Childhood Tracheobronchial Tumors Treatment (PDQ®)–Patient Version
General Information About Childhood Tracheobronchial Tumors
- Tracheobronchial tumor is a type of childhood lung cancer that forms in the lining of the trachea or bronchi.
- Signs and symptoms of a tracheobronchial tumor include wheezing and dry cough.
- Tests that examine the trachea and bronchi are used to help diagnose tracheobronchial tumor.
- Certain factors affect treatment options and prognosis (chance of recovery).
Tracheobronchial tumor is a type of childhood lung cancer that forms in the lining of the trachea or bronchi.
There are several types of tracheobronchial tumors or cancers, such as the following:
Most tracheobronchial tumors in children are malignant (cancer). Sometimes, a slow-growing tracheobronchial tumor, such as inflammatory myofibroblastic tumor, becomes cancer that may spread to other parts of the body.
Signs and symptoms of a tracheobronchial tumor include wheezing and dry cough.
Conditions other than tracheobronchial tumors may cause these same signs and symptoms. For example, symptoms of tracheobronchial tumors are a lot like the symptoms of asthma, which can make it hard to diagnose the tumor.
Tests that examine the trachea and bronchi are used to help diagnose tracheobronchial tumor.
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the neck and chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Rarely, the following tests and procedures may be used:
- Bronchography: A procedure to look for abnormal areas in the larynx, trachea, and bronchi and to check whether the airways are wider below the level of the tumor. A contrast dye is injected or put through a bronchoscope to coat the airways and make them show up more clearly on x-ray film.
- Octreotide scan: A type of radionuclide scan used to find tracheobronchial tumors or cancer that has spread to the lymph nodes. A very small amount of radioactive octreotide (a hormone that attaches to carcinoid tumors) is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body.
Certain factors affect treatment options and prognosis (chance of recovery).
Treatment options and prognosis depend on the following:
The prognosis for children with tracheobronchial tumors that can be removed by surgery is very good. This is the case for most tracheobronchial tumors except rhabdomyosarcoma, which require more aggressive treatment.
Stages of Tracheobronchial Tumors
- There is no standard staging system for childhood tracheobronchial tumors.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the body.
There is no standard staging system for childhood tracheobronchial tumors.
The process used to find out if cancer has spread from the trachea or bronchi to nearby areas or to other parts of the body is called staging. There is no standard system for staging childhood tracheobronchial cancer. The results of the tests and procedures done to make a diagnosis are used to help make decisions about treatment.
There are three ways that cancer spreads in the body.
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if a tumor in the trachea or bronchi spreads to the liver, the cancer cells in the liver are actually from the trachea or bronchi. The disease is metastatic tracheobronchial cancer, not liver cancer.
Treatment Option Overview
- There are different types of treatment for children with a tracheobronchial tumor.
- Children with a tracheobronchial tumor should have their treatment planned by a team of doctors who are experts in treating childhood diseases.
- Four types of standard treatment are used:
- Radiation therapy
- Targeted therapy
- New types of treatment are being tested in clinical trials.
- Treatment for childhood tracheobronchial tumor may cause side effects.
- Patients may want to think about taking part in a clinical trial.
- Patients can enter clinical trials before, during, or after starting their cancer treatment.
- Follow-up tests may be needed.
There are different types of treatment for children with a tracheobronchial tumor.
Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.
Children with a tracheobronchial tumor should have their treatment planned by a team of doctors who are experts in treating childhood diseases.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health professionals who are experts in treating children with cancer and who specialize in certain areas of medicine. This may include the following specialists and others:
Four types of standard treatment are used:
Surgery to remove the tumor is used to treat all types of tracheobronchial tumor except rhabdomyosarcoma. Sometimes a type of surgery called a sleeve resection is used. The tumor and lymph nodes and vessels where cancer has spread are removed.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
Chemotherapy is used to treat rhabdomyosarcoma. For more information, see Drugs Approved for Rhabdomyosarcoma.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Radiation therapy is used to treat rhabdomyosarcoma.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells.
New types of treatment are being tested in clinical trials.
Treatment for childhood tracheobronchial tumor may cause side effects.
Side effects from cancer treatment that begin after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include:
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
As your child goes through treatment, they will have follow-up tests or checkups. Some of the tests that were done to diagnose the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back).
Treatment of Childhood Tracheobronchial Tumors
For information about the treatments listed below, see the Treatment Option Overview section.
- Surgery to remove the tumor, for all types of tracheobronchial tumors except rhabdomyosarcoma.
- Chemotherapy and radiation therapy, for rhabdomyosarcoma that forms in the trachea or bronchi. For more information about rhabdomyosarcoma and its treatment, see Childhood Rhabdomyosarcoma Treatment.
- Targeted therapy (crizotinib), for inflammatory myofibroblastic tumors that form in the trachea or bronchi.
Sometimes childhood tracheobronchial tumors can recur (come back) after treatment. If your child is diagnosed with a recurrent tracheobronchial tumor, your child's doctor will work with you to plan treatment.
For information about the treatment of tracheobronchial carcinoid tumors, see Childhood Gastrointestinal Neuroendocrine Tumors Treatment.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
To Learn More About Tracheobronchial Tumors
For more childhood cancer information and other general cancer resources, see the following:
- About Cancer
- Childhood Cancers
- CureSearch for Children's Cancer
- Late Effects of Treatment for Childhood Cancer
- Adolescents and Young Adults with Cancer
- Children with Cancer: A Guide for Parents
- Cancer in Children and Adolescents
- Coping with Cancer
- Questions to Ask Your Doctor about Cancer
- For Survivors and Caregivers
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This PDQ cancer information summary has current information about the treatment of childhood tracheobronchial tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
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Clinical Trial Information
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PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Tracheobronchial Tumors Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/lung/patient/child-tracheobronchial-treatment-pdq. Accessed <MM/DD/YYYY>.
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