Primary bronchial cancer, or lung cancer for short, is a malignant tumor originating from the mucosa or glands of the bronchi. The incidence of lung cancer ranks first among male tumors, and the incidence of female lung cancer has been increasing year by year in recent years. According to the information released by the World Health Organization, lung cancer is the most common cancer worldwide in terms of incidence and mortality.
I. Why lung cancer is highly prevalent – lung cancer is an artificial tumor.
The primary cause is smoking. Statistics show that 9 out of 10 patients who die of lung cancer are smokers. About 80-99, 5% of lung cancer patients are smokers. The mortality rate of lung cancer among smokers is 10-15 times higher than that of non-smokers. The longer you smoke and the more you smoke, the higher the incidence rate. Lung cancer incidence is also related to the age of starting to smoke, and the risk of lung cancer increases by more than 10 times for those who start smoking before the age of 20. In recent years, the number of female lung cancer patients has been increasing year by year, one is due to passive smoking, the other is due to kitchen fumes, passive smoking is more harmful, in a public place where many people meet, if there are 4 people smoking at the same time, the non-smokers present will be equal to each of them smoking a cigarette. Therefore, the incidence of lung cancer will continue to grow. Therefore, for the sake of your health and your family’s health, stay away from smoking.
Secondly, environmental pollution. Epidemiological surveys show that the incidence of lung cancer is higher in industrially developed and heavily polluted areas than in industrially underdeveloped areas, and higher in urban than in rural areas. This is also related to modern urban development, and is closely related to the exhaust gases emitted from automobiles and so on.
Again, it is lifestyle. For example, in some alpine zones in China, people use “fire pits” containing bituminous coal to heat their homes for years, which leads to serious indoor air pollution and an alarmingly high incidence of lung cancer in local rural areas, especially among women who stay indoors for a long time. In addition, epidemiological surveys have shown that the large amount of fumes from canola oil used for cooking may also be one of the main factors contributing to the increased incidence of lung cancer. Lung diseases, as well as immunity and genetics, are also direct causes of lung cancer.
In addition, inflammatory or scar tissue in the lung can cause abnormal epithelial proliferation, which can lead to carcinogenesis: patients with pneumoconiosis, tuberculosis scar, foreign body scar, pulmonary infarction, chronic occlusive inflammation of lung, etc. have 3-4 times higher incidence of lung cancer than the general population. So lung diseases are treated early.
Finally, lung cancer incidence is also related to family genetic factors: the risk of lung cancer increases more than 4 times if the offspring of lung cancer patients smoke or work or live in the above cancer-causing environment. If they no longer smoke or are removed from the related cancer-causing environment, they may not develop lung cancer. Among the dietary nutritional factors, the risk of lung cancer increases with severe vitamin A deficiency or low serum vitamin A level.
II. Early symptoms of lung cancer.
Lung cancer does not have any special symptoms in early stage, which are only symptoms common to general respiratory diseases, such as cough, coughing up blood, low fever, chest pain and tightness, so it is easy to be ignored.
Specific manifestations of common symptoms of early lung cancer.
1. Cough. Lung cancer, because it grows on bronchopulmonary tissues, usually produces irritating cough due to respiratory tract irritation symptoms. If patients have a long-term cough that cannot be cured, it is recommended to have a comprehensive examination to avoid delays.
2.Low fever. After the tumor blocks the bronchus, there are often obstructive lung lobes present, the degree of which varies. In mild cases, there is only low fever, while in severe cases, there is high fever, which can temporarily improve after medication, but will recur soon. Therefore, patients with long-term low fever should not be careless and go to the hospital for examination as soon as possible.
3. Chest distension and pain. Early stage of lung cancer chest pain is mild, mainly manifested as boring pain, hidden pain, the location is not certain, and the relationship with breathing is not certain. If the distension pain continues to occur, it indicates that the cancer may involve the pleura.
4. Sputum and blood. When tumor causes tissue necrosis and capillary breakage, there will be a small amount of bleeding, which is often mixed with sputum and appears intermittently or intermittently. Many patients with lung cancer visit the doctor because of sputum blood.
Extra-pulmonary manifestations of lung cancer in early stage.
Many patients do not have respiratory symptoms as the first symptoms, but many extra-pulmonary symptoms may appear before respiratory symptoms.
1. Bone and joint symptoms: such symptoms are more common. This is because lung cancer cells can produce certain special endocrine hormones (heterogenous hormones), antigens and enzymes, which can operate on bone and joint parts, causing bone and joint swelling and pain, often involving tibia, fibula, ulna, radius and other bones and joints, and the ends of fingers and toes are often enlarged in the form of pestle-like fingers. Some male patients come to the clinic because of breast development and are finally diagnosed with lung cancer because of the same reason.
2.Shoulder and back pain: lung cancer of peripheral type often develops posteriorly and superiorly, eroding the pleura and involving the ribs and chest wall tissues, thus causing shoulder and back pain. Such patients rarely have respiratory symptoms.
3. Hoarseness: lung cancer metastases compress the laryngeal nerve (left side lesions are mostly), which can paralyze the vocal cords and cause hoarseness. Since metastases of lung cancer can appear at an early stage, and the metastases can sometimes grow faster than the primary ones, the clinical manifestations of metastases can appear before the primary ones. Therefore, when these symptoms appear, lung cancer should be investigated.
Diagnostic tests.
1.X-ray examination.
X-ray examination is the most common and important means to diagnose lung cancer. The location and size of lung cancer can be understood through X-ray examination. In early stage lung cancer cases, although the mass is not yet visible on X-ray, local emphysema, pulmonary atelectasis or infiltrative lesions or inflammation in the lung adjacent to the lesion due to bronchial obstruction may be seen.
2. Bronchoscopy.
Bronchoscopy is an important measure to diagnose lung cancer. Through bronchoscopy, the pathological changes of bronchial lining and lumen can be directly observed. If cancer or cancerous infiltration is detected, tissue can be taken for pathological sectioning or bronchial secretion can be aspirated for cytological examination to clarify the diagnosis and determine the histological type. So as to provide us with better treatment plan.
3. ECT examination.
ECT bone imaging detects lesions 3-6 months earlier than ordinary X-ray, and can detect bone metastases earlier. If the lesion has reached the middle stage of the bone lesion part of the decalcification up to its content of 30% to 50% or more, X-ray film and bone imaging have positive findings, such as the lesion part of the osteogenic reaction is quiescent, metabolism is not active, the bone imaging is negative X-ray film is positive, the two complement each other, can improve the diagnosis rate.
4.Mediastinoscopy.
Mediastinoscopy should be performed under general anesthesia when enlarged lymph nodes in the anterior, paratracheal and inferior ramus (2, 4, 7) groups are seen on CT. Biopsies are obtained by dissecting and peeling with special biopsy forceps. Clinical data show an overall positive rate of 39%.
V. Classification of metastases.
Metastases of different organs can appear in the late stage of lung cancer, which can cause corresponding symptoms and often bring great pain to patients and even threaten their lives. The most common clinical metastases include the following parts.
1. Lung cancer brain metastasis.
The unexplained headache, vomiting, visual disturbance and change in personality and temperament of lung cancer patients may be caused by intracranial hypertension or brain nerve damage caused by lung cancer metastasis to the brain. Headache is the most common symptom, vomiting mostly occurs when the headache is intense and is characterized as jet vomiting; visual impairment indicates that the tumor has affected the compression or invaded the optic nerve, therefore, brain CT should be listed as a routine examination for patients diagnosed with lung cancer to detect brain metastasis as early as possible.
2.Bone metastasis of lung cancer.
About 50% of lung cancer patients will eventually develop bone metastases in multiple locations. Bone metastases are usually asymptomatic in the early stage, and bone isotope scan can detect the lesioned bones. The symptoms of bone metastases are related to the location and number of tumor metastases. For example, the chest pain caused by lung cancer rib metastases is mostly manifested as pain with limited chest wall area and clear pressure points. Spinal metastasis causes pain in the middle of the back or at the lesion site, while bone metastasis in the extremities or trunk causes limited pain in that area. Bone metastasis is not the direct cause of life threatening lung cancer patients, but if the tumor metastasizes to the weight-bearing bones of the body, such as cervical, thoracic and lumbar spine, it can cause serious consequences of paralysis. Therefore, lung cancer patients with bone metastasis should be treated in time.
3.Liver metastasis of lung cancer.
Liver is also a common metastatic site of lung cancer, and about 28-33% of lung cancer has liver metastasis. Liver metastasis is the invasion of primary lung cancer cells into the liver through blood circulation and planting and growing in the liver, and liver metastasis can be single or multiple nodal metastases. The most common symptom is pain in the liver area, which is a persistent rising pain, and may be accompanied by loss of appetite, indigestion and other signs of impaired liver function.
4.Lung cancer kidney and adrenal metastasis.
Kidney and adrenal gland are the result of blood metastasis in the late stage of lung cancer. About 17%-20% of lung cancer patients have kidney and adrenal gland metastasis, which are often asymptomatic, and some patients may have pain in the kidney area, but rarely affect kidney function.
5.Metastasis to other parts of lung cancer.
In addition to the above common metastatic sites, the less common metastatic sites include skin, subcutaneous tissue, muscle, intra-abdominal cavity, heart and other parts of lung cancer, and the symptoms are often related to the metastatic sites. If the metastasis reaches the heart, symptoms such as chest tightness, palpitation or even shortness of breath, syncope and heart rhythm disturbance may appear.
VI. Treatment and care
Besides surgery (early stage) which we all know, there are also chemotherapy, radiotherapy, radiofrequency and other tumor treatment methods. Surgery includes radical resection and palliative resection. Early stage patients who are able to operate account for about 20% of the total number of patients, and late stage surgery is palliative surgery.
Awareness of Chinese medicine in lung cancer.
This disease belongs to the category of “lung accumulation” in Chinese medicine. Therefore, lung cancer is a kind of disease in which the whole body is deficient and the local area is real. In lung cancer, Yin deficiency and Qi and Yin deficiency are the most common; in reality, the pathological changes include Qi stagnation, blood stasis, phlegm coagulation and toxin accumulation.
Patients’ dietary preferences and contraindications.
Desirable foods.
(1) Foods with immune enhancing and anti-lung cancer effects, such as barley, sweet almond, rhizome, oyster, jellyfish, yellow fish, sea cucumber, poria, yam, jujube, string beans, shiitake mushroom and walnut are suitable.
(2) It is advisable to eat white fruit, radish, almond, orange peel, loquat, olive, orange cake, seaweed, nori, winter melon, loofah, sesame, figs, pine nuts, walnuts, rooibos, peach, orange and grapefruit.
(3) It is advisable to eat cucumber, winter melon, bitter melon, lettuce, eggplant, lily of the valley, amaranth, stone flowering cabbage, horsetail, plum, watermelon, pineapple, pear, orange, lemon, olive, mulberry seeds, duck and green fish.
(4) Eating plums, lotus root, jellyfish, sea cucumber, lotus seeds, black beans, tofu, eggplant, milk, crucian carp, squid, yellowtail, oyster, sugar cane is suitable for hemoptysis.
(5) Foods to reduce the side effects of radiotherapy and chemotherapy are recommended: mushrooms, cinnamon, eels, walnuts, kiwi, goldenseal, dates, sunflower seeds, apples, carp, mung beans, soybeans, adzuki beans, shrimps, crabs, loaches, green tea.
Avoid food.
(1) Avoid smoking and alcohol.
(2) Avoid spicy stimulating food: onion, garlic, leek, ginger, pepper, chili, cinnamon, etc.
(3) Avoid frying, barbecue and other hot foods.
(4) Avoid greasy and sticky foods that produce phlegm.
Common sense of family care for lung cancer patients.
(1) Moderate sun exposure helps prevent lung cancer There are many small details in life, such as daily sun exposure, which can help you prevent lung cancer.
A recent study found that. Too little sun exposure is not a good thing, because sunlight can help our skin produce healthy vitamin D. “It is a mistake to stay out of the sun all day to avoid skin cancer, in which case our body cannot produce enough vitamin D.”
(2) Observe the patient closely. Besides observing whether the patient has abnormal conditions such as cough, sputum, hemoptysis, chest pain, chest tightness, dyspnea, fever, etc., special attention should be paid to whether there is difficulty in swallowing, hoarseness, edema of head, neck and upper limbs. If there is difficulty in swallowing, it indicates that the tumor invades or compresses the esophagus; if there is hoarseness, it indicates that the tumor directly or indirectly compresses the recurrent laryngeal nerve; if there is edema in the head and neck and upper limbs, as well as bruising and varices in the anterior chest, accompanied by headache, dizziness or vertigo, it indicates the occurrence of superior vena cava compression syndrome.
VII. Precautions for late stage lung cancer.
1.Diverse, light and nutritious diet, mainly meat porridge, fish porridge, egg porridge, Coix rice porridge, lily porridge, Chinese wolfberry porridge and other kinds of porridge and soup, together with fruits and fresh vegetables.
2. Help patients who cannot take care of themselves to turn over regularly, scrub and massage their hands and feet every day. Safflower alcohol can be applied to the pressure area to prevent bedsores from occurring.
3.Patients with pain should try to meet their pain relief requirements and not be afraid of the addictive nature of narcotic painkillers in order to improve their quality of life.
4.For patients who can move slightly, you can accompany them to walk slowly or take a walk to move their muscles and bones, so as not to overdo it.
5.Listen to light music, folk music, and symphonic music to relax the body and mind and improve their quality of life.
6.Give more spiritual comfort to the patients to eliminate their fears. Encourage and train the patients’ spouses and relatives to give care to the patients, speak softly, communicate more and express their love for the patients, so that the patients can get spiritual joy.
7. Closely observe the patient’s respiration, blood pressure, pulse, body temperature, and changes in mental status. If there is any abnormality, report it to the physician immediately and deal with it symptomatically.
8.If there is sputum in cough, encourage the patient to cough it out by himself. If there is difficulty in excreting sputum, pat the back to help him excrete sputum and use aspirator if necessary. If patients are found to have sudden aphasia, color change and respiratory arrest, they must be reported to the doctor immediately for emergency resuscitation.
VIII. Lung cancer patients are getting younger.
Bad lifestyles are the culprits.
The youngest lung cancer patient is only in his twenties, and bad lifestyle such as smoking and alcoholism are the root causes of the rejuvenation of lung cancer patients. The incidence and mortality rate of lung cancer in Beijing is the highest among all kinds of malignant tumors, and heavy smokers are the most prevalent group of lung cancer patients, which is mainly concentrated in young and middle-aged people between the ages of 35 and 55. Clinical observation found that: “If people smoke and drink hard when they are in a bad mood, all the internal organs will be negatively idle, and the toxic substances in tobacco and alcohol will directly infringe on human health.” Therefore, it is recommended that a healthy lifestyle should be promoted among young and middle-aged people: no smoking, less alcohol, and proper exercise. At the same time, health checkups should be conducted for high-risk groups, and lung cancer screening and screening should be done regularly for early detection and early treatment.
IX. Prevention of lung cancer.
According to the causes of lung cancer, the following lung cancer prevention methods are proposed.
Life prevention.
(1) Quit smoking, which is the most effective way to prevent lung cancer.
(2) Drink less strong alcohol.
(3) not to eat moldy and spoiled food and less pickled food.
(4) Chew slowly when eating, and do not eat food that is too hot.
(5) Do not consume too much fat, eat more fresh vegetables and fruits.
(6) Eat less smoked food.
(7) Do not abuse drugs, especially sex hormone drugs and cytotoxic drugs, to prevent the risk of drug carcinogenesis.
(8) Eat fruits, vegetables and coarse cereals daily.
Environmental prevention: pay attention to pollution in the kitchen and strengthen ventilation in the kitchen and bathroom. Southwest China is a region with a high incidence of female lung cancer, which may be related to local people’s preference for fried and stir-fried foods. Therefore, you should use less oil when frying, avoid burning oil to smoke, choose low-smoke salad oil, and always turn on the hood during cooking; go to the countryside every week to breathe fresh air, and try to avoid going to factories and factories that emit exhaust fumes; try to avoid contact with car exhaust.
Psychological prevention: develop an optimistic, open-minded personality; exercise at least three times a day to strengthen the body; develop a good lifestyle.