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Bronchial Carcinoma – Causes, Symptoms & Treatment

Bronchial carcinoma is a malignant tumor of the bronchi and is the leading cause of cancer-related death worldwide. Early diagnosis significantly improves treatment outcomes.

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Things worth knowing about "Bronchial carcinoma"

Bronchial carcinoma is a malignant tumor of the bronchi and is the leading cause of cancer-related death worldwide. Early diagnosis significantly improves treatment outcomes.

What is Bronchial Carcinoma?

Bronchial carcinoma is a malignant (cancerous) tumor that originates in the mucous membrane cells lining the bronchi – the airway structures within the lungs. It is the leading cause of cancer-related death in both men and women worldwide. It is commonly referred to as lung cancer, although bronchial carcinoma is the more precise term, as the tumor primarily arises in the bronchi.

Causes and Risk Factors

The most significant cause of bronchial carcinoma is smoking, which accounts for approximately 85 % of all cases. Additional risk factors include:

Passive smoking: Long-term exposure to secondhand smoke increases the risk in non-smokers.
Asbestos: Occupational exposure to asbestos fibers is a well-established risk factor.
Radon gas: This naturally occurring radioactive gas can accumulate in buildings and increase cancer risk.
Air pollution: Chronic exposure to fine particulate matter and pollutants raises the risk.
Genetic factors: A family history of lung cancer can increase individual risk.

Types of Bronchial Carcinoma

Medically, two main groups are distinguished:

Non-Small Cell Lung Cancer (NSCLC)

Non-small cell lung cancer accounts for approximately 80–85 % of all cases and is the most common form. It is further divided into:

Adenocarcinoma: The most frequent subtype, often occurring in non-smokers.
Squamous cell carcinoma: Predominantly arises in the larger bronchi and is closely associated with smoking.
Large cell carcinoma: A rarer subtype with rapid growth and spread.

Small Cell Lung Cancer (SCLC)

Small cell lung cancer accounts for approximately 15–20 % of all cases. It grows very rapidly and tends to metastasize early. It is almost exclusively associated with heavy smoking.

Symptoms

In its early stages, bronchial carcinoma often causes no noticeable symptoms. As the disease progresses, the following symptoms may appear:

Persistent or changing cough
Coughing up blood (haemoptysis)
Shortness of breath and breathlessness
Persistent chest pain
Unexplained weight loss and loss of appetite
Chronic fatigue and exhaustion
Hoarseness or difficulty swallowing (in advanced disease)

Diagnosis

The diagnosis of bronchial carcinoma involves a combination of investigations:

Imaging: Chest X-ray and computed tomography (CT) to assess the location and size of the tumor.
Bronchoscopy: Examination of the bronchi using a flexible endoscope to obtain tissue samples (biopsy).
PET-CT: To assess the extent of tumor spread (staging).
Molecular pathology: Analysis of tumor mutations (e.g., EGFR, ALK, PD-L1) to guide targeted therapies.
Laboratory tests: Blood count and tumor markers for monitoring disease progression.

Treatment

Treatment depends on the tumor type, stage, and the general health of the patient:

Surgery

In early-stage disease, the tumor may be surgically removed. Common procedures include lobectomy (removal of a lobe of the lung) or pneumonectomy (removal of an entire lung).

Radiotherapy

Radiotherapy is used when surgery is not possible, or as a complementary treatment before or after surgery.

Chemotherapy

Chemotherapy uses cell-damaging drugs to destroy cancer cells. It is frequently used in advanced stages or in combination with other therapies.

Targeted Therapy

In tumors with specific mutations (e.g., EGFR or ALK mutations), tyrosine kinase inhibitors can be used to selectively attack cancer cells while sparing healthy tissue.

Immunotherapy

Immunotherapy using checkpoint inhibitors (e.g., Pembrolizumab) enhances the immune system's ability to recognize and destroy cancer cells. It has significantly improved the prognosis for many patients.

Prognosis and Prevention

The prognosis depends strongly on the stage at the time of diagnosis. When detected early, treatment outcomes are considerably better. The most effective preventive measure is not smoking. Non-smokers and high-risk former smokers may benefit from low-dose CT screening, which enables early detection of the disease.

References

Leitlinienprogramm Onkologie: S3-Leitlinie Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms, Version 2.1 (2023). AWMF registration number: 020-007OL.
World Health Organization (WHO): Cancer Fact Sheet – Lung Cancer (2023). Available at: https://www.who.int/news-room/fact-sheets/detail/cancer
Niederhuber JE et al.: Abeloff's Clinical Oncology, 6th Edition. Elsevier (2020).

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