Bronchogenic carcinoma is another term for

lung cancer. At one time it was used to

describe a specific type of cancer that arises in
the bronchi (the largest airways of the lungs)
and bronchioles (the small branches into
which the airways divide). Sometimes it's still
used in reference to that subtype of lung
cancer, but more commonly, it's used
interchangeably with lung cancer of all types.
Bronchogenic carcinoma is the most common
cancer worldwide and is the leading cancer-
related cause of death in both men and women
in the U.S.1 While the survival rate for lung
cancer continues to be extremely poor
compared to other cancers, treatment options
are improving. Those diagnosed with
bronchogenic carcinoma today live longer,
more active lives than those diagnosed in
previous generations.
There are three types of bronchogenic
carcinoma:2
 Small cell lung cancer (SCLC):
Approximately 10% to 15% of people with
 lung cancer are diagnosed with SCLC.
Small cell lung cancer is named for the
size of the cells as viewed under a
microscope. There are two subtypes of
SCLC: small cell carcinoma (sometimes
called oat cell cancer) and combined small
cell carcinoma.
 Non-small cell lung cancer (NSCLC):
Non-small cell lung cancer accounts for
most bronchogenic carcinomas (around
80% to 85%). NSCLC is further broken
down into lung
adenocarcinoma, squamous cell
carcinoma of the lungs, and large cell lung
cancer.
 Carcinoid tumors: This rarer type of
bronchogenic carcinoma accounts for less
than 5% of lung cancer cases.
Historically, squamous cell NSCLC was the
most common type of bronchogenic
carcinoma. Over the past generation, that trend
has been changing as rates of squamous cell
carcinoma, which is associated with smoking,
have fallen as smoking habits have changed.3
Adenocarcinoma is now the most common
form of bronchogenic carcinoma.
Approximately 40% of NSCLC patients are
diagnosed with adenocarcinoma, which
usually begins with tumors in the outer areas
of the lungs and often isn't detected until the
cancer has grown large enough to affect
breathing in the central region of the lung.4
While a bronchogenic carcinoma will be
classified into a general category, everyone's
cancer is different. Today, doctors use genetic
testing, population data, and personalized
medicine to better understand how your
particular lung cancer can best be treated.5
The Most Common Types of Lung Cancer
Symptoms of Bronchogenic Carcinoma
People with adenocarcinoma will often have
no symptoms in the early stages of the disease.
With other types of bronchogenic carcinoma,
however, there may be some general signs of
cancer such as:6
 Unintentional weight loss
  Fatigue
 Shortness of breath, especially with
exercise
As tumors begin to interfere with the function
of the lungs and cause problems in the large
airways, symptoms specifically related to
breathing usually occur. Other body systems
may also be affected by the tumors growing or
secreting substances that interfere with normal
functions.
Among the most common symptoms of
bronchogenic carcinoma are:7
 Persistent cough
 Wheezing
 Coughing up blood
 Hoarseness
 Pain in the chest or back
 Repeated infections such
as pneumonia or bronchitis
 Clubbing (rounding) of the fingers
Under the original definition of bronchogenic
carcinoma—which refers to problems with the
bronchial airways—coughing is considered
the first main symptom.
Signs and Symptoms of Lung Cancer
Causes
The leading risk factor for bronchogenic
carcinoma is smoking, which is linked to 80%
to 90% of lung cancer deaths each year.8
Other leading risk factors for developing
bronchogenic carcinoma include:
 Secondhand smoke: An estimated 7,330
lung cancer deaths each year are related to
secondhand smoke, which is defined as
smoke exhaled by smokers and emitted
from the lit end of a cigarette, pipe, or
cigar, or from tobacco burning in a
hookah.9
 Radon exposure: Radon is the second
most common cause of NSCLC and the
most common cause among never-
smokers. It is responsible for roughly
21,000 lung cancer deaths each year.10
  Occupational exposure to carcinogens:
Jobs in which you have direct contact with
certain metals, chemicals, or fibers that
cause lung cancer are very dangerous to
your health. Among the substances known
to raise your risk of bronchogenic
carcinoma are arsenic, beryllium, vinyl
chloride, polycyclic aromatic
hydrocarbons (PAHs), silica, wood dust,
and asbestos. Asbestos is also highly
associated with mesothelioma, a rare type
of cancer that affects the lungs.
 Ionizing radiation: This type of radiation
administered to the chest, usually as a
treatment for another disease such as
breast cancer, can significantly increase
your risk of bronchogenic carcinoma.11
Risk Factors for Lung Cancer
Diagnosis
The diagnosis of bronchogenic carcinoma may
be made in several ways including imaging,
tissue sample evaluations, and blood tests.
Imaging
Sometimes a physician finds an abnormality
on a chest X-ray prompting further evaluation
with chest computed tomography (CT) or
other imaging methods.
A positron emission tomography (PET) scan
may also be ordered. This is the most sensitive
test and may offer the best means of
accurately staging the disease.
 Small cell lung cancer is usually divided
into two stages: limited and extensive.
 Non-small cell lung cancer is divided into
four stages with subtypes and designations
for each.
Determining the stage of your cancer is
essential in determining the best treatment for
your condition.
An Overview of Lung Cancer Stages
Biopsy
A lung biopsy is also usually required to make
an accurate determination about the stage of
bronchogenic carcinoma.
It is also used for genetic testing, in which
doctors identify genetic mutations that might
be present in your lung cancer cells. If they
identify certain known mutations, targeted
therapies can be used to prevent the cancer
cells from growing or causing further
problems.
A biopsy may be done in a few different ways.
 Fine needle aspiration (FNA): A special
long needle is inserted into the chest to
remove a small number of tumor cells.
 Thoracoscopic biopsy: A tissue sample is
taken through small incisions that are non-
invasive.
 Open lung biopsy: The chest is opened
and a tissue sample removed surgically.
 Thoracentesis: Chest fluid samples are
taken using a special needle.
When an abnormality is found on an imaging
study, physicians often recommend a lung
biopsy of some kind to both confirm the
diagnosis and learn about the genetic profile of
the lung cancer.
Lung Biopsy: What to Expect
Blood Tests
Doctors will also order a complete blood count
and blood chemistries to get a comprehensive
picture of your cancer and overall health. If
tumors are associated with paraneoplastic
syndromes, your tests may include measures
of sodium and calcium levels in the blood.12
Increasingly, doctors are using liquid biopsy
tests to help diagnose and direct treatment of
cancer.13 Also referred to as rapid plasma
genotyping, a liquid biopsy can tell your
doctor if there are cancer cells circulating in
the blood. It can be used to detect genetic
mutations in those cells as well. Using those
results, doctors determine if your cancer might
respond to treatment with targeted
medications.
Screening
Low-dose CT screening is now available for
bronchogenic carcinoma in people who meet
certain criteria. It has been found that for
people between the ages of 55 and 80 who
have a 30 pack-year history of smoking (and
either smoke or quit in the past 15 years),
screening may decrease the mortality rate
from lung cancer by at least 20%.14
If you meet these criteria, or if you have other
risk factors for lung cancer, talk to your doctor
about screening. Unfortunately, only a
minority of people who are eligible for
screening are currently screened. As a result,
lung cancers that could have been caught and
more effectively treated early on aren't
diagnosed until they advance to later,
incurable stages.
Facts About CT Lung Cancer Screenings
Treatment
The treatments your doctor recommends will
depend on several factors, including the type
and stage of lung cancer you are diagnosed
with. It is important to learn about your
diagnosis because being actively involved in
your lung cancer care may help you have a
better outcome.
Possible treatments may include:15
 Surgery: Surgery may be an option for
early-stage NSCLC. Not all tumors can be
removed via surgery either due to their
location or the extent of the metastasis,
however.
 Chemotherapy: Chemotherapy drugs kill
cancer cells and may be used alone or after
surgery to ensure all the cancer cells are
destroyed.
 Radiation therapy: Radiation therapy
may be used to target local tumors or to
support chemotherapy or surgery.
 Targeted therapies: Targeted therapy
drugs can stop cancer cells with specific
genetic mutations from growing or
damaging healthy cells.
 Immunotherapy: These drugs help your
own immune system recognize and attack
cancer cells.
New cancer treatments are continually being
tested. You can enroll in clinical trials if you
want to try out experimental treatments, which
may offer new hope.
The Future of Treatment
Researchers are taking the new information
about bronchogenic carcinoma and using it to
transform the way patients are treated. A more
personalized approach to lung cancer care is
now the goal of oncologists, using genetic
testing and personal information to tailor
treatments to the person—not the disease.
New options are resulting in a "durable
response" among some patients, leading some
doctors to believe that the possibility of curing
lung cancer beyond the earliest stages is
within reach.
Lung Cancer Treatment Options
Prognosis
Sadly, the prognosis of bronchogenic
carcinoma is not what anyone wishes it to be,
with an overall five-year survival rate of only
about 18.6%.1 Prognosis varies based on the
type and stage of lung cancer, with survival
rates being much better when the disease is
diagnosed in the earlier stages.
Though these statistics are sobering, advances
in the treatment of lung cancer are improving
survival—even for people with metastatic
(stage 4) disease.16
The survival rate for lung cancer has increased
steadily over the past 40 years from 12.4% in
the mid-1970s to 20.5% by 2016. This
includes steady improvements in the treatment
of stage 4 lung cancer.17
It is challenging even for lung cancer
specialists to keep up with all of the advances
in this field of medicine, and finding the right
treatment may take some additional testing
and a new perspective. Getting a second
opinion, preferably at a National Cancer
Institute-designated cancer center, is important
for anyone with the disease.