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Unmasking the Rare Pancoast Tumour : Symptoms, Causes, and Treatment Options

Pancoast Tumour

You may have heard of lung cancer, but did you know that there is a rare and specific type of lung cancer that affects the top part of the lung and causes different symptoms than other lung cancers? This type of lung cancer is called a Pancoast Tumour.

In this blog, we will learn more about what a pancoast tumour is, whether pancoast tumour is a type of lung cancer, causes of pancoast tumour, risk factors, treatment options and recovery time.

What is a Pancoast Tumour?

A Pancoast tumour is a rare and specific type of lung cancer. It starts in the top part of your lung (the apex), just above your first rib, and can affect nearby nerves and blood vessels. 

They are different from most lung cancers because they usually do not make you cough or give you chest pain. But they often cause shoulder pain, arm weakness, and other problems. Doctors call this group of problems “Pancoast syndrome.”

Pancoast syndrome can make it hard to find these tumours early because they do not have the usual signs of lung cancer. Sometimes, the cancer has already reached nearby nerves and blood vessels before doctors can diagnose it.

Pancoast Tumour Symptoms

The side of your body where you have a Pancoast tumour will show the symptoms. For example, if the tumour is on your right lung, then the right side of your body will have the problems.

Some of the symptoms of a Pancoast tumour are:

  • Severe shoulder pain that may radiate to the arm, neck, upper ribs, or chest.
  • Arm and hand weakness, swelling, tingling, numbness, or loss of dexterity.
  • Drooping of the eyelid, flushing, or displacement of the eyeball on the affected side (Horner’s syndrome).
  • Fatigue, weight loss, or chest tightness.

Causes Of Pancoast Tumour

Causes and risk factors of Pancoast tumour lung cancer are similar to other lung cancer tumours. Possible causes of Pancoast tumours include:

  • Smoking or exposure to secondhand smoke.
  • Long-term exposure to chemicals, heavy metals, or diesel exhaust.
  • Long-term exposure to high levels of radon or asbestos..
  • Other cancers, fungal infections, bacteria, or diseases like tuberculosis (TB).

How do Pancoast Tumours spread?

Pancoast tumours can spread from the upper lung into your

Upper chest

Upper back

Thoracic ribs (in your chest)

Nearby blood vessels in your chest and neck.

A complex network of nerves known as the brachial plexus that sends signals to the shoulder, arm, and hand from the spinal cord.

When cancer spreads, cancer cells break away from the original tumour, travel through your lymph system or blood, and form new tumours in other parts of your body. This is called metastasis. Most commonly, Pancoast tumours can metastasize to your:

  • Regional lymph nodes (small, bean-shaped structures found throughout the body).
  • Brain.
  • Bones.
  • Liver.
  • Adrenal glands.

Pancoast Tumour Treatment

The treatment for Pancoast tumour depends on the location of the tumour and how far the cancer has spread. 

Some of the treatment options:

  • Chemoradiation and surgery.
  • Chemoimmunotherapy and surgery.
  • Chemoradiation and immunotherapy.
  • Radiation therapy.
  • Targeted treatment.

Chemoradiation and surgery: 

This is the most common treatment for Pancoast tumours. Chemoradiation is a combination of chemotherapy (drugs that kill cancer cells) and radiation therapy (high-energy beams that shrink tumours). Chemoradiation is given before surgery to make the tumour smaller and easier to remove. Pancoast tumour treatment resection involves removing the tumour and some surrounding tissues, such as the chest wall, ribs, or nerves.

Chemoimmunotherapy and surgery: 

This newer treatment option may be more effective for some people. Chemoimmunotherapy combines chemotherapy and immunotherapy (drugs that boost the immune system to fight cancer). Chemoimmunotherapy is given before surgery to shrink the tumour and prevent it from spreading.

Chemoradiation and immunotherapy:

This is another newer treatment option that may be more suitable for some people. If surgery isn’t an option, your medical team may recommend Chemoradiation, followed by immunotherapy, to prevent the cancer from coming back. Immunotherapy may be given as a pill or an injection.

Radiation therapy:

This is a treatment option for people who cannot have surgery or chemotherapy. Radiation therapy uses high-energy beams to shrink the tumour and relieve symptoms. Radiation therapy may be given alone or in combination with other treatments, such as immunotherapy or targeted therapy.

Targeted therapy: 

This treatment option is for people with a specific gene mutation in their cancer cells. It uses drugs that target the mutation and stop the cancer from growing. Targeted therapy may be given as a pill or an injection, alone or in combination with other treatments, like radiation therapy or immunotherapy.

Recovery time from Pancoast tumour treatment depends on the type and extent of the treatment, as well as the individual’s health and healing process. Generally, surgery is a complex and challenging procedure that requires an extended hospital stay and intensive care. It may take several weeks or months to recover from the surgery and its complications, such as pain, infection, nerve damage, and bleeding. A full recovery from Pancoast tumour treatment may take two months or longer.

Common FAQs

How does a Pancoast tumour cause Horner’s syndrome?

When the tumour compresses or damages the sympathetic nerves, it can disrupt the signals that regulate the facial and eye muscles. This can lead to the symptoms of Horner’s syndrome on the same side as the tumour.

Can Pancoast tumour affects both arms?

Pancoast tumours usually affect only one arm, depending on which lung the tumour is located in. However, in rare cases, Pancoast tumours can affect both arms if the tumour is large enough to compress the nerves and blood vessels on both sides of the chest. This can cause symptoms such as weakness, pain, numbness, tingling, and swelling in both arms.

How fast does pancoast tumour grow?

The growth rate of Pancoast tumours varies from tumour to tumour, depending on the type and subtype of the cancer cells, the stage of the disease, and the individual’s health and immune system. In general, Pancoast tumours tend to grow slowly, but there are some cases where they can grow very rapidly.

Consult Dr Taj Chowdhry for lung Pancoast Tumour treatment.

Dr Taj Chowdhry is a leading surgeon who has performed hundreds of successful surgeries for Pancoast tumours. He will work with you to create a personalised treatment plan that suits your needs and goals.

Don’t wait any longer. Contact Dr Taj today to get the best care for your Pancoast tumour.