Trachea

Primary malignant tumors of the trachea are rare 1 || Primary malignant tumors of the trachea are very uncommon, and usually metastasize to the trachea from another area.1 The most common cause is directly related to smoking. || The following are the most common signs and symptoms of Tracheal cancer.1 Diagnostic procedures for cancer of the trachea include: Malignant tumors of the trachea include: Most common is squamous cell carcinoma and adenoid cystic carcinoma.1 || The adjacent lymph nodes to the trachea are the first to become involved when the cancer spreads, which can ultimately lead to metastasis to distant organs down the line. The tracheal nodes drain to the bronchomediastinal lymph trunks. 1 || Determined at the first doctor’s appointment, approximately 1/3 of patients with tracheal cancer have mediastinal spread or pulmonary metastases.1 At first the tumor will involve neighboring lymph nodes and any mediastinal structures via direct extension.1 Metastasis to distant organs such as the lungs, liver, and bone are common.1 Also, when dealing with the histology of adenoid cystic carcinoma, extension beyond the trachea is 3 times more common than with the histology of squamous cell carcinoma.1 || No staging system exists for primary tracheal tumors1 || Some of the most common side effects of radiation therapy to the trachea include.1 Prognosis Survival for patients affected with cancer of the trachea is highly dependent on the type of tumor, how advanced the disease is at the time of diagnosis and the overall health of the patient. For adenoid cystic carcinoma the mean survival range is 78% for 5 years. For squamous cell carcinoma the 5 year survival is only 34%. If the patient undergoes total resection of the tumor, the prognosis is much better, 5 and 10 year survival rates are between 90% and 95%.² || Treatment of choice is primarily surgery. Postoperative irradiation is generally recommended. If a patient is unable to undergo surgery, then external-beam irradiation and/or endotracheal brachytherapy are recommended. Chemotherapy alone is not generally useful and is recommended in conjunction with other modalities.1 || There isn't a specific TD5/5 for the trachea itself, so when treating tracheal cancers, it's important to focus on the surrounding structures such as the lungs (3000cGy), spinal cord (4500cGy), heart (4500 cGy), esophagus (6000cGy), etc. 2 || > Back to Week 3
 * **Epidemiolgy:** || Kevin Tsai
 * **Etiology:** || Erin
 * **Signs & Symptoms:** || Spencer
 * Hemoptysis
 * Dyspnea
 * Hoarseness
 * Cough
 * Recurrent Pneumonia
 * Vocal Cord Palsy ||
 * **Diagnostic Procedures:** || Pablo
 * Complete medical history
 * Blood test
 * X-rays
 * Computerized tomography (CT)
 * Magnetic resonance imaging (MRI)
 * Bronchoscopy¹ ||
 * **Histology:** || Becky
 * Adenocarcinoma
 * Squamous cell carcinoma
 * Adenosquamous carcinoma
 * Adenoid cystic carcinoma
 * Mucoepidermoid carcinoma
 * Neuroendocrine carcinoma
 * **Lymph node drainage:** || Adam
 * **Metastatic spread:** || Megan
 * **Grading:** || Kevin Tsai
 * Low grade - cancer cells look similar to normal cells and grow more slowly which is less likely to spread
 * High grade - cells look more abnormal and are more likely to spread.2 ||
 * **Staging:** || Erin
 * **Radiation side effects:** || Spencer
 * Acute Odynophagia/Dysphagia
 * Cough
 * Local irritation
 * Late effects include softening of the cartilage, tracheitis, and tracheal stenosis
 * <span style="color: #ff0000; font-family: Arial,Helvetica,sans-serif;">Esophageal stricture
 * <span style="color: #ff0000; font-family: Arial,Helvetica,sans-serif;">Esophageal fistulas and vocal cord paralysis ||
 * **Prognosis:** || Pablo
 * **Treatments:** || Becky
 * **TD 5/5:** || Adam
 * **References:** || # Chao C, Perez C, Brady L. Radiation Oncology Management Decisions. 3rd ed. PA: Lippincott Williams and Wilkins; 2011:341-350.
 * 1) Cedars-Sinai Website. Trachea Tumors. []. Accessed June 10, 2013.
 * 2) <span style="color: #ff0000; font-family: Arial,Helvetica,sans-serif;">Chao C, Perez C, Brady L. Radiation Oncology Management Decisions. 3rd ed. PA: Lippincott Williams and Wilkins; 2011: 327-356.
 * 3) Macmillan Cancer Support. Web site. [|http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Tracheawindpipe/Trachealcancer.aspx#DynamicJumpMenuManager_6_Anchor_5]. Accessed Jun 9, 2013.
 * 4) Chao KSC, Perez CA, Brady LW. Lung. In: Chao KSC, PerezCA, Brady LW, eds. Radiation Oncology Management Decisions. Philadelphia, PA: Lippincott, Williams and Wilkins; 2011: 327-351.
 * 5) Chao C, Perez C, Brady L. Radiation Oncology Management Decisions. 3rd ed. PA: Lippincott Williams and Wilkins; 2011.
 * 6) Chao KS, Perez CA, Brady LW. Radiation Oncology Management Decisions. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2002:328.
 * 1) Macmillian Cancer Information. Cancer of the Trachea. Available at: http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Tracheawindpipe/Trachealcancer.aspx#DynamicJumpMenuManager_6_Anchor_7 . Accessed June 13, 2013.
 * 2) Medscape reference. Web site. []. Accessed Jun 9, 2013.
 * 3) Washington CM, Leaver D. Principles and Practice of Radiation Therapy. 3rd ed. St. Louis, MO: Mosby-Elsevier; 2010. ||