What Is Bronchogenic Carcinoma?

Brochogenic carcinoma viewed under a microscope
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Bronchogenic carcinoma is another term for lung cancer. At one time it was used to describe a specific type of cancer that arises in the bronchi (the largest airways of the lungs) and bronchioles (the small branches into which the airways divide). Sometimes it's still used in reference to that subtype of lung cancer, but more commonly, it's used interchangeably with lung cancer of all types.

Bronchogenic carcinoma is the most common cancer worldwide and is the leading cancer-related cause of death in both men and women in the U.S. While the survival rate for lung cancer continues to be extremely poor compared to other cancers, treatment options are improving. Those diagnosed with bronchogenic carcinoma today live longer, more active lives than those diagnosed in previous generations.

If you or a loved one has been diagnosed with bronchogenic carcinoma, take time to understand how different types of lung cancers manifest and the treatment options that are available. This can help you make the best choices to battle the disease and manage your symptoms.

Types of Bronchogenic Carcinoma

There are three types of bronchogenic carcinoma:

Historically, squamous cell NSCLC was the most common type of bronchogenic carcinoma. Over the past generation, that trend has been changing as rates of squamous cell carcinoma, which is associated with smoking, have fallen as smoking habits have changed.

Adenocarcinoma is now the most common form of bronchogenic carcinoma. Approximately 40% of NSCLC patients are diagnosed with adenocarcinoma, which usually begins with tumors in the outer areas of the lungs and often isn't detected until the cancer has grown large enough to affect breathing in the central region of the lung.

While a bronchogenic carcinoma will be classified into a general category, everyone's cancer is different. Today, doctors use genetic testing, population data, and personalized medicine to better understand how your particular lung cancer can best be treated.

Symptoms of Bronchogenic Carcinoma

People with adenocarcinoma will often have no symptoms in the early stages of the disease. With other types of bronchogenic carcinoma, however, there may be some general signs of cancer such as:

As tumors begin to interfere with the function of the lungs and cause problems in the large airways, symptoms specifically related to breathing usually occur. Other body systems may also be affected by the tumors growing or secreting substances that interfere with normal functions.

Among the most common symptoms of bronchogenic carcinoma are:

Under the original definition of bronchogenic carcinoma—which refers to problems with the bronchial airways—coughing is considered the first main symptom.

Causes

The leading risk factor for bronchogenic carcinoma is smoking, which is linked to 80% to 90% of lung cancer deaths each year.

Other leading risk factors for developing bronchogenic carcinoma include:

  • Secondhand smoke: An estimated 7,330 lung cancer deaths each year are related to secondhand smoke, which is defined as smoke exhaled by smokers and emitted from the lit end of a cigarette, pipe, or cigar, or from tobacco burning in a hookah.
  • Radon exposure: Radon is the second most common cause of NSCLC and the most common cause among never-smokers. It is responsible for roughly 21,000 lung cancer deaths each year.
  • Occupational exposure to carcinogens: Jobs in which you have direct contact with certain metals, chemicals, or fibers that cause lung cancer are very dangerous to your health. Among the substances known to raise your risk of bronchogenic carcinoma are arsenic, beryllium, vinyl chloride, polycyclic aromatic hydrocarbons (PAHs), silica, wood dust, and asbestos. Asbestos is also highly associated with mesothelioma, a rare type of cancer that affects the lungs.
  • Ionizing radiation: This type of radiation administered to the chest, usually as a treatment for another disease such as breast cancer, can significantly increase your risk of bronchogenic carcinoma.

Diagnosis

The diagnosis of bronchogenic carcinoma may be made in several ways including imaging, tissue sample evaluations, and blood tests.

Imaging

Sometimes a physician finds an abnormality on a chest X-ray prompting further evaluation with chest computed tomography (CT) or other imaging methods.

A positron emission tomography (PET) scan may also be ordered. This is the most sensitive test and may offer the best means of accurately staging the disease.

  • Small cell lung cancer is usually divided into two stages: limited and extensive.
  • Non-small cell lung cancer is divided into four stages with subtypes and designations for each.

Determining the stage of your cancer is essential in determining the best treatment for your condition.

Biopsy

A lung biopsy is also usually required to make an accurate determination about the stage of bronchogenic carcinoma.

It is also used for genetic testing, in which doctors identify genetic mutations that might be present in your lung cancer cells. If they identify certain known mutations, targeted therapies can be used to prevent the cancer cells from growing or causing further problems.

A biopsy may be done in a few different ways.

  • Fine needle aspiration (FNA): A special long needle is inserted into the chest to remove a small number of tumor cells.
  • Thoracoscopic biopsy: A tissue sample is taken through small incisions that are non-invasive.
  • Open lung biopsy: The chest is opened and a tissue sample removed surgically.
  • Thoracentesis: Chest fluid samples are taken using a special needle.

When an abnormality is found on an imaging study, physicians often recommend a lung biopsy of some kind to both confirm the diagnosis and learn about the genetic profile of the lung cancer.

Blood Tests

Doctors will also order a complete blood count and blood chemistries to get a comprehensive picture of your cancer and overall health. If tumors are associated with paraneoplastic syndromes, your tests may include measures of sodium and calcium levels in the blood.

Increasingly, doctors are using liquid biopsy tests to help diagnose and direct treatment of cancer. Also referred to as rapid plasma genotyping, a liquid biopsy can tell your doctor if there are cancer cells circulating in the blood. It can be used to detect genetic mutations in those cells as well. Using those results, doctors determine if your cancer might respond to treatment with targeted medications.

Screening

Low-dose CT screening is now available for bronchogenic carcinoma in people who meet certain criteria. It has been found that for people between the ages of 55 and 80 who have a 30 pack-year history of smoking (and either smoke or quit in the past 15 years), screening may decrease the mortality rate from lung cancer by at least 20%.

If you meet these criteria, or if you have other risk factors for lung cancer, talk to your doctor about screening. Unfortunately, only a minority of people who are eligible for screening are currently screened. As a result, lung cancers that could have been caught and more effectively treated early on aren't diagnosed until they advance to later, incurable stages.

Treatment

The treatments your doctor recommends will depend on several factors, including the type and stage of lung cancer you are diagnosed with. It is important to learn about your diagnosis because being actively involved in your lung cancer care may help you have a better outcome.

Possible treatments may include:

  • Surgery: Surgery may be an option for early-stage NSCLC. Not all tumors can be removed via surgery either due to their location or the extent of the metastasis, however.
  • Chemotherapy: Chemotherapy drugs kill cancer cells and may be used alone or after surgery to ensure all the cancer cells are destroyed.
  • Radiation therapy: Radiation therapy may be used to target local tumors or to support chemotherapy or surgery.
  • Targeted therapies: Targeted therapy drugs can stop cancer cells with specific genetic mutations from growing or damaging healthy cells.
  • Immunotherapy: These drugs help your own immune system recognize and attack cancer cells.

New cancer treatments are continually being tested. You can enroll in clinical trials if you want to try out experimental treatments, which may offer new hope.

The Future of Treatment

Researchers are taking the new information about bronchogenic carcinoma and using it to transform the way patients are treated. A more personalized approach to lung cancer care is now the goal of oncologists, using genetic testing and personal information to tailor treatments to the person—not the disease.

New options are resulting in a "durable response" among some patients, leading some doctors to believe that the possibility of curing lung cancer beyond the earliest stages is within reach.

Prognosis

Sadly, the prognosis of bronchogenic carcinoma is not what anyone wishes it to be, with an overall five-year survival rate of only about 18.6%. Prognosis varies based on the type and stage of lung cancer, with survival rates being much better when the disease is diagnosed in the earlier stages.

Though these statistics are sobering, advances in the treatment of lung cancer are improving survival—even for people with metastatic (stage 4) disease.

The survival rate for lung cancer has increased steadily over the past 40 years from 12.4% in the mid-1970s to 20.5% by 2016. This includes steady improvements in the treatment of stage 4 lung cancer.

It is challenging even for lung cancer specialists to keep up with all of the advances in this field of medicine, and finding the right treatment may take some additional testing and a new perspective. Getting a second opinion, preferably at a National Cancer Institute-designated cancer center, is important for anyone with the disease.

A Word From Verywell

While the overall incidence of bronchogenic carcinoma has been decreasing in recent years, it has increased significantly for young women who have never smoked. This shows that there is still much to learn about the risks of lung cancer and the ways doctors should approach the disease.

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