According to the survey on the causes of death of urban and rural residents in China in recent years, malignant tumors have surpassed cardiovascular diseases to take the first place, while lung cancer takes the first place among malignant tumors, thus it can be said that lung cancer has become the first killer of people’s health!
The incidence and mortality rate of lung cancer is rising rapidly, which is a worldwide trend. Smoking, passive smoking, environmental pollution, especially air pollution, are the main culprits contributing to this grim reality, together with kitchen fumes and other factors, which also make the incidence rate of lung cancer among women rise significantly, far faster than that of men. The World Health Organization predicts that by 2025, the annual number of lung cancer deaths in China will exceed 1 million, the highest in the world. Lung cancer is one of the malignant tumors with the worst prognosis. Early detection, together with surgery and other comprehensive treatments, is the only way to achieve better results. Therefore, it is very important to fully understand the relevant knowledge, self-discovery and timely consultation!
1.Understanding our lungs
The lungs are two spongy organs that grow in the chest cavity. They bring air into the body and take it out, taking in oxygen and eliminating the useless product, carbon dioxide. The right lung has three parts, called lobes. The left lung has two lobes. The left lung is relatively small, and that’s because the heart takes up more space on the left side of the body. The lining that surrounds the lungs is called the pleura and helps protect the lungs and allows them to move around inside when you breathe. The trachea carries air down into the lungs. The trachea divides into tubes called bronchi, which then divide into smaller branches called fine bronchi. The end of these small branches are very thin air sacs called alveoli.
2.What is lung cancer?
Due to the influence of external or internal factors, some originally normal human cells have undergone genetic changes, and the growth and division of cells have lost control and continued to proliferate malignantly, and then turned into cancer cells. The so-called lung cancer is this malignant cancer cells originated from the tissue cells of the lung. Most lung cancers occur in the inner layer of the bronchi, but they can also occur elsewhere, such as in the trachea, fine bronchi or alveoli.
Cancer cells that grow and divide gradually invade and destroy the tissues around them, causing disruption of normal tissue function. If the cancer cells enter the blood or lymphatic fluid and enter other organs or tissues with the blood or lymph, the cancer cells will take root in these places and form new cancer tumors, and then we call it tumor metastasis.
3.How does lung cancer happen?
The biggest risk factor for lung cancer is smoking, with up to 9 out of every 10 patients smoking. The risk factor is related to the duration of smoking and the amount of cigarettes smoked per day. The risk of lung cancer is 8 times higher for patients who smoke 20 cigarettes per day for 40 years than for patients who smoke 40 cigarettes per day for 20 years. Passive smoking is also an important risk factor for lung cancer, with the incidence of lung cancer about 25% higher in people whose spouses smoke, and about 17% higher in people who smoke passively in the workplace. Other risk factors include: history of radon or asbestos exposure, history of previous lung diseases (e.g. tuberculosis), family history of lung cancer, and history of chemotherapy.
Therefore, the best way to prevent lung cancer is to quit smoking or never start smoking!
4. Are you or your family members ignoring the symptoms?
Lung cancer is relatively large and deep inside the chest cavity. Early stage of lung cancer rarely causes obvious symptoms or discomfort due to small lesions, and only when the tumor is larger and invades more surrounding tissues will there be more obvious symptoms, which patients usually find by chance when they come to the doctor for some other problems. Moreover, many patients still delay to seek medical treatment despite some signs of lung cancer, for fear of being diagnosed as a malignant disease. As a result, most lung cancers are already in the advanced stage when they are diagnosed.
However, the earlier the lung cancer is diagnosed and the more timely the treatment is, the better the prognosis is. Therefore, one should not ignore some early signs of lung cancer and should not consider it as a common cold or pneumonia when these early signs appear, but should go to the hospital for timely screening in order to detect lung cancer at an early stage, so as to seize the best time for treatment and improve the prognosis.
The common early signs of lung cancer include
(1) Chronic cough that persists for a long time, shortness of breath, asthma/ wheezing.
(2) Persistent chest pain or persistent site symptoms, such as bone pain.
(3) Cough with blood in the sputum and hoarseness.
(4) Recurrent episodes of bronchitis or pneumonia.
(5) Facial or neck edema.
(6) Unexplained fever.
(7) Unexplained loss of appetite or weight loss.
Of course, these symptoms can be caused by other reasons, but if you smoke (or are a passive smoker), or if you have an immediate family member who has had lung cancer, it is recommended that you seek medical attention to detect or rule out lung cancer at an early stage.
5.Diagnostic tests of lung cancer
For patients with possible signs of lung cancer, doctors will perform some targeted tests to determine whether lung cancer does exist, taking into account the patient’s medical history. For example, chest X-ray can be taken to understand the abnormalities in the lungs. Routine blood tests as well as sputum for pathological cells and other relevant laboratory tests may also be performed to help with the diagnosis. Thereafter, a series of in-depth tests may be performed, including bronchoscopy, mediastinoscopy, lung tissue biopsy, and thoracoscopy, which allow for a targeted examination of the lung or chest cavity and, if necessary, the taking of tissue samples. If these examinations suggest the possibility of lung cancer, further examinations are also feasible.
6.What should I do after finding small lung nodules?
Accurate and timely diagnosis of lung nodules, especially the differential diagnosis of benign and malignant, is a difficult task for clinicians. Early detection of cancerous nodules and timely surgical intervention are the keys to improve the outcome!
Once a small lung nodule is found, it should be seen in a regular hospital immediately. Doctors usually make a preliminary judgment based on the imaging characteristics and medical history, and if it is new, regular anti-inflammatory treatment will be given for 1-2 weeks, and then X-ray examination will be repeated to exclude inflammation, and sometimes tuberculosis examination, sputum for tumor cells and blood-related tumor indexes will be performed at the same time.
When lung cancer cannot be excluded by the above methods, PET-CT examination is feasible if available (at your own expense, about 7000 RMB), PET is also called positron emission computed tomography, which is a kind of imaging technology with the feature of non-invasive detection of radionuclide distribution in the body. It can reflect the abnormal metabolism and perfusion of tumor, protein synthesis, DNA replication, and metabolic kinetics of anti-cancer drugs in a flexible and accurate way.
Specific applications include the following.
(1) Differential diagnosis of intrapulmonary lesions.
(2) Judgment of lung malignancy, especially the extent of lung cancer, local invasion, lymph node metastasis, which is more helpful for clinical staging.
(3) It is more helpful in determining the residual or recurrence of fibrous scar lesions formed after lung cancer treatment, such as surgery and radiotherapy.
(4) Monitoring the effect of treatment. However, PET, like other imaging examinations, is not 100% accurate.
Pathological diagnosis is the “gold standard” of lung cancer diagnosis. When the diagnosis cannot be confirmed by non-invasive examination, invasive examination is needed, usually fiberoptic bronchoscopy is the first step. In general, puncture is not recommended for diagnosis because the lung must move up and down constantly with breathing, especially for small lung lesions, it is more difficult to accurately locate puncture for diagnosis, and if the puncture is negative, it is likely that the lesion is not reached and there is a risk of tumor implantation.
If the diagnosis is still not confirmed, unless the clinical diagnosis of benign is likely to be large and regular follow-up is possible, surgery should be performed as early as possible to avoid delaying treatment.