Lung cancer is the most common malignant tumor at present. In recent years, the incidence and death rate of lung cancer are rapidly increasing, and it is the number one cause of cancer death worldwide. The incidence of lung cancer is mostly in men, while the incidence of lung cancer in women has been on the rise in recent years. The disease mostly develops at the age of 40 or above, and the peak age of incidence is between 60 and 79 years old, while the number of young lung cancer patients is increasing, and we can even see lung cancer patients as young as 20 years old.
1.Classification of lung cancer
The most common types of lung cancer are squamous carcinoma, adenocarcinoma and small cell lung cancer.
(1) Squamous carcinoma is mostly found in males, mostly originates from larger bronchi, and is often a central type of lung cancer, which often loses the chance of surgery upon detection. However, squamous carcinoma generally has a slow growth rate and a long course of disease. It is more sensitive to radiation and chemotherapy and metastasizes first through lymphatic metastasis, and hematogenous metastasis occurs later.
(2) In recent years, the incidence of adenocarcinoma has been increasing year by year, and it is especially common in women. Most adenocarcinomas are peripheral type lung cancer. There are no obvious clinical symptoms in the early stage, and it is often detected during physical examination. It appears as a round or oval lump and generally grows slowly, but sometimes metastasis to distant organs occurs at an early stage of detection and the opportunity for surgery is lost.
(3) 20% of lung cancer patients belong to small cell lung cancer, which is closely related to smoking, and almost all small cell lung cancer patients are heavy smokers. The tumor progresses rapidly and is often accompanied by systemic symptoms such as endocrine abnormalities or carcinoid syndrome; patients develop bloodstream metastasis at an early stage, but are sensitive to radiotherapy.
2.Etiology of lung cancer
There are many causes of lung cancer, exogenous stimulation is the main cause of cancer, meanwhile, lung cancer has certain genetic characteristics, but it is not the main factor.
(1) Smoking: Currently, smoking is considered to be the most basic high-risk factor for lung cancer. There are more than 3000 chemicals in tobacco, and multi-chain aromatic hydrocarbon compounds have strong carcinogenic activity.
(2) Occupational and environmental exposures: chemical stimuli such as arsenic, asbestos, chromium compounds, coke ovens, mustard gas, and vinyl chloride can induce lung cancer. Long-term exposure to cadmium, silicon, and formalin can also increase the incidence of lung cancer.
(3) Radiation: Uranium and fluorite miners exposed to inert gas radon gas, decaying uranium by-products, etc. have significantly higher incidence of lung cancer than others.
(4). Chronic lung infections Chronic inflammation, tuberculosis, bronchiectasis and other patients have significantly higher incidence of lung cancer.
3. Symptoms of lung cancer
Lung cancer is mostly asymptomatic in early stage, and almost 2/3 of lung cancer patients are already in advanced stage (stage III or IV) when they are diagnosed, losing the opportunity of surgery. Central type lung cancer manifests as irritating dry cough, breath-holding, recurrent pneumonia, hemoptysis (blood in sputum), asthma, hoarseness, facial swelling, etc. Peripheral type tumor is more common with symptoms such as chest pain, breath-holding or pleural effusion; one-third of patients can have distant metastasis at the time of diagnosis.
4.Diagnosis of lung cancer
The treatment effect of lung cancer is closely related to the early and late detection. Most of the early stage lung cancer can be cured, while the effect of late stage lung cancer is relatively poor, therefore, early detection and early treatment is the key. The main diagnostic methods of lung cancer include
(1) Symptoms: early stage lung cancer can be asymptomatic, by the time symptoms appear, most patients are already in advanced stage. Typical symptoms of lung cancer include cough, blood in sputum, coughing up blood, chest pain, etc. If the above symptoms appear, especially for patients who smoke, they should go to hospital in time to avoid delaying treatment.
(2) Chest X-ray examination: Early lung cancer can be detected through X-ray examination, therefore, it is extremely important to insist on physical examination, especially for patients who smoke. According to statistics, chest X-ray physical examination can improve the diagnosis rate of lung cancer in early stage and improve the treatment effect.
(3) CT examination: CT is the most important examination item for patients with lung masses. Through CT, the nature of lesions can be assessed, the location and size of lesions can be understood, and the presence of intrapulmonary metastases and pleural metastases can be observed. Radiotherapy for lung cancer may be performed through chest CT to delineate the target area, meanwhile, CT is the best method to judge the treatment effect of lung cancer.
(4) Pathological diagnosis: pathology is the gold standard for lung cancer diagnosis, and different pathological types are not all treated the same way. Radiotherapy has certain killing effect on the normal tissues of the body, therefore, it is necessary to make a clear diagnosis before all treatments can be carried out. Pathological diagnosis can be obtained through surgery, micro bronchoscopy, cytological aspiration and CT-guided aspiration. In recent years, our center has carried out CT-guided puncture technique for lung tumor diagnosis, which has achieved very good results and brought new hope for patients with advanced stage or advanced age who cannot tolerate surgery.
5.Treatment of lung cancer
Lung cancer is one of the most malignant tumors. In the past, the death rate of lung cancer was extremely high, and patients had very little chance to be cured. It is a wrong view to be afraid of cancer or to give up treatment.
The treatment of lung cancer is a comprehensive treatment mainly based on surgery. For lung cancer patients detected at early stage, the cure rate can reach more than 85% after surgery combined with chemotherapy. Therefore, early detection and treatment is the key to cure lung cancer.
For mid-stage lung cancer, such as stage II/IIIA, surgery can be performed to remove the mass first, followed by chemotherapy and radiotherapy, and the cure rate can be close to 30%-40%, even if it is not completely cured, the patient’s survival time and quality of life will be significantly benefited by radiotherapy.
For advanced lung cancer, such as stage IIIB and IV, radiotherapy is the first choice. In recent years, the research and development of chemotherapy drugs has progressed rapidly, and its side effects have been significantly reduced, such as vomiting, hair loss, bone marrow suppression and other side effects can mostly be effectively controlled by drugs. Radiotherapy has a strong killing effect on tumors. In recent years, our center has carried out three-dimensional adaptive and intensity-modulated radiotherapy, which specifically targets tumor cells, minimizes the damage to surrounding normal tissues, significantly reduces patients’ side effects, and improves patients’ survival and cure rates.
Small cell lung cancer is highly malignant and most of them have systemic metastasis in early stage. The treatment of small cell lung cancer should be based on systemic chemotherapy and combined with radiotherapy as the main treatment. Some small cell lung cancer patients can be completely cured by radiotherapy, while most of them die within six months after giving up treatment.
In recent years, individualized and targeted treatment of lung cancer has progressed rapidly, and many patients can achieve treatment by taking oral drugs. Our center is a first-class lung cancer treatment center in China, and many clinical trials and funded projects have been carried out at home and abroad, bringing hope for treatment for patients with family difficulties.
Advanced lung cancer does not mean death. Our center has cured many advanced lung cancer patients in recent years, and the center’s lung cancer cure rate has reached the leading level in China.
Lung cancer treatment is a long-term process, chemotherapy usually includes 4-6 courses, each course takes about a week, radiotherapy usually takes about a month, our center adopts individualized treatment plan for all patients, after each course, patients can go home to rest and call for appointment before the next course starts, which solves patients’ worries.