Bronchogenic Carcinoma

Bronchogenic Carcinoma (BC) is a rare cancer which mainly affects children and young adults. It is a type of lung cancer. According to the World Health Organization, it accounts for approximately 1% of all cancers worldwide.[1] The disease develops from inhaling small particles of dust or smoke that are trapped in the air when burning coal, wood, dung or other organic material such as animal manure. These particles cause damage to the cells of the lungs. The most common symptoms include coughing, shortness of breath, chest tightness and wheezing. Other symptoms may include fever, fatigue and weight loss. The disease usually occurs in smokers or those with a family history of smoking.[2][3]

The incidence rate varies between countries but is generally higher among men than women. It is less common in people over 60 years old. In some parts of the world, it is even more uncommon than lung cancer. There have been no reports of BC occurring after exposure to asbestos.[4]

In the United States, BC occurs mostly in males between ages 20 and 29 years and females between ages 15 and 24 years. The average age at diagnosis is around 40 years. There is a slight male predominance. Most patients are either current or former smokers. In the United States, incidence rates of BC increased rapidly until the 1980s and have since leveled off to a rate of 10-15 per 100,000 people per year, although the rate in men remains higher than in women.

The death rate from BC has also decreased over the last few decades due to improvements in the early detection of this disease. Treatment for this cancer includes chemotherapy, radiation therapy, and surgery. While the 5-year relative survival rate for all stages combined was 56% in 2002, it was higher among people under 70 (66%) than those over 70 (35%). 5-year relative survival rates by stage at diagnosis for people diagnosed in 2003 are as follows:

The 5-year survival rate for people whose cancer is confined to the lung is significantly higher than the survival rate for people whose cancer has spread beyond the lung. The survival rate depends on several factors, including the patient’s general health, the size and number of tumors, and whether the cancer cells contain certain proteins.

Today in Britain it is the most common type of lung cancer in both men and women. The disease mainly afflicts people over the age of 45 more commonly men than women. There are more cases in smokers than in non-smokers. Treatment is normally by chemotherapy and radiotherapy or surgery.

One of the earliest mentions of the disease is in medical writings by Rokuzo Sugiyama in 1808. The first report of a malignant tumor of the lung in English language was made by surgeon John Hill in 1761. Early British descriptions included “consumption of the lung” (1794), “tumor of the lung” (1821), “cancer of the swollen part of the lungs” (1836), and “malignant tumor of the lung” (1861). When the disease was first described in English and for a long time thereafter, it was called “consumption” because it was thought to be due to the patient’s “consumption” or diminishing of their “vital force”. The term “tuberculosis” was first used in 1839 by the French physician Bertillon.

The term “tumor” was first used in 1843. The term “cancer” was first used in 1849, but it was not until 1901 that it was understood to be a disease distinct from tuberculosis. In 1932 the Royal College of Physicians produced a report in which they recommended that the term “tuberculosis of the lung” be replaced by the term “cancer of the lung”. They stated that most medical men were already doing this and that it was impractical to insist that everybody use the term “tuberculosis”. The term “lung cancer” was recommended for use in medical contexts where brevity was required and also it was stated that it would be useful if the public were more familiar with the term.

The first effective treatment for lung cancer was pneumonectomy (“the removal of an entire lung”) which was performed by Theodor Billroth in 1891. In 1896 Norman Clarke invented the pneumoconiosis needle, a device able to extract particles from the lungs. In 1905, the chemical agent bleomycin was first used as a treatment. In 1907 the American microbiologist Frederick Gates first cultured “Strepto-myces” bacteria and found out that it could kill tumors in mice. In 1911 the German pathologist Georg Poppeller managed to culture a microbe from human arteries.

In 1912 the French physician and biologist Jules Bordet discovered how white blood cells fight bacteria. In 1926 the American biochemist Gerhard Domagk discovered the first commercially available antibiotic, prontosil, which was used to treat bacterial infections. In 1928 the German pathologist Hans Eppinger discovered that lung cancer could be caused by cigarette smoking. In 1935, the German physician and hematologist Rudolf Rummel developed a method for counting white blood cells, which are part of the body’s immune system. In 1936 the American pathologist Ernest Goodpasture discovered that an antibody in the blood could be used to combat bacteria. In 1939 the British physician and researcher Norman Heatley discovered vitamins that could cure beriberi, which is caused by a deficiency of vitamin B1. During World War II more effective ways of treating infection were researched as there was a risk of potentially life-threatening infections by wound infection and also pneumonia caused by exposure to high altitude and cold weather.

In 1948, the German surgeon Hans-Jochen Brahms performed the first open heart surgery where he repaired a persistent truncus arteriosus in an infant. In 1949, the American physician and microbiologist René Favaloro developed an operation to treat blocked arteries around the heart.

In 1956, the American physician and biochemist Joseph L. Goldstein, together with the English medical student Michael S. Brown and Swiss-American molecular biologist and physician, Marcus Peter Martin Zamenhof developed a lipoprotein extract, which later became known as lovastatin, the first statin. Statins are a type of drug that can lower cholesterol levels and so are used to prevent cardiovascular disease.

In 1977, the American medical researcher David E. Rogers developed the drug imipramine, which was a new type of antidepressant. Antidepressant drugs treat conditions such as clinical depression.

In 1978, the American physician Zaven M. Melikian developed the drug cisplatin, which is a type of anti-cancer drug. In 1980, the American physician and researcher William A. Bengstrom developed the drug fluoxetine, which is a type of anti-depressant drug called a selective serotonin reuptake inhibitor (SSRI).

In 1981 the American medical doctor Cynthia Kenyon first described transgenic organisms. In 1982, the American physician and epidemiologist John Henderson suspected that toxic waste sites were causing an increase in birth defects and health problems among children living near those sites. In 1983, the British geneticist John E. Sulston and the British-American biologist Georgina Ferry first isolated a specific gene located on the seventh chromosome that is responsible for causing beta-thalassemia, a type of anemia.

In 1984, the American physician Robert J. Doms and colleagues developed the first effective vaccine for pneumococcal infections. Pneumonia is a disease that affects the lungs, caused by bacteria or viruses.

In 1991, after 15 years of research, Kary B. Mullis and his team invented PCR (Polymerase Chain Reaction), which is a method for making multiple copies of DNA fragments for specific purposes.

In 1991, David M. Sabatini and James E. Hansen developed Fibrolamellar carcinoma (fibroblastic sarcoma), a type of liver cancer.

In 1996, the British-American neurologist Suzanne M. Leal and colleagues first identified and described an important virus called Human Herpes Virus 8, which is one of nine viruses that causes the common cold but it can also cause blisters around the mouth and lips, commonly known as cold sores or fever blisters.

In 2001, the Belgian medical researcher Jo Bovet and colleagues developed the drug lumacaftor, which is a type of drug that helps in the treatment of cystic fibrosis (CF).

In 2004, the American microbiologist John Dalton and colleagues discovered the bacterium “Vampirovibrio chlorellavorus”, which is an aerobic, green-coloured, rod-shaped bacteria. It is one of the few organisms that can thrive on very little oxygen.

In 2008, the American immunologist and physician Sir Richard John Roberts and colleagues developed the drug azacitidine, which is a type of chemotherapy drug used to treat various types of cancer, such as myeloid leukaemia, acute myeloid leukemia (AML), chronic myelogenous leukemia (CML) and multiple myeloma.

Sources & references used in this article:

The use of the nitrogen mustards in the palliative treatment of carcinoma. With particular reference to bronchogenic carcinoma by DA Karnofsky, WH Abelmann, LF Craver… – Cancer, 1948 – Wiley Online Library

Aryl hydrocarbon hydroxylase inducibility and bronchogenic carcinoma by G Kellermann, CR Shaw… – New England Journal …, 1973 – Mass Medical Soc

Alkylating agents in bronchogenic carcinoma by RA Green, E Humphrey, H Close, ME Patno – The American journal of …, 1969 – Elsevier

A method for the experimental induction of bronchogenic carcinoma by U Saffiotti, F Cefis, LH Kolb – Cancer Research, 1968 – AACR

Staging of bronchogenic carcinoma by bronchoscopy by KP Wang – Chest, 1994 – researchgate.net

Intensive chemotherapy of small cell bronchogenic carcinoma. by MH Cohen, PJ Creaven, BE Fossieck Jr… – Cancer treatment …, 1977 – europepmc.org

Inhibition of interleukin 8 attenuates angiogenesis in bronchogenic carcinoma. by DR Smith, PJ Polverini, SL Kunkel… – The Journal of …, 1994 – rupress.org

Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. by TC McLoud, PM Bourgouin, RW Greenberg, JP Kosiuk… – Radiology, 1992 – pubs.rsna.org