A 42-year-old fitness coach was diagnosed with lung cancer. Why was I diagnosed with lung cancer even though I didn’t feel any discomfort?

A 42-year-old fitness coach was diagnosed with lung cancer. When he received the medical report, he still couldn't believe that he, who was so young and had a regular lifestyle, would be diagnosed with lung cancer. He held the pathology report and yelled in the clinic: "Doctor, I don't feel any discomfort. Could it be a mistake? How could I have lung cancer?"

Lung cancer ≠ respiratory discomfort First of all, many people have a misunderstanding that lung cancer patients will definitely experience chest tightness, chest pain, cough, hemoptysis, and even general discomfort. Indeed, some lung cancer patients will have one or several of the above symptoms, but not all.

Why do lung cancer patients feel uncomfortable? It is simply because the presence of the tumor causes certain symptoms in the body.

For example, when a tumor gradually grows and invades the pleura, nerves or bones, it will cause the so-called pain.

For example, if the tumor continues to grow, it may cause local tracheal obstruction, leading to atelectasis and chest tightness symptoms.

Or the presence of the tumor repeatedly stimulates the tracheal mucosa, causing a "cough reflex", resulting in an irritating dry cough.

However, we must remind everyone that the above symptoms will only appear when the tumor is large enough or is located at the segmental bronchus or above. The symptoms of many early lung cancers, especially peripheral lung cancer, are often not obvious.

To give an easy-to-understand example, if we compare the lungs to urban traffic, when a small accident occurs in a suburb far away from the city, it does not affect the traffic of the entire city. At this time, except for the camera (CT screening), other people do not know that a car accident has occurred somewhere; but when a car accident occurs on the main traffic artery in the city center, it often has a larger impact on the city’s traffic, and people are more likely to notice the existence of the accident.

Therefore, patients with early-stage lung cancer often do not feel any discomfort. When respiratory discomfort occurs, the tumor is often larger in diameter or closer to the main airway.

How to detect lung cancer earlier? Since early lung cancer often causes no symptoms, how can we detect early lung cancer in the body? The answer is: low-dose spiral CT scan of the chest.

For a long time in the past, physical examination packages often included chest X-rays or chest radiography. In the eyes of us thoracic surgeons, these two items are more like scratching the surface for screening early lung cancer and cannot solve the real problem.

Just like when we take pictures with a camera we often pursue higher pixels and higher resolution, in the early years, chest X-rays and chest X-rays in chest imaging examinations had insufficient resolution, which led to the missing of many early lung cancers. In particular, many early lung cancers smaller than 1 cm were not discovered and operated on in time due to limited resolution. It is really a pity to think about it.

But all this has changed with the development of chest CT. Have you noticed that there are more patients with lung nodules around you in recent years? This is largely related to the widespread use of chest CT for early screening of lung cancer.

The so-called pulmonary nodules refer to round or quasi-circular nodules with a diameter of ≤3CM in the lung parenchyma, excluding nodules with increased density due to enlarged hilar lymph nodes or atelectasis. A small number of these pulmonary nodules are early lung cancers, and because the nodules are small, many patients do not feel any discomfort, and they are often found during physical examinations. Due to timely detection, when early lung cancer is removed in time, the prognosis is very good and does not affect the survival cycle. In other words, for these lung cancer patients, they are lucky because regular and correct physical examinations have discovered asymptomatic early lung cancer. If they do not undergo chest CT screening, when symptoms such as chest tightness, cough, and chest pain occur, the treatment effect is often not so good.

Which groups are the key groups for lung cancer screening? ● Family history of lung cancer: direct relatives who have been diagnosed with lung cancer or died of lung cancer;

●Personal tumor history: patients who have been diagnosed with other malignant tumors before;

● History of long-term smoking and secondhand smoke exposure: Smoking is an important risk factor for lung cancer. The longer you smoke and the more you smoke, the higher your risk of lung cancer.

● Long-term exposure to carcinogens such as asbestos, benzene, and chromium: Long-term exposure to certain chemicals in daily life and work can easily increase the risk of lung cancer

● History of other lung diseases: such as chronic obstructive pulmonary disease or pulmonary fibrosis

If you meet one or more of the above conditions, it is recommended that you conduct regular early screening for lung cancer through low-dose spiral CT scans of the chest. Scientific cancer prevention and screening is the most meaningful.

Summary: Early lung cancer often has no respiratory symptoms. Early lung cancer screening is performed through low-dose spiral CT of the chest. Regular screening must be performed for high-risk groups.