Bronchial carcinoma is associated with the widespread habit of cigarette smoking, carcinoma of the bronchus is the commonest malignancy in males and is approaching the importance of breast cancer in females. The disease is unusual in non- smokers and the increased incidence in smokers is related to the number of cigarettes consumed. Passive smoking causes lung cancer in non-smokers. Clinical features Symptoms of local disease Bronchial carcinomas frequently arise in major bronchi, and therefore common problems include cough, haemoptysis, breathlessness, wheeze and stidor.
Some patients have diffuse, poorly localised chest pain, and many have chest infections.
Of these symptoms, haemoptysis, progressive breathlessness and persistent respiratory infection are the most important. A normal chest X-ray is unusual in bronchial carcinoma, but does not exclude a tumour. Breathlessness This is common in smokers who have developed generalised airways obstruction but progressiona is usually gradual and accelerated breathlessness commonly occurs as a tumour narrows a major airway. Such narrowing may produce a localised wheeze and occasionally stridor if the trachea or major bronchi are affected. Breathlessness may also be due to the accumulation of a malignant pleural effusion.