Cancer of bronchial tubes

Description:

Cancer of bronchial tubes and lung usually consider together, combining them the name "bronkhopulmonalny cancer". Distinguish two forms: the central cancer of a lung proceeding from a large or small bronchial tube and the peripheral cancer developing from the tissue of a lung. Distinguish the central cancer of a lung growing preferential inside - or peribronkhiapno (80% of cases); peripheral cancer; the mediastinal form, a miliary (nodular) carcinosis, etc. is seldom diagnosed.

Symptoms of Cancer of bronchial tubes:

Symptoms of bronkhopulmonalny cancer are various depending on where there is primary tumor - in a bronchial tube or in lung tissue. At bronchial tube cancer (the central cancer)  the disease usually begins with dry hoarse cough, and then there is a phlegm, is frequent with blood impurity. Periodic causeless emergence of an inflammation of a lung - the so-called pneumonitis which is followed by strengthening of cough, high temperature, the general weakness, sometimes stethalgias is very characteristic of this form. As the reason of development of pnevmoiit serves temporary bronchial obstruction a tumor owing to the joining inflammation. At the same time there comes the atelectasis (bezvozdushnost) of this or that segment or a lung lobe which inevitably is followed by the outbreak of an infection in the atelektazirovavny site. At reduction of an inflammatory component around a tumor or disintegration its gleam of a bronchial tube is partially recovered again, the atelectasis disappears, and all phenomena temporarily stop to flash again in several months. Very often these "waves" of a pneumonitis take for flu, an exacerbation of bronchitis and carry out drug treatment, without inspecting the patient radiological. In other cases carry out raying of lungs after subsiding of the phenomena of a pneumonitis when the atelectasis symptom, characteristic of cancer, disappears, and the disease remains not distinguished. Further the course of a disease accepts resistant character: persistent cough, the increasing weakness, temperature increase and stethalgias. Disturbances of breath can be considerable at development of hypoventilation and atelectasis of a share or all lung. For peripheral cancer of the lung developing in the pulmonariest fabric, an onset of the illness almost asymptomatically. In these stages the tumor is quite often found accidentally at preventive radiological inspection of the patient. Only with the increase in the sizes joining an inflammation or at germination by a tumor of a bronchial tube or pleura there is a bright symptomatology of severe pains, cough with temperature increase. In the started stage owing to spread of a tumor to a pleural cavity cancer pleurisy with the progressing accumulation of a bloody exudate develops.

Reasons of Cancer of bronchial tubes:

Chronic inflammatory processes can precede development of cancer of bronchial tubes: chronic pneumonia, a bronchoectatic disease, chronic bronchitis, hems in the easy ambassador of earlier postponed tuberculosis, etc. A considerable role is played also by smoking as, according to the majority the statistician, lung cancer at smokers is observed considerably more often than at non-smoking. So, when smoking two and more packs of cigarettes in days the frequency of cancer of lung increases by 15 - 25 times. Other risk factors - work on asbestos production, radiation.

Cancer therapy of bronchial tubes:

The choice of treatment depends on a histologic form of cancer, its prevalence, existence of metastasises. At not small-celled cancer of a lung cancer therapy of a lung can be both purely surgical, and combined. The last method yields the best long-term results. At the combined treatment it is begun with carrying out a remote gamma therapy on a zone of primary tumor and metastasises. After an interval of 2-3 pedel undertake surgical intervention: removal of all lung - a pneumonectomy - or removal one (two) a share - a lobectomy and a bilobectomy. Lung operations, especially at the weakened cancer patients, - extremely responsible and heavy intervention demanding special training of the patient, high qualification of the surgeon, skillful anesthesia and careful postoperative leaving. Training of patients consists of fortifying means - full, protein-rich and vitamins of food, antiinflammatory therapy in the form of the general antibiotiko-and a sulfannlamidoterapiya, and also local leading of antibiotics via the bronchoscope (medical bronkhoskopiya), purpose of tonic cardiovascular means and medical, especially respiratory, gymnastics. In the postoperative period of the patient it has to be provided with constant supply of oxygen. After an exit from an anesthesia it is given a semi-sitting position and watch closely a condition of pulse, arterial pressure, a respiration rate and a habit view of the patient. Besides, in the first 2-3 days carry out active aspiration from a pleural cavity through the left drainages by means of a suction. Constant control behind active aspiration from drainages because the delay of the streamed blood and air in a pleura threatens with mediastinum shift with heavy disorders of action of the heart and a possibility of the subsequent suppuration with development of an empyema of a pleura is necessary. Usually after operation appoint a course of antibiotics and other medicines depending on a condition of the patient, volume of operation and the arising complications. The diet of patients does not change, except for the first days when the diet is a little limited. In the postoperative period from the second day begin respiratory gymnastics for improvement of blood circulation and the prevention of congestive pneumonia in a healthy lung. A recurrence of cancer of lung arises after not enough radical operations, usually in the form of a tumor regrowth in the left bronchial tube stump when there was a considerable infiltration of its wall far beyond visible limits of a tumor. Treatment of a recurrence usually especially palliative. At the disseminated form of a disease of the main method of treatment is chemotherapeutic. As an additional method apply radiation therapy. An operative measure is applied very seldom. At widespread cancer, existence of the remote metastasises, damage of supraclavicular lymph nodes or exudative pleurisy the combined chemotherapy is shown. In the absence of effect of chemotherapy or existence of metastasises in a brain radiation gives palliative effect. At very common, inoperable forms of cancer of lung with the palliative purpose conduct a remote gamma therapy or courses of chemotherapy, sometimes combining both of these methods. Palliative radiation therapy or treatment by antineoplastic means allows to receive temporary improvement and to prolong life to the patient. Innidiation of cancer of lung goes in both the lymphogenous, and hematogenous way. Lymph nodes of a root of a lung, mediastinum, and also more remote groups on a neck, in supraclavicular area are surprised. Gematogenno cancer of a lung extends in a liver, bones, a brain and in the second lung. Small-celled cancer differs in an early metastaeirovaniye and an aggressive current. The forecast at cancer of a lung depends first of all on a process stage, and also from a histologic picture of a tumor - anaplazirovanny forms very zlokachestvenno proceed. At not small-celled cancer of a lung survival - 40-50% in the I stages and 15-30% in the II stage. In the started or inoperable cases radiation therapy gives 5-year survival within 4-8%. At cancer limited small-celled at the patients who received the combined chemotherapy and radiation, indicators of long-term survival fluctuate from 10 to 50%. In cases of widespread cancer the forecast adverse. The maximum survival is reached after expanded removal of mediastinal lymph nodes. Radical surgical intervention (a pneumonectomy, a lobectomy with removal of regional lymph nodes) manages to be carried out only at 10-20% of patients when cancer of a lung is diagnosed in early stages. At a locally-spread form of a disease make an expanded pneumonectomy with removal of bifurcation, trakheobronkhiapny, lower paratracheal and mediastinal lymph nodes, and also if necessary with a resection of a pericardium, a diaphragm, a chest wall. If operation is impossible because of prevalence of process or in connection with existence of contraindications, carry out radiation therapy. The objective effect which is followed by significant symptomatic improvement is reached at the same time at 30-40% of patients.