Cancer Treatment
Mediastinal Cancer
The mediastinal cavity comprises the heart, the aorta, the oesophagus, the thymus, and the trachea. Mediastinal tumours develop in the chest region adjacent to the heart, lungs and spine.
Cancers in the mediastinum can develop from structures that are anatomically located inside the mediastinum or that transverse through the mediastinum during development and also from metastases or malignancies that originate elsewhere in the body. It is challenging to treat tumours that develop in this area since the mediastinum is a critical area.
Symptoms of Mediastinal Cancer:
People with mediastinal cancer may experience any of the following symptoms; in some cases, the cancer is not symptomatic.
Cough
Shortness Of Breath
Chest Pain
Fever/Chills
Night Sweats
Coughing Up Blood
Unexplained Weight Loss
Swollen Lymph Nodes
Respiratory blockage
Coughing or hoarseness
Cancer Treatment
Types of Mediastinal Cancer
There are several categories of mediastinal tumours, with their causes linked to where they originate within the mediastinum.
Anterior (front) mediastinum
- Lymphoma: It includes both Hodgkin’s and Non-Hodgkin’s Lymphoma
- Thymoma and thymic cyst: It’s one of the most common types of cancer, with the majority of thymomas being benign and surrounded by a fibrous capsule. However, about 30% of those could also be more aggressive and grow through the sac into other tissues. It is one of the most common types.
- Germ cell: The majority of germ cell neoplasms (60 to 70%) are benign and seen in both men and women.
- Thyroid mass mediastinal: It is usually benign enlargement of the thyroid gland below the neck and into the chest.
Posterior (back) mediastinum
- Neurogenic tumours: Approximately 70% of neurogenic neoplasms are benign and are classified into nerve sheath neoplasms, ganglion cell neoplasms, or paraganglionic cell neoplasms.
- Lymphadenopathy: This refers to an enlargement of the lymph nodes.
- This refers to an enlargement of the lymph nodes.
- It’s a rare growth involving the neural and gastrointestinal elements.
- These consist of infectious, malignant and traumatic abnormalities of the thoracic spine.
Middle mediastinum
- Bronchogenic cyst: This is a benign growth with respiratory origins.
- Mediastinal Lymphadenopathy: This is an enlargement of the lymph nodes.
- Pericardial cyst: It’s a benign growth in the pericardium – the outer layer of the heart.
- Tracheal tumours: These can be either benign or malignant.
- Oesophagal tumours: These can be either benign or malignant
- Oesophagal abnormalities: These include achalasia oesophagal, diverticulum, and hiatal hernia.
- Vascular abnormalities: These include aortic aneurysm and aortic dissection
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Causes of Mediastinal Cancer
The causes of mediastinal cancer may be as follows:
- The tumour in the mediastinum typically depends on the patient’s age, wherein children are more likely to develop them in the back of the mediastinum. About 25% of mediastinal tumours and 60% of anterior mediastinal tumours are cancerous.
- Diet: Certain substances within the diet may increase the chances of oesophagal cancer risk. Reports suggest that a diet high in processed meat may increase the prospects of developing oesophagal cancer, but these are not proven.
When to see the doctor?
It is best to consult our specialist at the earliest if you frequently experience any of these problems or symptoms mentioned above.
Dedicated oncologists, surgeons and specialists provide customized treatment approaches to ensure the best patient outcomes.
Screening of Mediastinal Cancer
The following tests may be recommended by your doctor to diagnose and evaluate mediastinal tumour:
Blood Tests
Tumour markers: Alpha-fetoprotein (AFP), beta HCG, LDH
Tissue Biopsy
Chest x-ray
Computed tomography (CT) scan or a CT-guided biopsy of the chest.
Magnetic resonance imaging (MRI) of the chest.
Mediastinoscopy, done to collect tissue samples through a 1-inch incision in the neck, is an outpatient procedure performed under general anaesthesia. It does not help with posterior or anterior mediastinum.
Anterior mediastinotomy (Chamberlain procedure): A tube is inserted through an incision made near the sternum to have a clear vision of the area between the lungs, breastbone and heart.
EBUS (Endobronchial Ultrasound): It's the process of collecting tissue samples through a needle aspiration procedure. The disadvantage of this procedure is that only a small sample can be obtained using this procedure.
Prevention of Mediastinal Cancer
The occurrence of mediastinal tumours cannot be prevented however diagnosing tumours at early stages improves treatment chances and patient outcomes.
The prospects for patients with mediastinal tumours depend on the tumour location. Doctors tailor treatment approaches depending on the category, placement and stage of mediastinal tumours.
Staging of Mediastinal Cancer
Stage I: Macroscopically and microscopically completely encapsulated
Stage IIA: Microscopic trans capsular invasion
Stage IIB: Macroscopic invasion in the surrounding tissue
Stage III: Macroscopic invasion in the neighbouring organs
Stage IVA: Pleural or pericardial dissemination
Stage IVB: Lymphogenous or hematogenous metastasis
Treatment for Mediastinal Cancer
Surgery: Surgery is the foremost treatment approach for Mediastinal Cancers and is dependent on the tumour location.
Chemoradiation therapy: Mediastinal tumours can be treated with surgery, chemotherapy and radiation or a combination of these therapies. Chemoradiation therapy is a combination of chemotherapy and radiotherapy to get the best possible results after treatment.
Doctors
Surgical oncology
Dr. Saravana Rajamanickam
MS., M.Ch
Medical Oncology
Dr. Bhavesh Poladia
DNB, DM
Medical Oncology
Dr. Deepan Rajamanickam
MD, DM
Radiation oncology
Dr. Karthick Rajamanickam
MD