An elderly patient had a pair of hands like “drumsticks”, so to speak, because the end segments of the fingers were thicker and bluntly rounded, just like the drumsticks used for drumming. This symptom started half a year ago, but there were no other symptoms except for the unsightly fingers. However, when the old man felt unwell and went for a checkup, it was already too late. The patient was diagnosed to have advanced central squamous carcinoma of the right lung, which is not curable by surgery. Is there any connection between finger changes and lung cancer? Drumstick-shaped fingers are clinically known as “pestle fingers”, which are enlarged, thickened and pestle-shaped at the end of the fingers or toes. About 2-9% of lung cancer patients will have pestle-like fingers. Some patients will go to orthopedics, and experienced doctors will suggest taking a chest X-ray to exclude lung tumors, and the pestle-like fingers will gradually return to normal when lung cancer treatment has achieved good results, but will grow again when lung cancer recurs. For middle-aged and elderly people who have been smoking for a long time, they must be alert to the appearance of pestle finger. Then, why do lung cancer patients have pestle finger? There are many explanations, but there is no definite conclusion. One theory is that when a lung tumor is created, the transformation of megakaryocytes into platelets in the pulmonary vasculature is affected and a substance called “platelet-derived growth factor” is released in the peripheral circulation, which will stimulate the tissue at the end of the finger to proliferate into a pestle shape. Other theories include infectious factors, mechanical factors, other endocrine factors, etc., which will not be explained here. Two points need to be clarified: first, lung cancer is not the only disease that can produce pestle-like fingers, some chronic lung diseases can also appear, just need to exclude lung cancer, and second, not only the fingers can form pestle-like fingers, some patients can also appear in the toes. In addition, joint pain, back and leg pain, etc. may also be caused by bone metastasis of advanced lung cancer. Bone metastasis is a common complication of advanced lung cancer, with ribs and spine as the most frequent sites, followed by pelvis, limbs and skull. Pain is the first symptom of lung cancer bone metastasis, and about 75% of lung cancer bone metastasis patients will have pain. Prevention and treatment of lung cancer depends on early examination Ordinary lung X-ray is almost impossible to detect early lung cancer below 1 cm, and most of the lung cancers that can be detected through such examination are already in the middle and late stages. To detect early lung cancer, it is still necessary to rely on CT. Studies show that the chance of detecting early lung cancer by CT is about 24%, while that by X-ray chest film is only 6.9%. However, because CT is expensive and not suitable for mass screening, experts generally recommend that people over 40 years old who have smoked and have a family history of cancer should have a low-dose CT of their lungs once a year. If “hairy glass” is found in the lungs on CT, it is likely to be a sign of early lung cancer. However, since it takes 7-8 years for some people to develop from “hairy glass” to true early-stage lung cancer, it requires careful judgment by the doctor whether to operate to remove it or not.