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Neoplastic changes, like other disease states, can occur in the respiratory tract, or in the lung parenchyma or in the pleura.
They can arise as a result of tumor growth into the lung tissue from the side of the bronchi (so-called bronchial carcinoma), or as a result of primary tumor growth from the cells of the alveolar walls or small bronchioles.
It should be emphasized here that in recent years respiratory system cancers have become the most common cause of death among cancers, especially among tobacco smokers and in large, dusty cities.
In recent years, both among women and, in particular, among men, a dramatic increase in their incidence has been observed, disproportionate to the incidence of other cancers.
The relationship between the occurrence of neoplasms in the respiratory system and smoking is currently considered fully proven.
It is also assumed that over 50% of nonsmokers’ respiratory cancers are caused by the so-called passive smoking, i.e. inhaling tobacco smoke (nicotine) from the environment of smokers. Therefore, smokers cannot put other people at such great risk and expect acceptance and tolerance of smoking in living or working spaces.
Also, inhalation of vapors of many chemicals that irritate the mucosa of the respiratory tract and air contaminated with various smoke and dust particles, especially asbestos, are considered to be further factors contributing to the formation of neoplasms in the respiratory system.
symptoms
As the period of their formation (disclosure) is less known and rather long-lasting, therefore some symptoms and ailments, such as chronic, persistent cough, frequent, recurrent, non-treatable inflammation of the airways and lungs, especially with long-term concomitant fluid in the cavities pleura, hoarseness, and especially the sputum stained with blood, should be a signal for a thorough examination of the respiratory system, so that appropriate treatment is initiated as soon as possible in the event of any changes of this type.
Bronchial cancer
Bronchial cancer is becoming more common recently. Among the unequivocally proven factors contributing to the development of bronchial cancer, smoking should be mentioned. Nicotine, by stimulating the mucous glands to produce mucus, promotes chronic bronchitis, which prevent the snap epithelium from “melting in the mucus” from properly cleaning the respiratory tract of various dusts and pollutants that penetrate during breathing. Thus, when introduced into the respiratory tract, they stick to the bronchial mucosa for a long time and irritate both mechanically and chemically, contributing to neoplastic growth under favorable circumstances.
The neoplasm that grows from the altered bronchial epithelium can grow both into the bronchus, causing a progressive narrowing of its lumen, and into the surrounding lung tissue, resulting in a deepening limitation of the space (tissue) in which essential gas exchange takes place. Relatively quickly metastasizes to the neighboring peribronchial and mediastinal lymph nodes and to other organs of the body (liver, kidneys, bones, etc.).
symptoms
Growing into the lumen of the bronchus, it may initially give no symptoms, and if it does, then:
• usually the earliest symptom is a dry cough,
• later, bloody sputum with the appearance of raspberry jelly is removed,
• then shortness of breath – as an expression of a more significant narrowing of the bronchial lumen,
• at a later stage, pleural effusions may be added.
As a result of this narrowing, there is a poorer ventilation of a specific part of the lung and the development of atelectasis. Atelectasis usually promotes inflammatory complications in its area, and even the formation of abscesses within them.
Diagnosis
Final diagnosis requires hospital observation, chest X-rays, and sputum cytology. The bronchoscopic examination of the respiratory tract and the histopathological examination of specimens from suspicious places are decisive.
Treatment
Depending on the location and duration of the disease, it is either surgical or chemical. Early diagnosis and appropriate treatment are given a chance of recovery.
Prevention
It consists mainly in general cancer prevention and not smoking – both active and passive – tobacco. It is believed that over 50% of bronchial cancers in non-smokers come from the so-called passive smoking.
Lung cancer
Its features include peripheral location in the lung, slow growth and rare, single metastatic lesions.
The described primary changes in the lungs should be distinguished from secondary metastatic neoplasms to the lungs from the primary tumor located outside the respiratory organ (e.g. stomach, liver, prostate gland). Metastatic lung neoplasms are more common than primary lung tumors.
Diagnosis
With primary lung cancer, it is difficult. Sometimes it requires longer hospital observation, serial radiological and cytological examinations, etc.
Therapeutic and prophylactic management. It is analogous to bronchial cancer. It should be emphasized once again that early diagnosis and appropriate treatment are given a chance of a cure.
Pleural tumors
Pleural neoplasms – as in the lungs – may be primary or – more often – secondary.
Primary pleural neoplasms are usually a rare pleural endothelioma, a neoplasm that grows from altered cells in the endothelial lining the pleural cavity. Sometimes there are other cell types.
symptoms
Pleural endothelioma is usually manifested by chest pain, fever, sometimes coughing, almost always bloody and fairly rapidly growing pleural effusion fluid (cancer cells can be found in the fluid sediment), loss of appetite, and progressive general weakness and weight loss.
Diagnosis
It is possible on the basis of a chest X-ray showing fluid in the pleural cavity, the blood-blood character of the fluid, and, above all, the characteristic tumor cells in its sediment.
Treatment
Chemotherapy and measures adapted to the general condition of the patient and symptoms of the disease are applied.
Secondary pleural neoplasms are much more common than primary ones. Currently, it is widely believed that almost any metastatic tumor can spread to the pleura, e.g. breast, thyroid, ovarian, stomach, bronchial cancer. It is also possible for the tumor to penetrate from an adjacent primary site (chest wall, lung).
Prevention
In prophylaxis of pleural endothelioma, it is recommended to avoid contact with asbestos. Hence the necessity to eliminate asbestos in all technologies of boards and devices with which a person could have direct or indirect contact (e.g. dust).
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