Tracheal Cancer

Overview

Tracheal cancer is a rare cancer that arises in the trachea, the windpipe that carries air between the voice box and the lungs. Because it is uncommon and its early symptoms resemble more ordinary breathing problems, it can be mistaken for asthma or bronchitis at first.

The two most common types are squamous cell carcinoma, which is strongly linked to smoking, and adenoid cystic carcinoma, which grows more slowly and is not clearly tied to smoking. As a tumor grows, it can narrow the airway and interfere with breathing. Diagnosis and treatment are best handled by specialists experienced with this rare cancer.

Symptoms

Symptoms often develop as the tumor narrows the airway and may include:

• A persistent cough
• Wheezing or noisy breathing
• Shortness of breath, especially with activity
• Coughing up blood or blood-streaked mucus
• Hoarseness or a change in voice
• Difficulty swallowing
• Frequent or recurring respiratory infections

Because these symptoms overlap with common conditions, tracheal cancer is sometimes diagnosed late. New, persistent, or unexplained breathing symptoms should be evaluated.

Causes

The exact cause of tracheal cancer is not fully understood, but several factors are linked to it:

• Smoking: A strong risk factor for squamous cell carcinoma of the trachea.
• Exposure to certain inhaled irritants over time.
• Spread from nearby cancers, such as those of the lung, voice box, or esophagus, which can involve the trachea.

Adenoid cystic carcinoma, another tracheal cancer type, is not clearly associated with smoking, and its cause is unknown.

Risk Factors

• Current or past tobacco smoking
• Long-term exposure to inhaled irritants or pollutants
• A history of other cancers of the head, neck, or chest

Because tracheal cancer is rare, most people with these risk factors will never develop it.

Diagnosis

Diagnosis usually follows persistent breathing symptoms and involves several tests:

• Bronchoscopy: A thin scope passed into the airway to view the trachea directly and take a biopsy.
• Imaging: CT scans, and sometimes MRI or PET, to assess the tumor's size, location, and spread.
• Biopsy: Examining a tissue sample under a microscope to confirm the cancer type.
• Breathing tests to assess airway narrowing.

Treatment

Treatment depends on the tumor type, size, location, and whether it has spread, and often combines several approaches.

• Surgery: Removing the affected portion of the trachea and rejoining the healthy ends is the main treatment when the tumor can be removed.
• Radiation therapy: Used alone, after surgery, or when surgery is not possible.
• Chemotherapy: May be combined with radiation or used for more advanced disease.
• Airway procedures: Stents or other techniques to keep the airway open and ease breathing.

Care is typically coordinated by a team of specialists, and treatment plans are individualized.

Prevention

• Do not smoke, and seek help to quit if you do
• Avoid secondhand smoke and limit exposure to inhaled irritants
• Use appropriate protection when working around airborne chemicals or fumes
• Get persistent breathing symptoms evaluated rather than assuming they are minor

When to See a Doctor

See a doctor for breathing symptoms that are persistent or unexplained, particularly:

• A cough that does not go away
• Coughing up blood
• Worsening wheezing or shortness of breath
• Hoarseness or trouble swallowing that lasts more than a couple of weeks

Seek emergency care immediately for severe difficulty breathing or a sense that the airway is closing.

Related Topics

Frequently Asked Questions

References

1. National Cancer Institute (NCI).
2. American Cancer Society.
3. Mayo Clinic. Tracheal tumors.
4. MedlinePlus, U.S. National Library of Medicine. Tracheal disorders.