Pancoast Syndrome, (Apical Lung Cancer) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Pancoast Syndrome or tumors are cancers that form at the very top part of the lung (the apex).
Pancoast tumors are a subset of non-small cell lung cancers that invade the top of the chest.
Because of their location, they invade adjoining tissue
Cancers in the top part of the lung are rare.
Pancoast tumor normally spread into one or more structures in the top part of the chest which are:
1. The top ribs in the chest (the thoracic ribs)
2. Nerves in the top of the chest
3. Bundles of nerves close to the spinal cord
4. Blood vessels that supply blood to the arms
Most pancoast tumors are a type called non small cell cancer and most often squamous cell cancer.
Causes
The risk factors for almost all lung cancers are similar.
1. Smoking
2. Secondary smoke exposure
3. Prolonged asbestos exposure
4. Exposure to industrial elements (such as gold or nickel)
5. Exhaust fumes from cars
Symptoms
While a Pancoast tumor is a lung tumor, it rarely causes symptoms that are typically related to the lungs (like cough or chest pain).
ecause the cancer is at the top of the lungs, it might put pressure on or damage a group of nerves that runs from the upper chest into the neck and arms.
The group of nerves is called the brachial plexus.
Pressure on the brachial plexus can cause several very specific symptoms:
1. Severe pain in the shoulder or the shoulder blade (scapula)
The initial symptom is normally pain in the shoulder, the inner part of the shoulder blades, or both.
2. Pain in the arm and weakness of the hand on the affected side
The affected person normally needs to support the elbow of the affected arm in the opposite hand to ease the tension on the shoulder and upper arm.
3. Horner's syndrome
There is flushing on one side of the face and that side does not sweat.
The eye on the same side has a smaller (constricted) pupil with a drooping or weak eyelid.
4. In up to 25% of people with a Pancoast tumor, compression of the spinal cord and paralysis of the lower half of the body develop when the tumor extends into the opening between two vertebrae.
Diagnosis
Pancoast tumors can be difficult to diagnose.
There is a need for an MRI scan to help diagnose it.
Arteriogram or venogram with dye may show the lung cancer
Bronchoscopy may help
Biopsy can make a diagnosis in 95%
Mediastinoscopy and PET scan may show spread of cancer
Treatment
Treatment for a pancoast tumor is dependent on the stage of the cancer, its exact position in the lung and the general health
The standard of care for people with a Pancoast tumor is chemotherapy and radiation followed by removal of the tumor and a portion of the chest wall if it is affected or if its removal facilitates surgery.
The reason for the chemotherapy and radiation is to reduce the size of the tumor and to prevent the cancer from spreading through lymph nodes.
An interval of two to four weeks after the chemo and radiation allows the procedures to reach their maximal effect
After four weeks, all patients are reassessed for surgery.
If the cancer has not spread to distant areas of the body, surgery will likely be offered.
Surgery
Before surgery, the doctor carefully assesses and stages the cancer.
During surgery, the doctor normally removes a portion of the chest wall and part of the lung.
If the patient is fit enough to have surgery, he or she normally have a combination of chemotherapy and radiotherapy (chemoradiotherapy) first to shrink the cancer.
This is called tri-modality treatment.
The surgery requires removing the top two ribs or sometimes more.
Immunotherapy and targeted cell cancer therapy have changed the treatment of lung cancer and have improved survival rates tremendously.

TABLE OF CONTENT
Introduction
Chapter 1 Pancoast Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapte

• Language: English
• Publisher: Kenneth Kee
• Release date: Oct 16, 2017
• ISBN: 9781370863860

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Pancoast Syndrome,

(Apical Lung Cancer)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2017 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Pancoast Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Pancoast Syndrome)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Pancoast Syndrome

What is Pancoast Syndrome?

Pancoast Syndrome or tumors are cancers that form at the very top part of the lung (the apex).

Pancoast tumors are a subset of non-small cell lung cancers that invade the top of the chest.

Because of their unique location, they invade adjoining tissue

Cancers in the top part of the lung are rare.

Fewer than 5 in every 100 cases of lung cancer (5%) are pancoast tumors.

Pancoast tumor normally spread into one or more structures in the top part of the chest which are:

1. The top ribs in the chest (the thoracic ribs)

2. Nerves in the top of the chest

3. Bundles of nerves close to the spinal cord

4. Blood vessels that supply blood to the arms

Pancoast tumors occur as an abnormal patch of tissue over the lung apex and principally affect the chest wall structures rather than the underlying lung tissue.

They may invade areas such as lymph nodes, nerves, ribs, and spine

Types of pancoast tumor

Most pancoast tumors are a type called non small cell cancer and most often squamous cell cancer.

These cancers develop from the cells that line the airways.

What are the causes of Pancoast Syndrome?

Causes

The risk factors for almost all lung cancers are similar.

These are:

1. Smoking

2. Secondary smoke exposure

3. Prolonged asbestos exposure

4. Exposure to industrial elements (such as gold or nickel)

5. Exhaust fumes from cars

What are the symptoms of Pancoast Syndrome?

Symptoms

While a Pancoast tumor is a lung tumor, it rarely causes symptoms that are typically related to the lungs (like cough or chest pain).

Because the cancer is at the top of the lungs, it might put