What is the treatment for lung cancer?

  According to the Ministry of Health, lung cancer has become the number one cause of death from malignant tumors among urban residents in China, and the World Health Organization predicts that lung cancer will be one of the major medical problems of the 21st century, along with AIDS. The incidence pattern and trend of lung cancer are: developed countries are higher than developing countries, coastal than inland, urban than rural, and male than female.  The causes of lung cancer include environmental lung cancer factors such as tobacco, air pollution, occupational exposure factors, etc. Environmental lung cancer factors must eventually affect cell genes to cause malignant changes.  The symptoms of lung cancer appear late, about 5-10% of patients find lung masses during physical examination without any symptoms. Other symptoms include liver metastasis, bone metastasis, brain metastasis, etc.  The basic treatment principle of lung cancer is multidisciplinary integrated treatment with surgery, chemotherapy, radiotherapy, biology and Chinese medicine.       The indications for surgery for non-small cell lung cancer are: (1) if the patient has been diagnosed with lung cancer, it is estimated that the lesion can be radically removed by surgery, and there is no absolute contraindication to surgery, in principle, surgery should be performed as much as possible; (2) if the patient has not obtained cytological and histological evidence, but the malignant lesion cannot be ruled out, it is appropriate to try to obtain the diagnosis by thoracotomy and perform the corresponding surgical treatment at the same time, provided that there is no contraindication to surgery.  The targets of surgery include: primary lung cancer, stage I, stage II, and some stage IIIa patients; metastatic lung cancer, patients with a single lesion; patients with isolated lesions in the lung, obstructive pneumonia and atelectasis, and patients with suspected lung cancer. Small cell lung cancer accounts for about 15-20% of all lung cancers and is a malignant neuroendocrine tumor of the lung, which proliferates and metastasizes very rapidly and is highly malignant.        Indications for surgery include: (1) stage I small cell lung cancer; (2) stage II small cell lung cancer after chemotherapy; (3) stage IIIa small cell lung cancer after remission from chemotherapy, or those who are not in remission but the extent of the lung lesion allows surgery.        Surgical methods: (1) Limited resection:for peripheral lung cancer with high-risk factors and cases that cannot tolerate more extensive resection, with a high rate of local recurrence after surgery (2) Lung segmental resection: for peripheral lung cancer with poor lung function in elderly patients. Complication rate is lower, but recurrence rate is higher than lobectomy.  (3) lobectomy: suitable for most isolated lesions and should be combined with local or standardized lymph node dissection.  (4) Total pneumonectomy: indicated for patients with tumor involvement of multiple ipsilateral lobes, or invasion of the ipsilateral common bronchus and/or pulmonary artery trunk, and with cardiopulmonary function that can tolerate surgery, with a high rate of postoperative complications and mortality and poor vitality.  (5) Extended resection: On the basis of the above-mentioned procedure, the invaded tissues outside the lung are removed together as a whole, which may include part of the chest wall, diaphragm, pericardium, left atrium, lateral wall of superior vena cava and the top of the thorax. The aim is to remove the tumor as completely as possible, with higher complication and mortality rates than in the standard procedure.