I have been working in the clinic for almost 30 years, and I often encounter patients and family members who have lung cancer asking me what to do, so let me talk about what should be done if you have lung cancer. 1. Stabilize emotion. This is very important. When a person knows he/she has lung cancer, at first he/she will be terrified and overwhelmed, and soon he/she will become incomprehensible and will say to others: “I am usually in good health, I don’t take medicine, I don’t take injection, I don’t smoke, I never catch cold, why do I still have this disease? grow on me”. As the saying goes, “There is no disease that does not occur when you eat grains and cereals”, and it is a natural law of life, old age, sickness and death. Today, medical science has made great progress and some cancers can be cured, including lung cancer of course. Therefore, when you learn that you have lung cancer, you must stabilize your emotion well and treat it as soon as possible is the best policy. In addition, many family members of lung cancer patients will show emotional excitement and anxiety at this time, and even individuals will be hospitalized first because of this sudden shock such as fainting or heart attack. Most of the family members will look around for consultation to see the film and check the internet about the treatment of lung cancer, but they cannot decide how to treat the patient with half knowledge, thus missing the best treatment time for the patient. Therefore, when learning that your loved one has lung cancer, family members should be more stable, keep their heads clear and trust professional doctors as your best choice. 2. Don’t have the idea of “taking shortcuts”. Other treatment methods such as Gamma Knife, Ar-He knife and slow-release library are palliative invasive treatments. The implementation of these methods is required on the basis of effective chemotherapy or targeted treatment, and the purpose is to relieve patients’ symptoms as soon as possible. Irresponsible propaganda such as “one injection can cure lung cancer” and “our treatment is cost-saving and minimally invasive” are not true, so you cannot trust such advertisements and “shortcut” treatments. There is no short-cut treatment method. Therefore, you should not believe such advertisements and there is no “short-cut” treatment method. Understanding the basic knowledge of lung cancer treatment is a good strategy to avoid being cheated. 3. Find a suitable treatment hospital, such as thoracic surgery and oncology departments of tertiary hospitals are the best choice for regular and professional treatment. This is extremely important for lung cancer patients. (1) Patients who are diagnosed with lung cancer should choose a hospital and doctor you trust together with their family members and rush to be hospitalized. As the saying goes, there are specialties in the field of lung cancer. Specialists in tertiary care hospitals specialize in lung cancer, and the training they receive and the academic conferences they often attend are mostly related to lung cancer, so they are more knowledgeable about the current status of lung cancer treatment and the current domestic and international progress than physicians in other specialties, and the treatment advice and help they provide to patients are more scientific and reasonable. Therefore, patients should choose the thoracic surgery and oncology departments of tertiary hospitals in their regions as their treatment sites for consultation. (2) The first thing to do after hospitalization is to conduct a comprehensive examination to determine the pathological type and stage, which includes laboratory tests, chest CT, abdominal ultrasound, bone scan, cranial CT (MRI), sputum examination of tumor cells or fibrinoscopic biopsy or percutaneous lung aspiration biopsy, etc. PT-CT can also be performed if necessary. I. The stage of lung cancer is important! The treatment plan differs with different stages. At present, internationally, lung cancer is divided into stage I, II, III and IV according to TNM.
T represents the size of the tumor; N represents lymph node metastasis; M represents the presence of distant organ metastasis. Among them, stage I lung cancer is divided into stage IA and stage IB, stage II lung cancer is divided into stage IIA and stage IIB, and stage III lung cancer is divided into stage IIIA and stage IIIB. Accurate and scientific staging is important to develop individualized treatment plans. For example, stage IA lung cancer can be cured by surgery alone and no longer requires any other treatment such as chemotherapy. Of course, the earlier the treatment effect is, the better it is, but there are many treatment options even at the advanced stage. II. The pathological type of lung cancer is also important! Because there are different treatment plans for different types of lung cancer. Currently in medicine, lung cancer is divided into small cell lung cancer and non-small cell lung cancer. Small cell lung cancer is a comprehensive treatment based on chemotherapy, and non-small cell lung cancer is a comprehensive treatment based on surgery. In addition, among non-small cell lung cancer, some of them are also suitable for targeted drug therapy, that is, taking one pill a day is OK! (3) After determining the pathological type and stage, patients and their family members should study your disease together with the patient’s supervising physician and work together to formulate a scientific, effective and optimal treatment plan that suits you! The current treatment for lung cancer requires to reach individualization and standardization. It is to provide you with a scientific and feasible treatment plan in accordance with international standards (NCCN guidelines) based on your individual circumstances such as disease condition, physical condition, including financial situation. Lung cancer treatment includes surgery, radiotherapy, chemotherapy, molecular targeted therapy, bioimmunotherapy and Chinese herbal medicine. Among them, the first four are the main treatment tools. I. Surgery is the preferred method and basic means of lung cancer treatment. Its role is mainly reflected in 1. removing early limited cancer tumor to achieve the purpose of radical cure; 2. removing all cancer tissues and intrathoracic lymph nodes relatively completely to achieve the purpose of radical cure; 3. removing most of cancer tissues to create favorable conditions for radiotherapy, chemotherapy, immunotherapy and traditional Chinese medicine; 4. relieving patients’ secondary and concurrent symptoms, reducing pain and improving their quality of life. II. Radiotherapy is to kill tumor cells by radiation. It includes radical radiotherapy, palliative radiotherapy and adjuvant radiotherapy. Radical radiotherapy refers to the application of radiotherapy to completely and permanently destroy the primary and metastatic lesions of malignant tumors. Tumors that are sensitive or moderately sensitive to radiation can be treated radically with radiotherapy. Palliative radiotherapy refers to the application of radiotherapy to treat recurrent and metastatic lesions of advanced tumors for the purpose of improving symptoms. Adjuvant radiotherapy is applied as a part of comprehensive treatment, combining radiotherapy with surgery or chemotherapy to improve the patient’s treatment effect. Before and after surgery or chemotherapy, radiotherapy can shrink the tumor or eliminate potential local metastases to improve the cure rate and reduce recurrence and metastases. III. Surgery and radiotherapy are local treatment, while chemotherapy is systemic treatment. Lung cancer is a systemic disease, and to cure it radically, using only one of these methods alone has its limitations. Surgery can completely remove the lung lesions, and when the tumor is indeed confined to the surgical site only, it can achieve the purpose of cure, such as stage IA lung cancer can be cured by surgery alone. Therefore, surgery should be preferred for early stage lung cancer. However, for most cases, at the same time of surgery, there may be potential metastatic small cancer foci in other parts of the body that have not been detected yet. For these cancer foci, surgery is not able to help. Radiation therapy has the same limitations, and it may not always kill all the cancer cells in the irradiated lesions. For patients with non-small cell lung cancer, preoperative chemotherapy can shrink or even eliminate the primary tumor; enable some patients who were previously denied surgery to regain it; find a relatively sensitive and effective adjuvant chemotherapy regimen; reduce the chance of recurrence and metastasis and improve the long-term survival rate of patients. Postoperative chemotherapy is even more widely recognized. In addition, more importantly, patients with advanced disease who undergo palliative chemotherapy can also obtain a much higher survival rate. For patients with small cell lung cancer, which is more malignant, surgery and radiotherapy are not effective because it is particularly prone to metastasis, but it is particularly sensitive to chemotherapy. Of course, chemotherapy, because of the lack of specificity, can involve normal cells while treating cancer, and this treatment is commonly known as enemy-me-not, or the resolution is poorer. Chemotherapy will kill tumor cells, and at the same time, it also has effects on normal cells with very active metabolism, such as hair loss, white blood cell reduction and some other side effects. IV. Targeted therapy, as the name implies, only targets cancer cells and has no or little effect on normal cells. Of course, targeted therapy must have a target, and not all lung cancers have a target, which needs to be tested before use.