If you think the following content is too professional, please remember this sentence: If you are over 45 years old, if you have bags on your lungs and blood in your sputum, you may have lung cancer!
High Risk Factors
Those who have a history of smoking with a smoking index greater than 400 cigarettes/year, a history of high-risk occupational exposure (e.g. exposure to asbestos) and a family history of lung cancer, etc. and are 45 years of age or older are at high risk for lung cancer.
Clinical manifestations
1.Lung cancer may not have obvious symptoms in early stage. When the disease develops to a certain extent, the following symptoms often appear.
(1) Irritating dry cough.
(2) Blood in sputum or bloody sputum.
(3) Chest pain.
(4) Fever.
(5) Shortness of breath.
When the respiratory symptoms cannot be relieved by treatment for more than two weeks, especially blood in sputum or irritating dry cough, or the existing respiratory symptoms are aggravated, the possibility of lung cancer should be highly alerted.
2.When lung cancer invades surrounding tissues or metastases, the following symptoms may appear.
(1) Hoarseness when the cancer invades the recurrent laryngeal nerve.
(2) The cancer invades the superior vena cava, and the symptoms of superior vena cava obstruction syndrome such as facial and neck edema may appear.
(3) The cancer invades the pleura and causes pleural effusion, which is often bloody; a large amount of effusion can cause shortness of breath.
(4) The cancer invades the pleura and chest wall, which can cause continuous severe chest pain.
(5) Upper lobe apical lung cancer may invade and compress the organ tissues located at the entrance of the thorax, such as the first rib, subclavian artery and vein, brachial plexus nerve, cervical sympathetic nerve, etc., producing severe chest pain, upper limb venous anger, edema, arm pain and upper limb movement disorder, ipsilateral upper eye and face drooping, pupil narrowing, eye inversion, facial sweating and other cervical sympathetic syndrome manifestations.
(6) Recent neurological symptoms and signs such as headache, nausea, vertigo or blurred vision should be considered as possible brain metastases.
(7) Bone metastasis should be considered for persistent bone pain at fixed sites and elevated plasma alkaline phosphatase or blood calcium.
(8) Right upper abdominal pain, hepatomegaly, elevated alkaline phosphatase, glutamic transaminase, lactate dehydrogenase or bilirubin should be considered as possible liver metastases.
(9) Nodules may be palpated under the skin in case of subcutaneous metastasis.
(10) Hematogenous metastasis to other organs may show corresponding symptoms of the metastatic organ.
Physical examination
1.Most lung cancer patients do not have obvious positive signs.
2.Patients present with extrapulmonary signs of unknown cause and long duration, such as pestle and mortar fingers (toes), non-wandering pulmonary joint pain, male breast enlargement, dark skin or dermatomyositis, ataxia, phlebitis, etc.
3.Patients with clinical manifestations highly suspicious of lung cancer, physical examination reveals vocal cord paralysis, superior vena cava obstruction syndrome, Horner’s sign, Pancoast’s syndrome, etc. suggesting the possibility of local invasion and metastasis.
4.Patients with highly suspicious clinical manifestations of lung cancer, hepatomegaly with nodules, subcutaneous nodules, enlarged lymph nodes in supraclavicular fossa, etc. on physical examination suggest the possibility of distant metastasis.
Imaging examination
1.Chest X-ray examination: chest X-ray is an important tool for early detection of lung cancer and one of the methods for postoperative follow-up.
2.CT chest examination: CT chest can further verify the location and extent of lesion involvement, and can also roughly distinguish benign from malignant, which is an important means to diagnose lung cancer at present. Low-dose spiral chest CT can effectively detect early lung cancer, while CT-guided transthoracic lung mass aspiration biopsy is an important technique to obtain cytological and histological diagnosis.
3.B-mode ultrasonography: It is mainly used to detect important abdominal organs and whether there are metastases in the abdominal cavity and retroperitoneal lymph nodes, and also used for the examination of double supraclavicular fossa lymph nodes.
For intrapulmonary lesions or chest wall lesions adjacent to the chest wall, it can identify their cystic and solid nature and perform ultrasound-guided puncture biopsy; ultrasound is also commonly used for pleural fluid extraction and localization.
4.MRI examination: MRI examination has certain value for clinical staging of lung cancer, especially for determining whether there are metastases in the spine, ribs and skull.
5.Bone scan examination: It is a routine examination for determining bone metastasis of lung cancer. When the bone scan suggests suspicious metastasis, MRI can be performed on the suspicious area to verify.
6.PET-CT examination: It is not recommended for routine use. It has higher sensitivity and specificity than CT in diagnosing mediastinal lymph node metastasis of lung cancer.