[Fat Bear Science] A girl with advanced lung cancer took a video to commemorate her family丨Can it be detected in the early stage? Is there no hope in the late stage?

Recently, a video of a girl with advanced cancer moved many people. The girl from Shenyang, Liaoning used the video to record the good times in her life, hoping to leave it to her family as a memorial after she is gone. Ms. Huo said: "When I was diagnosed with lung cancer, I was already in the advanced stage. I am going to die in the future, and I will leave this account for them to see. I will try to take as many videos as possible, happier and more cheerful ones, so that my parents will not be so sad when they see them in the future."

In the video, Ms. Huo looked young and pretty. Netizens expressed their regret and lamented: "Why did it develop to the late stage? Could it have been detected in the early stage?" "Is there no treatment in the late stage?"

Today, Pang Xiong invited experts from the Thoracic Tumor Center of the Affiliated Tumor Hospital of Chongqing University to talk about health knowledge about lung cancer.

Experts of this issue

Jiang Yuequan

Director of the Thoracic Tumor Center of the Affiliated Tumor Hospital of Chongqing University, chief physician, chief expert on esophageal cancer, doctor of medicine, and master's supervisor.

He specializes in thoracic surgery for esophageal cancer, lung cancer, and mediastinal tumors, especially thoracoscopic and laparoscopic radical resection of esophageal cancer, and single-port lobectomy and segmental resection.

Clinic hours: Monday morning, Tuesday afternoon (Esophageal cancer joint specialist clinic)

Xu Wei

Attending physician at the Thoracic Tumor Center of the Affiliated Tumor Hospital of Chongqing University, Master of Medicine.

He is good at the diagnosis and treatment of lung cancer, esophageal cancer, mediastinal tumors and other tumors, and is proficient in minimally invasive thoracic surgery.

one

Lung cancer usually has no symptoms in its early stages

Lung cancer is a malignant tumor formed by the malignant transformation of lung or bronchial epithelial cells. It is currently the malignant tumor with the highest incidence and mortality in my country. Every year, the number of new lung cancer cases in my country reaches 800,000, accounting for 40% of the total number in the world.

About 1/3 of lung cancer patients do not have any symptoms in the early stages. Lung nodules are often found during physical examinations or medical examinations for other diseases, and further examinations confirm the diagnosis. When most symptomatic patients seek medical treatment, lung cancer is usually in the middle or late stages, so the overall prognosis of lung cancer is poor. However, in the past 10 years, due to the strengthening of people's health awareness and the popularization of CT examinations, more and more early lung cancers have been discovered. The 5-year survival rate after surgery for early lung cancer is over 95%, with good treatment effects. Therefore, the key to overcoming the difficulty in treating lung cancer lies in early screening, early diagnosis, and early treatment.

two

Lung cancer screening: CT scan is the first choice

Relevant data show that the 5-year survival rate of early-stage lung cancer (carcinoma in situ, micro-invasive cancer) can reach almost 100% after standardized diagnosis and treatment, while the 5-year survival rate of advanced lung cancer is less than 30% after cancer cell metastasis. Studies have shown that early lung cancer screening can reduce the overall mortality rate of lung cancer by 14% and reduce the mortality rate of lung cancer in people who meet the screening criteria by 25%.

It can be said that early screening, early diagnosis and early treatment of lung cancer are particularly important, and the most direct, economical and effective screening method is low-dose spiral CT. So the question is, who needs to be screened for lung cancer? How should we screen for lung cancer?

01

Who is at high risk of lung cancer?

Before solving this problem, we need to understand the high-risk factors that may cause lung cancer. Air pollution and smoking (including second-hand smoke) are the most common high-risk factors; in addition, the following factors are also related to the occurrence of lung cancer:

1. History of long-term exposure to occupational carcinogens such as radon, chromium, asbestos, silica, diesel exhaust, kerosene fume, etc. (for example: coal burning in rooms with no ventilation or poor ventilation for ≥15 years; history of underground pit work or smelting for 10 years or longer);

2. History of lung-related diseases (such as chronic obstructive pneumonia, pulmonary fibrosis, etc.);

3. Cooking fumes and solid fuels (such as coal briquettes, firewood, etc.) in the kitchen may also be risk factors for disease;

4. Patients with previous malignant tumors;

5. Family history of lung cancer.

02

Who needs lung cancer screening?

55-77 years old, with a history of smoking 30 packs/year or more; with a history of smoking, but quitting smoking less than 15 years ago. If you have the above conditions, even if the first screening result is normal or the lung nodules do not meet the criteria for further screening, you still need to be screened every year.

If you are over 40 years old and have a smoking history of 20 packs/year or more, or have one or more of the high-risk factors for lung cancer mentioned above, regular screening is also recommended.

For those under 40 years old, screening should be conducted based on individual circumstances (such as family history, exposure to risk factors, etc.).

03

What are the effective methods for lung cancer screening?

Conventional lung cancer screening methods include conventional CT, low-dose CT, chest X-ray examination, sputum cytology examination, and serum tumor marker detection. Among them, chest X-ray, sputum cytology, and serum tumor marker detection are limited by sensitivity and specificity, and the results are not ideal. Conventional CT has large radiation and high costs, and is not suitable for widespread screening. Therefore, there is actually only one lung cancer screening method that has been proven to be effective and recommended by authoritative organizations, and that is low-dose CT.

three

How to prevent lung cancer in daily life?

Because the causes of lung cancer are relatively complex, there is no single drug or method that can prevent all lung cancers, but we can reduce the risk of lung cancer by staying away from known carcinogens.

01

Say no to tobacco

No matter how many years you have smoked or how old you are, please make up your mind to quit smoking immediately. Quitting smoking can not only reduce the incidence of lung cancer, but also provide better treatment results for lung cancer patients. After quitting smoking, the carcinogenic toxins deposited in your body will gradually decrease, and your immune function will gradually recover, your physical strength will be enhanced, and cancer and other diseases will be prevented.

02

Reduce the impact of environmental pollution

When the air pollution is severe, try to avoid going out and exercising, wear a mask when traveling, etc. In addition, in the living environment, such as installing a high-efficiency range hood in the kitchen, reduce the use of solid fuels, and install an air purifier.

03

Stay away from occupational hazards

Producers should avoid or reduce direct contact with known carcinogens, strengthen personal protection, and have regular physical examinations.

04

Develop good living and eating habits

Live a regular life, exercise regularly, increase immunity, eat more vegetables and fruits, and eat less high-fat and high-cholesterol foods.

Four

What other treatments are available for lung cancer in its late stages?

The most important treatment for early-stage lung cancer is surgery, which is supplemented by radiotherapy or chemotherapy depending on the pathological condition. Advanced tumors can be treated with radiotherapy and chemotherapy simultaneously. For advanced lung cancer, the main treatment is to alleviate symptoms and prolong survival.

Surgery can completely remove the primary lesion and metastatic lymph nodes of lung cancer and achieve clinical cure;

The second is cytoreductive surgery, which removes most of the tumor to create favorable conditions for other treatments;

Symptom-reducing surgery is suitable for a small number of patients, such as those with refractory pleural and pericardial effusions. By removing pleural and pericardial implant nodules and part of the pericardium and pleura, the clinical symptoms caused by pericardial and pleural effusions can be cured or alleviated, thereby prolonging life or improving quality of life.

Radiotherapy can be used for patients with early-stage non-small cell lung cancer who cannot undergo surgery due to physical reasons. It is also an important treatment method for patients who are suitable for surgery, as well as preoperative and postoperative adjuvant treatment, local treatment for patients with locally advanced lesions that cannot be removed, and advanced incurable patients.

In addition, drug therapy is also an important part of lung cancer treatment, which includes chemotherapy, molecular targeted therapy (TKI therapy) and immunotherapy. Chemotherapy is widely used in advanced non-small cell lung cancer, non-small cell lung cancer that cannot be surgically removed, and neoadjuvant or adjuvant therapy for perioperative non-small cell lung cancer. In recent years, drug therapy has made rapid progress, especially targeted therapy, which has brought good news to patients with sensitive gene mutations. Immune checkpoint inhibitors are newly discovered treatment methods in recent years, with fewer side effects and higher effectiveness.

In short, surgery is not the only treatment for lung cancer. Doctors will choose different individualized treatment strategies for patients with lung cancer at different stages and with different physical conditions to help patients have longer survival time and higher quality of life.

Life is full of ups and downs. Everyone has an end. While we are still healthy, we should do what we want to do and fulfill our unfulfilled dreams. We should maintain a positive attitude and live happily every day.

Text/Fat Bear

Picture/partially from the Internet (please contact us to delete if there is any infringement)

Audit/Thoracic Cancer Center

Member of China Medical We-Media Alliance

Science Popularization China Co-construction Base

Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Science and Technology Communication and Popularization Project

National Health Commission National Basic Public Health Service Health Literacy Project