Bronchioloalveolar carcinoma (BAC) is a relatively uncommon type of adenocarcinoma (lung cancer). BAC accounts for approximately 2.6–4.3% of all lung cancers. BAC is a subtype of non-small cell lung cancer that develops in the alveoli (small air sacs) in the outer regions of the lungs. BAC typically arises in the lung periphery and grows along alveolar walls without destroying the lung parenchyma (the portion of the lung that’s involved in gas transfer). It’s often multicentric (having more than one center), and may arise from a previously stable scar. BAC spreads primarily within the lungs themselves, unlike other forms of lung cancer which can often spread to the lining of the lungs and other places in the body.
Bronchioloalveolar carcinoma is unpredictable, and can range anywhere from a slow-growing, progressive tumor to a rapidly growing cancer—earning it the name “the mystery of lung cancer.” Until 2016, BAC was used to define a specific subtype of lung adenocarcinoma. It has since been reclassified as a form of lung cancer itself.
Types of Bronchioloalveolar Carcinoma
There are two main types of BAC: non-mucinous bronchioloalveolar carcinoma, and mucinous bronchioloalveolar carcinoma. (Mucinous refers to the mucous-producing qualities of the carcinoma; mucus secreted by cancer cells are commonly expelled as sputum/mucus.) Non-mucinous BAC is the more common of the two types and is found more often in smokers, while mucinous BAC is less common and found often in non-smokers.
Risk Factors for Bronchioloalveolar Carcinoma
Bronchioloalveolar carcinoma is more likely to affect non-smokers, Asians (specifically eastern Asians), and women.
Bronchioloalveolar Carcinoma Symptoms
BAC symptoms tend to be similar to other types of lung cancers… however, since BAC is unpredictable, it can sometimes be mistaken for pneumonia or other lung diseases—earning it another nickname: the “masquerader.”
Symptoms of bronchioloalveolar carcinoma include:
- Persistent cough
- Cough that produces blood
- Chest pain
- Shortness of breath
- Cough that produces frothy sputum/mucus
Because the parenchyma is preserved, and because BAC may arise simultaneously in multiple lobes, symptoms of BAC may be indistinguishable from pneumonia and other inflammatory respiratory processes and illnesses. If you’re concerned about your symptoms, call your doctor for a full health screening.
Diagnosing Bronchioloalveolar Carcinoma
Diagnosing bronchioloalveolar carcinoma is a similar process to diagnosing other types of lung cancer:
- Bone scan
- Lung biopsy
- CT scan
- PET scan of the chest
- Examination of sputum/mucus to look for cancer cells
In addition to the steps mentioned above, a tissue sample is required to diagnose BAC. In roughly half the cases of BAC, a fine-needle aspiration biopsy can provide a diagnosis. During this procedure, a fine needle is inserted through the skin and into the tumor. A small sample is taken through the needle and diagnosed in a lab.
Staging Bronchioloalveolar Carcinoma
Bronchioloalveolar carcinoma is staged similarly to other types of lung cancers. (Stages 1–4 or TNM staging.)
Bronchioloalveolar Carcinoma Treatment
Unlike other types of lung cancer where chemotherapy may be the first plan of attack, surgery is often the first choice for treating bronchioloalveolar carcinoma. When a single tumor is removed, the chances are very good that the cancer can be cured.
BAC has appeared to be responsive to new targeted therapies for lung cancer, which are treatments designed to target specific gene mutations within a specific tumor. For this reason, people with BAC make good candidates for having genetic testing performed on their tumor.
In addition to surgery and targeted therapy, lung transplants have been recently explored as treatment options for BAC.
Bronchioloalveolar Carcinoma Prognosis
Survival rates vary depending on the stage of cancer, but generally speaking, the survival rate for bronchioloalveolar carcinoma is much better than other forms of non-small cell lung cancer when caught early. The survival rate for later stages of the disease vary and are dependent on a number of varying factors.
The Lung Docs: Specialized Pulmonary Care
The Lung Docs provides specialized, state-of-the-art pulmonary care to our patients with bronchioloalveolar carcinoma in Chattanooga and the surrounding Southeast Tennessee and Northwest Georgia areas.
Dr. Mike’s Approach
I’m Dr. Mike Czarnecki, “The Lung Doc,” and I’m trained in all areas of pulmonary health, including the diagnosis and treatment of bronchioloalveolar carcinoma. I will work with you to formulate a personalized BAC treatment plan so you can live, laugh, love, and breathe better again! To get started, schedule an appointment online or call our office to speak to someone directly. I can’t wait to meet you!