The trachea is also known as the windpipe. It serves as a conduit for the passage of air to the lungs carrying oxygen. It is also lined by special cells that secrete mucus which prevents bugs, irritants, dust and other allergens from entering the lungs. Tracheal tumours although rare do carry a significant morbidity and mortality. They can be benign or malignant. A tracheal tumour can cause a number of severe symptoms. Prompt and timely treatment is essential to cure the disease and /or relieve symptoms. Is tracheal tumour treatment available in India ?
Very few hospitals in India offer the services for tracheal tumour treatment. Since this is a very complex surgery and requires a multidisciplinary approach, many hospitals and teams are not well equipped to take care of such cases.
Causes of Tracheal Tumours
There are several factors that can increase the risk of developing tracheal tumours, including:
- Age: People > 60 years
- Exposure to high level radiation
- Family history
Symptoms of Tracheal Tumours
The symptoms of tracheal tumours can vary depending on the size and location of the tumour. The most common symptoms are:
- Hoarseness: This can occur when the tumour affects the vocal cords
- Coughing: A persistent cough is a common symptom of tracheal tumours
- Shortness of breath: The tumour can obstruct the airway and make it difficult to breathe
- Chest pain: May be a result of tumour infiltration into the surrounding structures like the chest wall
- Weight loss: Unexplained weight loss like with any other tumour
You should seek medical attention if you notice any of these symptoms and see a Thoracic Surgeon as soon as possible. Early diagnosis and treatment is the key for a successful outcome.
Types of Tracheal and Bronchial Tumours
They can be divided into two main categories: Endobronchial tumours and Extrabronchial tumours.
Endobronchial tumours arise from within the lumen of the airway
- Adenoid Cystic Carcinoma
- Mucoepidermoid Carcinoma
- Squamous cell carcinomas
Extrabronchial tumours grow outside the airways and cause compression of the airway leading to symptoms
- Lung cancer
- Metastatic tumours
Diagnosing Tracheal Tumours
A comprehensive evaluation of the patient’s medical history, physical examination, and imaging tests are required to establish a diagnosis of tracheal tumours.
Important tests prior to starting tracheal tumour treatment in India:
- Bronchoscopy: To view the inside of the airway to directly visualise the morphology and extent of the tumour
- CT scan: It will clearly outline the size and extent of the tumour and any invasion of the surrounding tissues. A 3D reconstruction of the images will give additional information
- PET/CT scan: A PET/CT scan will pick up increased activity in the tumour (primary) as well as anywhere else in the body (metastasis)
- Biopsy: A tracheal tumour can be biopsied by a flexible bronchoscopy or rigid bronchoscopy to study the tissue cells in a laboratory
Treatment of Tracheal Tumour in India
The treatment of tracheal tumour depends on several factors, including the type and stage of the tumour, the patient’s age and co-morbidities. The common treatment options that are available are:
Surgical Treatment of Tracheal Tumour: Options in India
For tracheal tumours that are inoperable, bronchoscopy offers many solutions to relieve the distressing symptoms (palliation). There are many tools which can be used:
- Argon Plasma Coagulation
- Stents: Tracheal or Bronchial
- Laser therapy
- Rigid bronchoscopic coring & debulking
Radiation therapy uses high-energy X-rays or other particles to kill cancer cells and shrink tumours.
- External-beam radiation
- Brachytherapy- localized form of radiation therapy
Chemotherapy is a treatment that uses oral or intravenous drugs to kill cancer cells. In tracheal tumours its main use is in the treatment of Squamous Cell Cancers, where surgery is not possible.