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The bronchial cancer is a shrewd tumor taking his origin in the mucous membrane of the bronchi. It is the most frequent cancer of the man in the developed countries.Its frequency increases currently at the woman and the young adult. The prognosis is often bad.
Tobacco sometimes plays an important role in association with other carcinogenic agents: asbestos, arsenic, chromium-plated, nickel, béryllium, emanations of ovens to coal, radiations, oxide of iron, organic chemical substances...
The exact role of the atmospheric pollution is again known pain.
bronchial cancer: The signs of the illness
The cancer cannot give any symptom and can only discover at the time of a fortuitous x-ray of the lungs.
However, can appear:
* A troubling cough, rebel but often neglected at the chronic bronchitic smoker; * An expectoration (spits) variable and fickle; * A hémoptysie (sanguinolent spits); * A dyspnea (respiratory hindrance) variable; * A wheezing (screaming breathing) occurring in some positions; * Of the thoracic pains (extension of the tumor to the partition); * A trailing pneumopathie; * Of the pneumopathies to repetition; * A dysphonie (change in the stamp of the voice) often more belated; * A pulmonary suppuration, a sharp pneumopathie, a purulent pleurisy requires the radiological control of the recovery and sometimes a fibroscopie; * A change of the general state: asthénie, anorexia, thinning, fever to the long course; * A syndrome of compression of the vein hollows superior (the obstruction by the tumor of the venous drainage provokes the dilation of the collateral veins of the neck and the superior part of the thorax: collateral circulation with edema in tippet, edema and congestion of the face, the neck and the superior part of the thorax, suffusion and edema of the conjunctive).
..Sometimes, the beginning is more misleading:
It can be about:
* Of neurological unrests provoked by metastases: medullary compression, epilepsy, hypertension intracrânienne (PROBLEM)... * Of a syndrome paranéoplasique: oh cutaneous: dermatomyosite, acanthosis nigricans... oh endocrine: hypercorticisme, hyperthyroïdie, hyperparathyroïdie, syndrome of hypersécrétion of hormone antidiurétique (Schwartz-Bartter) oh neurological: myasthénie, polynévrite, sensory neuropathie, syndrome cérébelleux... * Of ostéo-articular unrests: oh Of the bony metastases with spontaneous fracture oh An ostéoarthropathie pneumonic hypertrophiante
The clinical exam is poor. The research of the metastases is attentive: palpation of the liver, of the areas ganglionnaires, neurological exam.
..bronchial cancer: Exams and complementary analyses
The thoracic x-ray shows:
* Either the picture of the tumor herself as an irregular tumorous opacity to the level of the pulmonary hile or in periphery of the lung; * Either of the indirect signs.
The bronchial fibroscopie (bronchoscopie) permits to see the lesion, to practice some biopsies and to appropriate mucosities, to make withdrawals directed for the peripheral cancers, that wants to say in small more faraway bronchi.
The cytology (microscopic exam of the cells) some expectoration is sometimes useful.
the tumorous scorers (carcino-embryonic antigen, neuron-specific énolase) are useful to the diagnosis, but especially then to follow the evolution.
The scanning and the imagery by magnetic resonance of the thorax and the abdomen are very useful for the balance of extension of the lesions (local extension and research of metastases).
Sometimes an exploring thoracotomie (exam of the inside of the thorax by the surgeon during an operation) is necessary.
The exam of the biopsies permits to make the diagnosis and to specify the type of the cancer:
* Carcinoma épidermoïde or squameux, the most frequent at the man; * Cancer to small cells (type 1, II or III); * undifferentiated Carcinoma to big cells; * Adénocarcinome, the most frequent at the woman, non bound to the tobacco addiction; * bronchiolo-alveolar Cancer, rather touch the bronchioles and the alveoli, reached the man and the woman, after 50 years.
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