Frequency
The primary as well as the secondary tracheal cancer caused by metastases are rather rare. The incidence is about 2% and is mostly related to tobacco abuse. Tracheal cancer most frequently occurs in the lower sections.
From the division (bifurcation) of the trachea into its two main trunks for the left and right lung wing, the tumors are already classified as lung cancer (bronchial carcinoma). These occur far more frequently. In terms of therapy, diagnostics play a very important role.
By means of a precise examination, the tumor is determined to its histological type and its spread and size. The information from which cells the tumor finally emerges is decisive for the selection of the right therapeutic agents. In the diagnostic procedure, the patient is first asked about her symptoms and abnormalities in detail during a conversation (anamnesis).This also includes obtaining detailed information on whether there are already known cases of cancer in the family and therefore whether a plant exists.
This is followed by an examination of the pharynx, larynx and the nasal and oral cavities as well as palpation for swelling and pain. In addition to the examination of the blood, x-rays in 2 planes (from the front and the side), a computer tomography (CT) or magnetic resonance imaging (MRI) are performed for a better view of the soft tissues. It is also useful to examine the sputum of the lungs to determine the contents for any existing inflammation or infectious changes.
Other basic diagnostic examinations in cases of suspected tracheal cancer are endoscopic procedures such as bronchoscopy, which can be performed down to the lung lobes, and panendoscopy. These are minimally invasive procedures that are particularly good at viewing cavities. With the help of a flexible endoscope or a rigid tube, the trachea and, especially in the case of panendoscopy, the oesophagus are visualized under anesthesia or local anesthesia.
In this way, the extent and location of the tumor can be assessed. To confirm or exclude the diagnosis, samples of the degenerated tissue are taken and histologically/cytologically determined. Since most tumors in the area of the trachea are disseminated tumors, it is important to find the primary tumor and possibly further disseminations (metastases) within the diagnostic process.
In addition to the CT and MRI already mentioned, it is recommended to perform ultrasound examinations, for example of the abdomen, and a whole-body positron emission tomography. In many cases, swollen lymph nodes can also be an indication that the cancer is spreading. Suspicious lymph nodes should be checked microscopically. The aim of the entire diagnostic process is to characterize the tumor precisely and accordingly to develop the best possible individual therapy for the patient.