Thoracic Cancer

    Last updated date: 07-May-2023

    Originally Written in English

    Thoracic Cancer

    Thoracic Cancer

    Lung cancer, esophageal cancer, and cancers of the mediastinum (the area between the lungs), pleura (the membrane that lines the thoracic cavity and surrounds the lungs), airway, thymus gland, and heart are all examples of thoracic cancers.

    Cancers that originate elsewhere in the body can spread to the chest. Mesothelioma is cancer that starts in the chest or belly lining and spreads to the lungs and other chest organs and tissues.

    Lung cancer, also known as bronchogenic carcinoma, is a type of cancer that starts in the lung parenchyma or the bronchi. In the United States, it is one of the top causes of cancer-related mortality. Since the 1980s, lung cancer has claimed the lives of more women than breast cancer. In the United States, it is estimated that 220,000 new cases of lung cancer are diagnosed each year, with 165,000 individuals dying from the disease. It's worth noting that lung cancer was a relatively uncommon disease at the turn of the century. Its remarkable rise in recent decades is mostly due to an increase in both male and female tobacco smoking.


    Lung Cancer

    Lung Cancer

    Lung cancer is the biggest cause of cancer mortality in both men and women, and it takes a long time to develop and is difficult to diagnose early on when it has a better chance of being cured. Lung cancer kills more Americans each year than breast, prostate, and colon cancers combined.

    The lungs are two sponge-like organs that transport air into and out of the body. They are located in the chest. The lungs are responsible for taking in oxygen and exhaling carbon dioxide gas. The pleura, or lining around the lungs, protects them while also allowing them to move during breathing. The trachea is responsible for bringing air into the lungs. It is divided into bronchial tubes, which are further divided into bronchioles, which are smaller extensions.

    Most lung cancers start within the lining of the bronchi, but they will also begin in other areas, like the trachea, bronchioles, or alveoli. As cancer grows, cancerous cells can break away and spread to other parts of the body in a process called metastasis. Lung cancer may be a life-threatening disease because it often spreads this way before it is detected.

    However, up to 81 percent of lung cancers are curable if caught early, and researchers are performing new tests to make this a reality.

    Doctors also offer screenings for longtime smokers and still improve treatment for the disease, including precisely targeted radiation, minimally invasive procedures, and therapies that focus on specific tumor characteristics.


    Lung Cancer Types

    Small cell lung cancer and non-small cell lung cancer are the two main forms of lung cancer, called after how the cells appear under a microscope. Lung carcinoid tumors are a third form that is far less common. Treatment options are influenced by the type of cancer you have.

    1. Non-small lung cancer

    Non-small cell lung cancer accounts for around 81% of lung cancer cases, and it develops and transmits to other parts of the body more quietly than small cell lung cancer. The following are the primary subtypes of non-small cell lung cancer:

    • Adenocarcinoma: Cancer that develops in epithelial tissue cells, usually in the lungs' outer layer.
    • Squamous cell carcinoma: Usually seen near an air tube in the center of the lung
    • Large cell carcinoma: This type of cancer can develop in any section of the lungs and is the most aggressive in terms of growth and metastasis.


    2. Small cell lung cancer

    Small cell lung cancer, which accounts for 10 to 17% of all incidences, is fast-growing, commonly detected in both lungs, and usually asymptomatic until it progresses. It's virtually usually linked to smoking, and it spreads quickly once discovered. Small cell carcinoma has two subtypes:

    • Small cell carcinoma (oat cell cancer)
    • Combined small cell carcinoma is a type of small cell carcinoma that includes both small cells and non-small cells.


    3. Mixed small/large cell lung cancer

    When cancer contains characteristics of both small and non-small cell lung cancer, it is referred to as this type of cancer.


    4. Lung carcinoid

    Other lung tumors exist in addition to the two primary categories. Lung carcinoid tumors are the third most common kind of lung cancer, accounting for less than 5% of all occurrences. The majority of cancers do not spread quickly and can be surgically removed.

    Cancer can spread to the lungs through the circulation or lymphatic system from other parts of the body. Even when cancer has spread to the lungs, it is still categorized and treated according to its origin.


    Lung Cancer Diagnosis

    Lung Cancer Diagnosis

    Lung cancer can be detected early, when it is most curable, using low-dose CT scan technology. This non-invasive, fast scan can reveal useful-even lifesaving- information. It is frequently covered by health insurance.

    However, like with other health conditions, the best strategy is prevention. Lung cancer is one among the foremost preventable kind of cancer.

    According to the American Cancer Society, tobacco use causes more than 78% of lung cancer fatalities, making stopping smoking the single most significant step in lowering the risk.

    Lung cancer, one of the most aggressive types of cancer, has the potential to spread to other parts of the body and cause additional life-threatening complications. It is critical to detect and treat cancer as soon as feasible. When a patient appears with symptoms that could indicate lung cancer or another type of disease, interventional pulmonologists will employ a variety of techniques to obtain a precise diagnosis.

    A biopsy is a procedure in which a small sample of tissue from the lung is removed to confirm the existence of malignancy. The tissue will next be examined under a microscope by a pathologist to see if malignancy is present. This tissue can be obtained through a variety of methods, including:

    • Navigational bronchoscopy is a cutting-edge imaging technique that enables less invasive sampling of lesions located throughout the lungs. Navigational bronchoscopy eliminates the need for high-risk invasive procedures like chest needle biopsies and open surgeries, allowing for earlier lung cancer detection. As a result, survival rates improve and the unpleasant wait-and-see strategy after a thoracic CAT scan is eliminated. The surgeon will use a specialized catheter to create a 3-D electromagnetic map of the lungs during the procedure. After reaching the lesion, the surgeon will remove the catheter and introduce an ultrasound device to see the lesion and its location in the airway. The surgeon will use small surgical equipment to extract enough tissue for the procedure as near to the lesion as possible.
    • Navigational bronchoscopy is a painless technique performed under general anesthesia that takes about one hour. There is no need to make two visits or have two surgical procedures that require anesthesia because doctors offer endoscopic and endobronchial ultrasonography at the same time as the navigational bronchoscopy exam.
    • Advanced diagnostic tools such as endoscopic and endobronchial ultrasonography allow real-time imaging of problems inside the chest. These processes are so powerful that they can sometimes obviate the need for the additional verification processes. Endoscopic and endobronchial ultrasounds employ real-time technology, and only a few doctors are trained to perform these.
    • Fine-needle aspiration during which a needle is inserted into the tumor by the doctor. The abnormality inside the lungs or lymph nodes is then extracted, along with tissue and cells. The doctor may suggest utilizing an ultrasonography or CT scan as a needle guide in some circumstances.


    Lung Cancer Treatment

    Lung Cancer Treatment

    Depending on the type of lung cancer and how far it has gone, there are numerous treatment options. Surgery, chemotherapy, radiotherapy, targeted therapy, or a combination of these therapies can be used to treat non-small cell lung cancer. Small cell lung cancer is usually treated with a combination of radiotherapy and chemotherapy.

    • Surgery with a procedure in which surgeons remove cancerous tissue from the body.
    • Chemotherapy using special medications to reduce or kill cancer cells. The drugs can be pills that you consume or medications that are injected into the veins, or both.
    • Radiotherapy is a type of treatment that involves the use of high-energy radiation to kill cancer.
    • Targeted therapy using medications to arrest cancer cells growing and spreading. The drugs are often taken orally or administered intravenously. Before targeted therapy is used, tests are going to be performed to work out if it is appropriate for the cancer type.

    In the treatment of lung carcinoma, doctors from various specialties frequently collaborate. Pulmonologists are doctors who specialize in lung illnesses. Surgeons are medical professionals who perform procedures. Thoracic surgeons specialized in surgery of the chest, heart, and lungs. Medical oncologists are doctors who specialize in using medications to treat cancer. Radiation oncologists are doctors who use radiotherapy to treat cancer.


    Malignant pleural diseases

    Malignant pleural diseases

    A double-layered membrane tissue that wraps around the lungs and lines the chest wall is known as the pleura. The pleural cavity is a narrow area between these two layers that is filled with pleural fluid to help the layers shift as the lungs move during breathing.

    The pleura can be affected by three different conditions:

    • Pleural plaque: Asbestos fibers cause the pleura to thicken, scaly, and hardness when they enter the lungs.
    • Pleural tumors are benign and malignant tumors that form in the pleura (the lining of the lung).
    • Pleural effusion: An accumulation of pleural fluid in the pleural cavity caused by a variety of benign and malignant diseases.

    The most significant risk factor for developing pleural problems is asbestos exposure.


    Pleural Diseases Symptoms

    Pleural disorders are usually discovered on a chest X-ray. Chest pain, breathing difficulty, and coughing are all symptoms of pleural diseases.


    Pleural Diseases Diagnosis

    Pleural Diseases Diagnosis

    The doctor will utilize numerous diagnostic approaches to make an accurate diagnosis when a patient appears with symptoms that could indicate pleural problems. These may include the following:

    • Bronchoscopy is a procedure that allows the doctor to examine the lungs and airways through a tube that is passed through the mouth or nose. It enables a visual examination of the lungs and airways in order to detect cancer, as well as the removal of a sample of tissue for testing if cancer is detected. A thoracic or chest surgeon, or a pulmonologist, usually performs the test.
    • Thoracentesis is a procedure in which a needle is put into the chest and a little amount of fluid is taken out. This fluid is evaluated for signs of cancer and other problems.
    • Video-assisted thoracoscopy is a videoscope is implanted through two tiny cuts while you are under general anesthesia. The doctor will take fluid and/or lung tissue from you and check it for cancers and other problems. In most cases, this procedure necessitates a night hospital stay.


    Pleural Diseases Treatment

    Treatment will be determined by the diagnosis. In some cases, the treatment will be focused on symptom management. In some circumstances, the treatment will focus on addressing the underlying problem.


    Esophageal Cancer

    Esophageal Cancer

    The muscular walls of the esophagus (placed right beneath the trachea) tighten as a person swallow, pushing food into the stomach. Mucus is produced by glands in the esophagus lining, which keeps the tube wet and makes swallowing smoother.

    Squamous cell carcinoma and adenocarcinoma are the two main forms of cancer that start in the esophagus, depending on the type of malignant cells.

    Squamous cell carcinoma is a type of cancer that develops in the squamous cells that line the esophagus, and it commonly affects the upper and middle portions of the esophagus.

    Adenocarcinoma is cancer that develops in glandular tissue, most commonly in the lower esophagus near the stomach. Adenocarcinomas account for 9 out of 10 malignant stomach cancers.


    Esophageal Cancer Symptoms

    Esophageal Cancer Symptoms

    Early signs and symptoms of esophageal cancer are frequently absent. However, as cancer progresses, the following symptoms may appear:

    • Swallowing is difficult or uncomfortable.
    • Weight loss that is extreme
    • Throat or back pain, pain below the breastbone, or pain between the scapulae
    • Hoarseness or a persistent cough
    • Vomiting
    • Coughing blood

    Esophageal cancer or other disorders might induce these symptoms. It is critical to urge medical advice.


    Esophageal Cancer Risk Factors

    Esophageal Cancer Risk Factors

    The specific causes of esophageal cancer are unknown. According to studies, any of the following factors can raise the chance of esophageal cancer. When two or more of the following factors are combined, the risk is greater:

    • Age, as people get older, they are more prone to develop esophageal cancer; most people who develop esophageal cancer are above the age of 58.
    • Men are more likely than women to develop esophageal cancer.
    • Tobacco use is one of the most important risk factors for esophageal cancer is smoking cigarettes or using smokeless tobacco.
    • Alcohol abuse, whether chronic or heavy, is another strong risk factor for esophageal cancer. People who consume both alcohol and smoke have a higher risk of developing esophageal cancer.
    • Barrett's esophagus: If stomach acid often backs up into the esophagus, a condition known as gastric reflux, the tissues at the lower part of the esophagus can become inflamed. Cells in the inflamed section of the esophagus may alter over time, resembling those that line the stomach. Barrett's esophagus, often known as Barrett's cancer, is a premalignant disease that can lead to esophageal adenocarcinoma.
    • Other types of irritation including irritation or injury to the esophageal mucosa, such as swallowing alkali or other caustic substances, can raise the risk of esophageal cancer.
    • Patients who have had other head and neck cancers, such as esophageal cancer, have a higher risk of having second cancer in the head and neck area.


    Esophageal Cancer Diagnosis

    The doctor can inspect the esophagus and collect tissue to be evaluated later in the lab for any symptoms of disease using an esophagoscope, which is a thin, illuminated tube.


    Esophageal Cancer Treatment

    Treatment for esophageal cancer is dependent on a number of factors, including the size, location, and spread of the tumor, as well as the patient's overall health. Each patient receives a specific treatment plan that may involve surgery, chemotherapy, and/or radiotherapy.

    A gastroenterologist (a doctor who specializes in detecting and managing digestive system diseases), a surgeon, a medical oncologist (a doctor who specializes in diagnosing and treating cancer), and a radiation oncologist are commonly part of the treatment team.

    Doctors frequently encourage patients to see a dentist for a dental exam and treatment before starting cancer treatment since cancer treatment can leave the mouth sensitive and susceptible to infection.

    The surgical resection of the esophagus is known as esophagectomy. There are two types:

    • Trans-Hiatal esophagectomy. The neck and abdomen are both operated on during a trans-Hiatal esophagectomy.
    • Transthoracic esophagectomy. The chest is opened during a transthoracic esophagectomy.

    In most situations, the doctor will construct a new esophagus from the stomach. The doctor will offer you detailed information on how to get ready for the surgery.


    Mediastinal Mass

    The mediastinum is the area of the chest between the two lungs in the middle. A mediastinal mass refers to any growth discovered in this cavity. These anomalies might be cancerous or non-cancerous.


    Mediastinal Mass Symptoms

    Mediastinal Mass Symptoms

    There may be no symptoms when thoracic cancer first appears. CT scans done for various reasons are commonly used to detect abnormalities of the mediastinum. Symptoms, on the other hand, could include:

    • Pain in the chest
    • Cough that does not go away
    • Sweats at night
    • Weight loss that isn’t explained
    • Fever


    Mediastinal Mass Diagnosis

    When a patient has symptoms that could indicate a mediastinal problem, the doctor will utilize a variety of diagnostic tools to obtain an accurate diagnosis, including:

    • Endobronchial Ultrasound is a cutting-edge diagnostic technique that allows for real-time imaging of abnormalities in the lungs. These techniques are so powerful that they can sometimes obviate the need for additional testing phases. Endobronchial ultrasounds need a lengthy learning curve, and only a few clinicians are qualified to conduct them. The thoracic surgeons, on the other hand, are well-trained to conduct these treatments correctly.
    • Mediastinoscopy. The surgeon will make a cut at the top of the breastbone and introduce a thin, illuminated tube into the chest to examine the inside. Any anomalies or lymph nodes that may be affected will be extracted and examined in the lab.
    • Mediastinotomy. A small cut is made into the side of the breastbone and a biopsy of the suspicious lump is taken under general anesthesia.


    Mediastinal Mass Treatment

    Depending on the type of tumor and whether it has spread, surgery, chemotherapy, and radiation are the most common treatments for mediastinal tumors.



    Lung cancer and other thoracic cancers are the biggest cause of mortality worldwide, and surgical excision is the only way to cure people with these types of diseases.

    This is mostly owing to the fact that lung cancer and other thoracic cancers develop and progress due to a number of variables, and the diagnostic procedures available for earlier and efficient identification are insufficient at this time.

    Despite the fact that lung cancer and other thoracic cancers research results have grown considerably in recent years, there is currently no resource dedicated to lung cancer molecular biology.