Tracheal Diseases: Treatment of Tracheal & Bronchial Tumors

Pictured: Mohit Chawla Mohit Chawla (right) is one of the few fully trained interventional pulmonologists in the world. He and others at Memorial Sloan Kettering are leaders in developing new, minimally invasive techniques for managing tumors that develop in the chest.

Tumors in the trachea and bronchi can block the airway and cause breathing problems. Most of the tumors that form in the trachea and bronchi in adults are cancerous, but a few are noncancerous. Squamous cell carcinoma, which usually arises in the lower part of the trachea, is the most common type of malignant tracheal tumor.

Memorial Sloan Kettering's multidisciplinary experts in complex airway diseases are experienced in selecting the appropriate treatments for people with tracheal and bronchial tumors. Treatment may include surgery, bronchoscopic treatments that are delivered through a tube with a tiny camera inserted through the mouth and into the airways, or radiation therapy, either alone or in combination.

In patients who are not candidates for complete surgical removal of the tumor, these therapies may be used to help restore breathing and slow tumor progression.

Surgery

Surgical removal of the tumor is the preferred treatment if you have a cancerous (malignant) or noncancerous (benign) tumor that involves less than half of the trachea. Our surgeons can remove the tumor and a small amount of healthy tissue surrounding it before rejoining upper and lower sections of the trachea.

Surgical removal of a tracheal tumor can be a complex procedure. The blood supply to the trachea is delicate and easily damaged. Any damage to the blood vessels around the trachea makes it more difficult for the trachea to heal, potentially increasing the complications of surgery.

Our surgeons are specially trained in techniques to preserve the blood supply and reduce the risk of these complications, improving the chance of a successful outcome.

Bronchoscopic Treatments

If your tumor is more extensive and you cannot have surgery, you may be eligible for a number of palliative therapies to help restore your breathing and slow tumor growth.   

Bronchoscopic treatments are delivered through a bronchoscope, a tube attached to a tiny camera that is inserted through the mouth. The doctor uses the bronchoscope to look inside the airways and inserts additional instruments through it – for example, to administer laser therapy or insert airway stents.

At Memorial Sloan Kettering, we commonly perform these bronchoscopic treatments for our patients:

Stent Therapy — This technique involves placing a narrow tube made out of metal or silicone – known as a tracheobronchial airway stent – in a narrowed or constricted airway to keep it open.

Laser Therapy — This treatment involves using a highly focused beam of light to shrink or remove the tumor.   

Argon Beam Coagulation — Similar to laser therapy, this treatment uses electricity and argon gas to kill tumor tissue.

Brachytherapy — A bronchoscope is used to help deliver radiation therapy directly to the tumor site, destroying tumor cells. Brachytherapy may be recommended when a patient is not eligible for external-beam radiation therapy (described below).

Rigid Bronchoscopy — This palliative procedure involves inserting a rigid bronchoscope (a straight, hollow tube) into the trachea and removing the tumor tissue inside the airway with the scope.

The above bronchoscopic treatments are often used in combination to relieve symptoms and provide the best possible outcome.

Radiation Therapy

Some patients with tumors of the trachea or bronchi, or those that have spread to nearby lymph nodes or other areas within the chest, may be treated with radiation therapy alone or after surgery.

External-beam radiation, in which a beam of radiation is delivered from an external source to the tumor site, is the main type of radiation therapy used to treat people with tracheal tumors. Brachytherapy — a localized form of radiation therapy — may be used to treat patients who are not candidates for external-beam radiation therapy.

Chemotherapy

Chemotherapy is a drug or combination of drugs that is given intravenously to stop or slow the growth of tumor cells. Chemotherapy may be used, usually in combination with radiation therapy, to treat large squamous cell tracheal tumors that cannot be surgically removed.