Unveiling the secrets of lung cancer: From symptom identification to precise treatment, read it in one article!

Author: Zhi Xiuyi, Chief Physician of Beijing Tsinghua Chang Gung Hospital affiliated to Tsinghua University

Reviewer: Zhang Yu, researcher at Chinese Center for Disease Control and Prevention

In today's society, with the change of lifestyle and the aggravation of environmental pollution, lung cancer, a malignant tumor, is gradually becoming a major threat to human health. Lung cancer, as a cancer originating from the bronchial mucosa or glands of the lungs, has a high morbidity and mortality rate.

Its pathogenesis is complex and diverse, with genetic factors playing a role as well as being closely related to environmental exposure, lifestyle and other factors. With the continuous advancement of medical technology, although the diagnosis and treatment of lung cancer has been significantly improved, early detection and early diagnosis are still the key to improving the survival rate of patients.

The symptoms of lung cancer are closely related to the location, size and stage of development of the tumor. Early peripheral lung cancer often has no obvious clinical symptoms and is usually discovered accidentally during physical examinations or screening programs. In contrast, central lung cancer is more likely to have symptoms, such as irritating coughs and coughing up blood in sputum. These symptoms often indicate that the tumor has begun to invade the airway or other important structures. In addition, if the tumor compresses the nerves or blood vessels, it may also cause symptoms such as hoarseness and facial edema. Therefore, for long-term smokers or people with other risk factors, once persistent coughs or coughing up blood occur, they should seek medical attention in time for investigation.

Figure 1 Original copyright image, no permission to reprint

In the process of diagnosing lung cancer, a series of examinations play a key role, including imaging examinations (such as chest X-rays, CT scans), metabolic examinations (such as PET/CT), cytology examinations (such as sputum cytology examinations), and blood tumor marker tests. In recent years, liquid biopsy, as an emerging diagnostic technology, helps to detect lung cancer at an early stage by detecting biomarkers such as circulating tumor DNA (ctDNA) in the blood, and can be used to monitor treatment response and disease progression.

Figure 2 Original copyright image, no permission to reprint

During the diagnosis process, it is also necessary to differentiate from other lung diseases such as pulmonary tuberculosis, tuberculoma, inflammatory pseudotumor, and hamartoma. For example, tuberculosis is often accompanied by poisoning symptoms such as low fever and fatigue, increased erythrocyte sedimentation rate, and a strongly positive tuberculin test. Through multidisciplinary consultation (MDT), combined with imaging, pathology, clinical symptoms and other information, the occurrence of misdiagnosis and missed diagnosis can be effectively reduced.

The treatment strategies for lung cancer are rich and varied, including surgery, drug therapy (chemotherapy, molecular targeted therapy), radiotherapy, and physical targeted therapy. For patients with early or some mid-stage lung cancer, surgery is the preferred treatment method. The application of modern minimally invasive surgical techniques has greatly reduced the pain of patients and improved the safety of surgery. After surgery, chemotherapy or molecular targeted therapy may be required to reduce the risk of recurrence, depending on the patient's specific situation.

In terms of drug treatment, although traditional cytotoxic chemotherapy is effective, it has significant side effects. In recent years, molecular targeted therapy has become a research hotspot. This type of drug can act on specific molecular targets on the surface or inside tumor cells to reduce damage to normal cells. With the development of genetic testing technology, targeted drugs for specific gene mutations continue to emerge, providing patients with more personalized treatment options.

Radiotherapy technology is also constantly improving. Modern radiotherapy, such as proton knife and neutron knife, can irradiate the tumor area more accurately and reduce the impact on surrounding normal tissues. In addition, for patients who are not suitable for surgery or radiotherapy, physical therapy such as radiofrequency ablation is also a viable option.