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What are they?

Thoracic tumours, or chest cancers, are malignant tumours affecting the chest or thorax. Based on their location, they can be classified into:

• Pleural tumours: malignant pleural mesothelioma, solitary fibrous tumour (SFT) of the pleura (usually a benign neoplasm, very rare), lymphoma and secondary malignancies;
• Mediastinal tumours: anterior mediastinal tumours (thymoma, fibroma, fibrosarcoma, lipoma, germ cell tumours, vascular tumours, lymphatic tumours, carcinoid tumours), middle mediastinal tumours (cysts and cardiac tumours), tracheal cancer (phaeochromocytoma and paraganglioma), posterior mediastinal tumours (neurogenic tumours, neurenteric cysts and oesophageal cancer). The most common mediastinal neoplasms are those affecting the thymus, the lymph nodes and those originating from the nervous tissues (neurinomas);
• Oesophageal cancer: based on the affected tissue, they can be classified into squamous cell carcinomas and adenocarcinomas.

What are the symptoms?

The symptoms of thoracic tumours vary considerably according to the specific type of tumour. For instance, in cases of pleural mesotheliomas, the symptoms are quite generic and could be attributed to more generic conditions. In such cases, you may feel pain in one side of your chest or on your lower back, as well as experiencing shortness of breath, coughing, swallowing problems, fever, weight loss, fatigue and muscle weakness. On the other hand, thymomas are usually asymptomatic, while oesophageal cancer can cause dysphagia, weight loss and a change in your voice.

How are they diagnosed?

The diagnosis of chest cancers largely depends on the specific type of tumour. Exams for diagnosing pleural mesothelioma include: CT scan with contrast medium, PET scan and a biopsy; for thymoma, a chest CT scan and biopsy are usually performed. Finally, for oesophageal cancer, a diagnosis can be formulated with an oesophagogastroscopy, X-ray scan with contrast medium, echoendoscopy, thoraco-abdominal CT scan with contrast medium or PET scan.

What causes them?

The cause for chest cancer greatly varies depending on the specific type of tumour. For instance, pleural mesothelioma is caused by exposure to asbestos, whereas there are no ascertained risk factors for thymoma. Oesophageal cancers can be caused by genetic factors, inflammations (Barrett's oesophagus), lifestyle choices (smoking and drinking alcohol) or by diet choices (eating a diet low in fruits and zinc and rich in fats).

How can they be prevented?

Preventive measures vary according to the specific type of tumour. You should lead a healthy lifestyle and avoid drinking alcohol and smoking. You should avoid exposure to asbestos and try to reduce your chances of getting gastroesophageal reflux disease.

How are they treated?

The treatment for pleural tumours (especially for mesothelioma) depends on the stage the cancer has reached: from surgery to chemotherapy or post-operative radiotherapy. Mediastinal tumours and oesophagus cancers are usually treated with surgery. However, surgery may not be a suitable option for lymphomas or metastatic tumours, which can be treated with chemotherapy and radiotherapy.

Which doctor should I talk to?

If you have chest cancer, you should see a specialised oncologist or thoracic surgeon.