I. What is lung cancer? As the name implies, lung cancer is a malignant tumor growing in the lung. According to its tissue source, it can be divided into primary lung cancer and secondary lung cancer, which is called primary lung cancer if it comes from the malignant transformation of lung tissue, or secondary or metastatic cancer if it is metastasized from other parts of the lung. According to its pathological and biological characteristics, it is further divided into two categories: non-small cell lung cancer (80%) and small cell lung cancer (20%). The tumors are further classified into central and peripheral lung cancer according to their growth sites in the lung. These classifications have certain significance in guiding treatment. Second, what is the incidence of lung cancer in China? The situation is very serious! The incidence rate of lung cancer has exceeded that of various malignant tumors in major cities in China. Nearly 800,000 people die of lung cancer in China every year, and one out of every four cancer deaths is a lung cancer patient, and the mortality rate has taken the top of cancer mortality, among which, non-small cell lung cancer patients account for about 80%. If smoking and air pollution are not controlled, China will have more than 1 million lung cancer patients every year, becoming the world’s first “lung cancer power”. What are the causes of lung cancer? 1.Smoking: currently recognized as the most dangerous factor, including passive smoking (second-hand smoke). 2.Atmospheric pollution: industrial waste gas, automobile exhaust, etc. 3, occupational factors: asbestos, arsenic compounds, coal tar in the work environment. 4.Ionizing radiation: including natural sources, medical exposure, 5.Other: diet and nutrition, previous diseases and genetics, etc. What are the symptoms of lung cancer? 1.Cough: About one-half to two-thirds of the patients have cough as the first symptom. 2. Hemoptysis: it is mostly episodic with blood in the sputum, and about one-third of the patients have this as the first symptom. 3. Chest pain: One-third to three-fifths of patients present with chest pain. 4.Fever: obstructive pneumonia or cancer fever. 5.Shortness of breath and chest: advanced symptoms. 6.Extrapulmonary symptoms: The extra-pulmonary manifestations of lung cancer are mainly divided into two categories. Since many extra-pulmonary manifestations appear before lung cancer is detected, they are often misdiagnosed or ignored. One of them is the changes caused by the abnormal secretion of biologically active substances from lung cancer cells acting on other organs, which is also called companion cancer syndrome, and the common ones are as follows: (1) pulmonary hypertrophic osteoarthropathy, which is clinically manifested as pestle and mortar finger and joint swelling and pain, and often misdiagnosed as arthritis or frozen shoulder. (2) Gynecomastia (3) Cushing’s syndrome. (4) Dilutional hyponatremia. (5) Neuromuscular syndrome. (6) Hypercalcemia. (7) Carcinoid syndrome. The second is the symptoms and signs caused by distant organ metastasis of lung cancer. The most common sites of metastasis are brain, bone, liver and adrenal gland. Lung cancer can also metastasize to lymph nodes on the body surface, the most common one is bilateral supraclavicular lymph node metastasis, which can appear as a local mass, but it is not painful or itchy, and is mostly discovered unintentionally. V. How can we diagnose or judge that a person has lung cancer? Clinical diagnosis is made by doctors based on the patient’s symptoms, combined with laboratory and physical examinations (X-ray, CT, etc.), while pathological diagnosis is determined by obtaining tumor cells or tissues and observing their cell morphology under microscope, and the latter is the basis for confirming the diagnosis. If a person has the above mentioned phenomena including intrapulmonary or extra-pulmonary symptoms, such as irritating cough with intermittent or persistent small amount of hemoptysis, chest pain in men over 40 years old who have been smoking for a long time, isolated nodules or masses in the lungs with lobar shape or fine burrs found on X-ray chest film or CT scan, segmental pneumonia, lobar opacification with signs of bronchial obstruction confirmed by tomography, limited lesions in the lungs after active anti-inflammatory or anti-tuberculosis If the treatment (2~4 weeks) is ineffective or the lesion tends to increase in size, or if there is no other cause of growing pleural fluid on one side, or a large amount of hemorrhagic pleural fluid on one side with atelectasis, etc. in a short period of time, lung cancer should be highly alerted. Then further examination is to obtain pathological basis, that is, to establish pathological diagnosis, the main methods are as follows: sputum cytology examination: sputum is used to find cancer cells, pleural fluid is drawn if there is pleural fluid, peripheral type lung cancer can be detected by percutaneous lung puncture to obtain cells or tissues, central type lung cancer can be examined by fibrinoscopy. How to treat lung cancer if it is diagnosed? Or what do I need to pay attention to? In principle, it can be summarized in one sentence: it is a multidisciplinary comprehensive treatment combining radiation, chemotherapy, biology, genetics and Chinese medicine with surgery as the main treatment. Lung cancer is best treated by surgery, and surgical resection is preferred for patients who are able to undergo surgery. Whether surgery is possible or not depends on the stage of lung cancer and the patient’s physical condition. Internationally, lung cancer is divided into four stages: I, II, III and IV using unified standards. Stages I and II are characterized by smaller tumors, easier to be removed and no distant metastases, which can be treated with surgery, radiotherapy and chemotherapy, and have better healing effect. Stage III, on the other hand, is based on surgery combined with radiotherapy and chemotherapy. Stage IV lung cancer has distant metastasis and cannot be operated, only radiotherapy and chemotherapy can be used. The physical condition of the patient is mainly to check whether the vital organs, heart, liver, lung and kidney functions are normal, and whether there are important underlying diseases such as diabetes mellitus and myocardial infarction. Chemotherapy is also used as adjuvant treatment before surgery and to consolidate the efficacy after surgery and radiotherapy. Patients should be reminded that lung cancer belongs to the field of thoracic surgery in medical science, so they must go to the thoracic surgery department of regular hospitals for treatment. In 2005, the Department of Thoracic Surgery of our hospital introduced and carried out minimally invasive small incision open-chest radical lung cancer surgery, which has a small incision and does not cut off the chest wall muscles, resulting in less pain and faster recovery for patients, especially for the elderly and frail patients. Some people say that the tumor cannot be operated and may spread if operated, right? This is not true, because the fundamental difference between malignant tumor and benign tumor is that malignant tumor invades surrounding organs and forms distant metastases, after malignant tumor is formed, it spreads to other parts of the body and forms micro-metastases, these lesions cannot be detected by existing detection methods before surgery, after a period of time, they form lesions that can be clinically detected by X-ray, CT, etc. Therefore, the recurrence of tumor after surgery is not This is the reason why chemotherapy is needed after surgery, which is to kill those micro-metastases invisible to the naked eye, prevent tumor recurrence and improve survival time. How can lung cancer be prevented or treated? Most patients have lost the opportunity of surgery when lung cancer is clinically diagnosed, so the key to improve the treatment effect of lung cancer is to raise the vigilance of lung cancer, early detection and early surgical treatment, and for individuals, quitting smoking is an important measure, as well as strengthening environmental protection and preventing air pollution. Therefore, the prevention of lung cancer is a common task for us medical workers and the people as well as governmental departments such as environmental protection. 9. Early treatment of lung cancer is more effective, but how can it be detected early? For people who are exposed to more causative factors of lung cancer, regular checkups are especially important. According to some data, it takes about 8-10 years from the formation of cancer cells by cell mutation to the growth of a clinically detectable tumor of 25px, while it takes much faster to increase from a 25px tumor to 3-125px. X. Is lung cancer hereditary? Lung cancer is not directly hereditary, that is to say, it will not be passed on directly from one generation to the next, but more and more research shows that lung cancer, including some other tumors, is related to heredity. If there is a lung cancer patient in the previous generation, the next generation may have a higher chance of developing lung cancer than other people in the same external environment, so it is more important to pay attention to self-protection. This also explains why some people who smoke equally or even more do not develop lung cancer.