation) in DNA this process is initiated (initiation). Often such changes can no longer be remedied by the DNA's own repair mechanism. This is finally followed by a disruption of the cells and leads to unimpeded growth (proliferation) of these already damaged cells. This stage of tumor development is called Latency phase designated. The original healthy cell is now changed (pathologically) to such an extent that factors in the cell which inhibit uncontrolled growth remain ineffective. In contrast, the change within the cell can also be a Overactivity of growth-promoting factors have triggered. These are then saved as Oncogenes designated.

frequency

The primary as well as the secondary caused by metastases Tracheal cancer are rather rare. The Frequency is around 2% and is mostly related to the Tobacco abuse. The most common tracheal cancer occurs in the lower sections. From the division (bifurcation) of the windpipe into their two main stems for the left and right Lungs the tumors are already dem Lung cancer (Bronchial carcinoma) added. These are far more common.

diagnosis

With regard to therapy, diagnostics play a very important role. By means of a detailed examination, the tumor is determined for its histological type and its extent and size. The information from which cells the tumor ultimately emerges is crucial for the selection of the right therapeutic agent.

During the diagnosis, the patient is first asked about his or her complaints and abnormalities in a conversation (anamnesis). This also includes receiving detailed information about whether cancer is already known in the family and whether there is a system.

This is followed by an assessment of the throat, larynx and the nasal and oral cavities as well as palpation for swelling and pain. In addition to examining the blood, x-rays are also made in 2 planes (from the front and side), a computed tomography (CT) or magnetic resonance tomography (MRT) for a better representation of the soft tissues.

An examination of the lung sputum is also useful in order to determine the contents for any inflammation or infectious changes.

Other basic diagnostic examinations for suspected tracheal cancer are endoscopic procedures such as bronchoscopy, which can be carried out into the lobes of the lungs, and panendoscopy. These are minimally invasive interventions with which cavities can be viewed particularly well. With the help of a flexible endoscope or a rigid tube, the trachea and, especially with panendoscopy, the esophagus, are visualized under or with local anesthesia. This allows the extent and location of the tumor to be assessed. In order to confirm or exclude the diagnosis, samples are taken from the degenerated tissue and determined histologically / cytologically. Since most of the tumors in the area of ​​the trachea are spread out, it is important to identify the primary tumor and possibly other spreads (metastases) during diagnosis. In addition to the aforementioned CT and MRT, it is also advisable to do ultrasound examinations of the abdomen, for example, and whole-body positron emission tomography.

Read more on the topic: Positron Emission Tomography (PET)

Often, swollen lymph nodes can also be an indication of the spread of the cancer. Suspicious lymph nodes should be checked microscopically.

The aim of the entire diagnosis is to precisely characterize the tumor and, accordingly, to work out the best possible individual therapy for the person affected.

Symptoms

Since tracheal cancer is usually not a primary tumor, but is caused as a spread, symptoms often appear in advanced tumor stages. Often this means that the cancer is diagnosed later. The symptoms can arise especially when degenerate tissue grows into the windpipe from the surrounding neighboring organs. These include malignant larynx tumors, cancer of the lower pharynx, esophageal cancer, and thyroid cancer.

The patient's clinical complaints can be varied. Typically, coughs that are chronic, i.e. H. strengthens for more than 6 months. It can also be permeated with blood and appear with different consistencies and characteristics. Many patients report increasing difficulty in breathing up to difficulty breathing and / or clearly audible whistling tones. One then speaks of dyspnea, which can be caused by the narrowing of the airways.

Depending on the size and location of the tumor, disturbances in voice formation or swallowing can also arise, as the tumor crosses the organ borders from the trachea and significantly impairs the function of the glottis or esophagus. Accordingly, hoarseness can also occur. In addition to these organ-related symptoms, which are triggered directly by the tumor, the characteristic symptoms of cancer can also occur.

The term B symptoms generally includes weight loss, fever and fatigue. The patients often suffer from loss of appetite and nausea as well as progressive deterioration in performance. In addition, skin changes such as itching can occur. Last but not least, the person affected is immunocompromised and can develop secondary infections more quickly. Due to the wide range of symptoms, in most cases the general condition is poor.

These symptoms are very similar to the symptoms of throat cancer.
Learn more about this at: What symptoms indicate throat cancer?

therapy

The Treatment of cancer is often extensive and interdisciplinary. That means doctors from different specialties like Internal Medicine, surgery, Specialists in cancer medicine (oncology) and also Psychotherapists and male nurse form a team to enable optimal care. They discuss the best options for the patient.

Therapy is depending on the size and type of tumor and must also be individually adapted to the advanced stage of the disease. Depending on the cell type, the degenerate tissue speaks differently to one Radiation and / or chemotherapy on. Since metastasis has already taken place in most cases, surgical removal with subsequent chemotherapy is only suitable in rare cases. The focus is then on palliative care of the patient. The aim is to relieve the patient of the pain and maintain or improve the quality of life as much as possible.

Especially important with Tracheal cancer is this Keeping the airways openso that the patient does not get into the situation of shortness of breath. To ensure this, the tumor can be reduced in size with a laser. In extreme cases, the installation of a Tracheotomy (Tracheotomy) to be necessary. Through the chemotherapy it can be the so called ANE syndrome - the treatment leads to stressful side effects such as loss of appetite (A.norexia), nausea (Nausea) and Vomit (E.mesis). A concomitant therapy of these symptoms is necessary to enable the patient a more comfortable therapy and to prevent premature discontinuation of the chemotherapy. Nausea medication and a well adapted one Pain therapy are an integral part of treatment in the Cancer medicine (oncology).

In addition to drug therapy, a psychotherapeutic support offered to the patient. The course of the disease and the treatment practice a lot stress and interventions with regard to coping with the disease and coping with everyday life can have a positive effect on dealing with the disease and ultimately on its further course. The goal is that To ensure quality of life and to support and strengthen the patient in his own resources.

forecast

The 5- year survival rate (5- JÜR) is used as a prognostic value for cancer. Patients, for example, at a Lung cancer suffer and possibly metastases in the windpipe have a 5 JUR of 5%. A prognosis always depends on the stage and extent of the tumor. The earlier the cancer is diagnosed and treated, the better it is.