New "weapons" for early detection and treatment of lung cancer continue to emerge

Editor's note: As the "three major killers" threatening the health of our country's people, coronary heart disease, stroke and lung cancer have always been the main targets of medical experts. In recent years, more and more new technologies and new concepts have been applied to the diagnosis and treatment of these diseases, helping doctors to extend the life of more patients and improve the quality of life. To this end, People's Daily Online and the Population Culture Development Center of the National Health Commission have launched a series of video reports to introduce disease knowledge and cutting-edge technologies in the medical field, and look forward to future medical trends.

Lung cancer is one of the most threatening malignant tumors to human health and life. Early detection and early treatment are still the most effective ways to reduce the mortality of lung cancer. What new technologies and methods are currently available? Focusing on these questions, Tan Fengwei, deputy director of the Department of Thoracic Surgery, Cancer Hospital of the Chinese Academy of Medical Sciences, Duan Jianchun, chief physician of the Department of Oncology, Cancer Hospital of the Chinese Academy of Medical Sciences, Wu Ning, chief physician of the Department of Diagnostic Imaging, Cancer Hospital of the Chinese Academy of Medical Sciences, and Huo Li, director of the Department of Nuclear Medicine, Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, shared with netizens.

Lung cancer has a high mortality rate and early symptoms are not obvious

The lungs are like a big tree growing in the human body. The emergence of lung cancer makes the originally thriving "tree" lose its vitality.

According to data from the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO), lung cancer accounted for 1.8 million of the 9.96 million cancer deaths worldwide in 2020, far exceeding other types of cancer.

Lung cancer mortality rate is high

According to the Guidelines for the Diagnosis and Treatment of Primary Lung Cancer (2018 Edition), from the perspective of pathology and treatment, lung cancer can be roughly divided into two categories: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer accounts for about 80% to 85%, and the rest is small cell lung cancer. If not otherwise specified, lung cancer refers to non-small cell lung cancer. A large number of epidemiological studies have shown that the main risk factors for lung cancer include smoking and passive smoking, indoor pollution, indoor radon exposure, outdoor air pollution, occupational factors, family history of lung cancer, and genetic susceptibility.

Tan Fengwei said that lung cancer has some symptoms, such as coughing, coughing up blood, blood in sputum, and pain in some parts of the body in the late stage. However, these symptoms are not very specific and can also occur in many benign diseases.

"Symptoms alone are not enough to diagnose lung cancer. Many auxiliary examination methods are also needed," Tan Fengwei pointed out.

There are various treatment methods, which can be selected according to the severity of the disease.

"Currently, there are many methods for treating lung cancer. We can choose the appropriate method for patients based on the type and severity (staging) of lung cancer," Tan Fengwei pointed out.

For patients with stage I-II lung cancer, surgery is the first choice for treatment. Tan Fengwei said that traditional thoracotomy requires an incision of about 30 cm, and some incisions even break ribs. Recently, single-port thoracoscopic minimally invasive surgery is used, which only requires an incision of 3-4 cm.

Minimally invasive thoracoscopic surgery

Today, even as tumor removal surgeries become more complex, surgical incisions are becoming smaller and operations are being performed faster.

For patients with advanced disease who have already developed metastasis and are not suitable for surgery, radiation, chemotherapy, targeted therapy and immunotherapy are the treatment strategies of choice.

Duan Jianchun said that radiotherapy is a method of using physical radiation to focus radiation on the tumor site, thereby killing the tumor. Chemotherapy is mainly a type of chemical drug treatment that internal medicine physicians are good at, and most of the treatments are intravenous infusions.

Improve patient survival and new therapies are used in clinical practice

In the past decade, two new anti-tumor therapies, targeted therapy and immunotherapy, have been continuously used in clinical practice. Immunotherapy achieves the purpose of anti-tumor treatment by enhancing the body's immune function or using various methods to restart the immune system's recognition and killing of tumor cells. Targeted therapy targets specific targets of cancer cells and performs targeted and specific inhibition to achieve the purpose of treating tumors.

"Through these two treatment methods, the survival of lung cancer patients has been greatly improved, and the survival period of lung cancer patients will become longer and longer," said Duan Jianchun.

Targeted therapy and immunotherapy applied in clinical practice

Lung cancer treatment is long and complicated. Doctors need to identify the lesions, differentiate between benign and malignant tumors, develop treatment plans, and accurately judge the treatment effect and development of tumors at each stage. This is inseparable from nuclear medicine molecular imaging. "Positron emission tomography (PET) imaging can play a role in all aspects of lung cancer diagnosis and treatment." Huo Li introduced that PET belongs to nuclear medicine molecular imaging, and its main clinical application area is tumor imaging. Doctors can determine whether the existing treatment plan is suitable for patients earlier based on the number, volume, metabolism and changes in the internal structure of the tumor detected, so as to make good plans for the next step of diagnosis and treatment.

Nuclear Medicine Molecular Imaging Technology

To reduce the incidence of lung cancer, early prevention and screening are the key

Wu Ning pointed out that early detection and early treatment are the most effective ways to reduce the mortality rate of lung cancer. "When patients come to see a doctor, more than 60% or 70% of the tumors are in the middle and late stages, so the treatment effect is poor, and the 5-year survival rate is less than 20%. If it is stage I, the 5-year survival rate after treatment can reach 70% or even more than 80%." Wu Ning said.

Low-dose spiral CT screening

Low-dose spiral CT is an important means of lung cancer prevention and early screening. Wu Ning explained that low-dose means significantly reducing the amount of X-rays for daily patient examinations, but without missing lung nodules and other lesions. Low-dose CT has been proven to cause almost negligible damage to humans and is within the permissible range.

In recent years, experts have been exploring more analytical methods to improve the accuracy of differential diagnosis of lung nodules, thereby reducing unnecessary overtreatment. Wu Ning also hopes that tumor markers will play a greater role in early screening of lung cancer in the future.