What is mediastinal cancer?
Mediastinal cancer is cancer that forms in the cavity between the sternum and the spine and the two lungs. Within the term mediastinal tumors are grouped a series of cystic and tumor lesions that originate in different mediastinal or extramediastinal tissues and organs. The most frequent mediastinal tumors are thymomas, lymphomas, intrathoracic goiters, neurofibromas and teratomas.
Prognosis of the disease
Mediastinal cancer is very rare and is usually asymptomatic. The clinical presentation is sometimes nonspecific, although it usually manifests with respiratory symptoms, especially in children. The prognosis depends on this and on the extent to which the organs and structures of the respiratory system are affected, i.e. the stage of the tumor. A characteristic presentation (although infrequent) is superior vena cava syndrome. In this case it does have a poor prognosis and specific measures, such as stenting or radiotherapy, will be necessary to improve the prognosis. Although it is a late symptom, it has a high mortality. In addition, mediastinal tumors must be treated because, if not, they could grow and cause compression of the spinal cord or spread to nearby structures, such as the heart.
What are the symptoms?
Approximately one-third of mediastinal tumors are asymptomatic, as those that do occur are due to pressure from structures in the chest. The most common symptoms are:
- Cough
- Chills
- Chest pain
- Fever
- Hemoptysis (coughing up blood)
- Hoarseness
- Shortness of breath
- Cold sweat
Mediastinal cancer affects the area in the middle of the chest
in the middle of the chest separating the lungs
Medical tests for mediastinal cancer
Tests that should be performed to diagnose possible mediastinal cancer include a chest x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI). Blood tests will also help determine the type of tumor. Tissue sampling may require a biopsy, mediastinoscopy procedures with biopsy or complete removal of the lesion with sternotomy or other minimally invasive procedure.
What are the causes of mediastinal cancer?
The most frequent causes or risk factors for this type of cancer are:
- Family history of mediastinal cancer.
- History of cancer: people who have had cancer in the past are more likely to get mediastinal cancer in the future.
- Tobacco: is a key cause of mediastinal cancer, as toxic substances from tobacco are deposited in central organs such as the heart and lungs.
- Environmental factors: exposure to chemical pollutants, such as pesticides or chemical fertilizers, can cause different types of neoplasia.
- Alcoholism: is a prevalent factor in esophageal cancer.
Can mediastinal cancer be prevented?
There is currently no known method to prevent it, although avoiding some of the risk factors mentioned, such as tobacco or alcohol, may help.
What is the treatment for mediastinal cancer?
There are several treatments for mediastinal cancer, and one or the other is used depending on the type of tumor:
- Thymic cancer: the appropriate treatment is surgery followed by radiation and/or chemotherapy, depending on the stage of the tumor and how the surgery went.
- Lymphomas: the best treatment is chemotherapy followed by radiation.
- Neurogenic tumors of the posterior mediastinum: the treatment of choice is surgery.
Which specialist treats it?
The specialists involved in the diagnosis, study and treatment of mediastinal cancer are experts in Thoracic Surgery, Pneumology and Medical Oncology. Doctors from the three specialties should complement each other and communicate in order to best resolve the patient’s case and know how to act.