The chief physician of thoracic surgery of the Affiliated Hospital of Inner Mongolia Chifeng College, Su Zhiyong Release date: 2011-08-12 Source: Health News The main departments in the treatment of lung cancer in general hospitals are thoracic surgery, respiratory medicine, oncology, radiotherapy, and the differences in treatment concepts, inevitable departmental benefits, the entanglement of doctors’ interests, so that many patients are trapped in the labyrinth of twists and turns, experiencing the attempted treatment that should not be The patients have been suffering from pain and suffering. Although the rise of clinical pathway management has made people seem to see the light of day, the light is still too faint. Especially in primary general hospitals, the problem of non-standardized treatment is very serious, mainly manifested in: Su Zhiyong, Department of Cardiothoracic Surgery, Affiliated Hospital of Chifeng College 1. No staging before treatment, no pathology, who receives treatment, to which department which department does not put, delaying the reasonable treatment time. 2. Many disciplines and doctors engaged in lung cancer treatment do not know how to read chest CT and X-ray films, lack basic knowledge and ability to deal with diagnosis, differential diagnosis, lung cancer image evolution and advanced lung cancer complications, and do not have effective methods to confirm diagnosis, such as lung puncture, tracheoscopy, thoracoscopy, mediastinoscopy biopsy to confirm the diagnosis of staging, and are unwilling to refer to other departments with diagnostic ability, but ” The treatment is delayed, which seriously affects the treatment effect. 3. Targeted therapy of interest without genetic screening is applied to patients. Targeted therapy costs patients around 200,000 yuan per year, and less than 30% of patients with positive EGFR expression are suitable for this treatment. Thoracic surgeons can take pathology through lung puncture, thoracoscopy, mediastinoscopy, and many other methods, and simply allow patients to spend less than $1,000 on genetic testing to determine whether or not to definitively receive targeted therapy, thus avoiding ineffective waste, which some physicians do not do. 4. Excessive preoperative radiotherapy deprives some patients who are suitable for surgical treatment of the opportunity to operate, and there is even blind chemotherapy without pathological diagnosis or PET-CT alone to guide radiotherapy. 5. Early intrapulmonary CT that shows isolated pulmonary nodules (SPN), pulmonary ground-glass changes (GGO) and abnormal shadows in the lungs is more than 50% malignant, and these patients are precisely the most compatible with the indications for surgical treatment. We must not let non-thoracic surgeons to “try”, “wait”, “look” and delay the treatment time. Therefore, it is urgent for general hospitals to establish a multidisciplinary consultation system for lung cancer, which includes thoracic surgery, respiratory medicine, oncology, radiotherapy and interventional medicine, and organize experts to review the films of lung cancer patients in the hospital on a regular basis, so as to formulate scientific and reasonable treatment plans. The purpose of the multidisciplinary consultation system is: based on the principle of patient first and condition first, lung cancer patients are first staged and then treated, so as to avoid treating whoever receives the diagnosis.