Cancer of Pancost: Causes, Symptoms, Diagnosis and Treatment

Cancer of Pancost is an oncological disease that is localized in the upper sulcus of the lung. On the symptomatology it is similar with a tuberculosis, an abscess, an echinococcus, a pneumonia, good-quality tumors and other pathologies.

The name Pancosta tumor was named after the radiologist Henry K. Pancost. He was the first of his colleagues to describe this disease in detail. This happened in 1924.

In addition to malignant pathology, similar symptoms can cause some inflammatory and oncological diseases, also located in the upper part of the lung. This phenomenon was called Pancost syndrome.

The urgency of the problem of Pancost's cancer lies in the difficulty of its early diagnosis in view of the specific location of the tumor, closed by a bone structure. Even with the help of fluorography, conducted in the most modern oncological clinics, in the early stages it is far from always possible to quickly identify the disease.

Causes of cancer of the upper part of the lung

In general, the appearance of Pancostic cancer is affected by the same reasons as for lung cancer of other species. What is this? The main reason for its manifestation is smoking: active or passive. An important role is played by the number of cigarettes smoked per day, the quality of tobacco used, and the total length of smoking. It is worth noting that if you abandon the addiction, a person leaves the risk zone only after ten years.

To be exposed to this disease can also be people who do not suffer from a passion for smoking. The percentage of cancers of Pancost cancer of passive smokers rises in 1,7-2 times. Children and teenagers, whose parents smoke regularly in their presence, also fall into the risk group. Tobacco smoking in 85% of cases is the cause of cancer of the apex of the lung.

In addition to smoking, environmental and industrial factors can cause cancer of Pankost. When exposed to substances such as pesticides, asbestos, heavy metals, arsenic, nickel or chromium, the percentage of people with Pancostic cancer also increases.

The role of various pulmonary diseases in the anamnesis is also great: tuberculosis, pneumonia transferred and bronchiectasis, all this increases the chance of the appearance of a Pancoast tumor in a person.

This disease affects men five times more often than women, and it manifests itself after 50 years. It is proved that the predisposition to cancer of Pankost is transmitted and at the gene level.

In general, there are several key factors that influence the onset of Pancostic cancer:

• age;
• smoking;
• Ecological situation in the region;
• Professional activity in the construction or chemical industry;
• heredity.

Symptoms of cancer

Often the patient seeks help with the already started stage of the disease. This problem is associated with the absence of symptoms in the early stages: the patient has no cough, hemoptysis and, most importantly, visible physical defects in the form of cones on the body. Pain in oncology of the early stages, as a rule, do not appear.

The only alarming symptoms in the 1 st and 2 nd stages of cancer are general weakness, constant fatigue, weight loss.

Syndromes of Pancost and Horner

With the further course of the disease, there is a manifestation of Pancost and Horner syndromes, both individually and in combination with each other. You need to know about this.

Pancost syndrome manifests itself in several of the following symptoms:

• Severe debilitating pain on the side of tumor localization - in the shoulder region, along the ulnar nerve and under the scapula;
• Weakness of the arm muscles on the affected side of the body, paresthesia, numbness of the fingers, muscle atrophy of the limb;
• Change of voice - the appearance of hoarseness, coughing.

When the tumor is exposed to sympathetic fibers, Horner's syndrome manifests itself:

• Omission of the upper eyelid (ptosis);
• Anhidrosis of the upper limb and part of the face with a tumor affected side;
• The narrowing of the pupil (miosis) and the occlusion of the eyeball (ethnophthalmus).

Quite often, Pancost's cancer is accompanied by a syndrome of the inferior vena cava at a tumor pressure on it. This syndrome is accompanied by the following symptoms:

• chest pain;
• cough;
• labored breathing;
• Headache and increased drowsiness;
• Whistling when breathing.

Diagnosis of lung cancer

As already mentioned above, the diagnosis of the disease is quite difficult, because in the early stages of cancer, Pancos can not always detect even an X-ray examination because the tumor in the place of its localization is not visible.

As a rule, patients turn first of all to a neurologist or surgeon with complaints of pain in the upper limbs and only after that get on reception to specialists-oncologists.

Given that the Pancoast tumor in its symptoms is similar to other diseases of the bronchopulmonary system, its diagnosis should be comprehensive and include the following types of examinations:

1. Radiography - determines the presence of the tumor at later stages due to the thickening of the pleura and the appearance of blackouts.
2. Computer tomography and MRI - determine the degree of involvement of vessels, ribs, lymph nodes, vertebrae in the process. The results of these studies are among the most important. They show the possibility of an operation.
3. Lymph node biopsy - allows to determine the stage of development of pathology.
4. Blood test - determines the condition of the body as a whole.

Also as additional examinations bronchoscopy is performed (it determines the state of bronchi and trachea, close to the affected area), arteriogram and phlebogram (assess the condition of veins and arteries in the clavicle zone).

Treatment of lung cancer

Treatment of Pancostic cancer occurs only in specialized oncological clinics, while the fundamental factor is the complexity of the therapy. As the statistics show, Pancostic cancer is most often detected at the 3rd stage, when the pains with oncology of this kind become intolerable. Treatment in this case must begin with the taking of pain medications, including narcotic analgesics.

The main methods of treating a Pancost tumor are:

• chemotherapy;
• radiation therapy;
• Operative intervention.

Preoperative therapy

The disease is treated in several stages: preoperative and postoperative treatment, surgical intervention.

Preoperative therapy is a complex of chemotherapy and radiation, necessary to reduce the tumor and prevent the spread of metastases to the lymph nodes. This allows you to perform an operation that was impossible before such treatment.

Radiation therapy can also be used as an independent method of treatment, when surgical intervention is impossible. Irradiation in this case reduces pain in the patient, but does not affect the life span.

Both radiotherapy and chemotherapy are conducted in several stages, with breaks between them in 2-3 weeks. After carrying out radiotherapy and chemotherapy, the patient is assigned a second examination, according to which a conclusion is made about the possibility of surgical intervention.

The urgency of the operation in the treatment of lung cancer

Surgical treatment is not always carried out in all cases: if there is no full guarantee that the patient's capabilities will allow him to reschedule the operation, or already numerous areas of the body removed from the lesion are affected, it is senseless to conduct the intervention. The survival rate for such a neglected state of the patient is minimal.

In other cases, when an operation is possible, there are several options for conducting it:

1. Pneumoectomy - removal of the entire volume of the affected lung.
2. Resection of a part of the lung.

With a significant growth of the tumor, it is possible to remove several edges and vertebrae, vessels, chest wall, brachial plexus. In rare cases, the patient must undergo amputation of the upper limbs.

After the operation, radiotherapy and chemotherapy are also performed to "finish off" tumor cells in order to avoid the occurrence of relapses.

Prognosis for upper limb cancer

Survival of patients who have survived Pancostic cancer, directly depends on the stage at which the disease was detected.

In patients diagnosed at the first stage of the disease, the survival threshold is about 60%, in the 2 nd stage - not more than 40%, and when diagnosed at the third stage of cancer, only 20% of patients overcome the five-year threshold.

At the 4th stage, Pancost's cancer is practically incurable: in 98% of cases, death occurs 6-7 months after the treatment.