How to detect the signs of lung cancer in early stage?
Although the symptoms of lung cancer are not specific and individual performance varies greatly, the following symptoms should be taken into consideration and promptly sought for medical treatment.
1. Cough: one of the common early symptoms. Due to the stimulation of bronchial mucosa by cancer tissue, most of the coughs of lung cancer patients are irritating dry coughs with little sputum, and anti-infection treatment is mostly ineffective.
2.Hemoptysis: one of the common symptoms of lung cancer. Most of the hemoptysis is small, often blood sputum, which can last for weeks or months or intermittently. Due to the small amount of hemoptysis or intermittent occurrence, it is easy to be neglected.
3. Chest pain: About 50% of lung cancer patients have chest pain. In peripheral type lung cancer, chest pain is often the first symptom.
4.Shortness of breath: caused by obstruction of bronchial tubes or large airways by lung cancer, or reduced lung function due to compression of lung tissue by cancerous pleural fluid;
5.Unexplained hoarseness, choking cough, fever, wasting, etc.
6.High-risk groups (over 40 years old, long-term heavy smokers, with strong family background of lung cancer) need to pay attention and be alert to the possibility of lung cancer if the following manifestations occur, and further examination must be done.
(1) Irritating cough without obvious cause lasting 2-3 weeks, and treatment is ineffective;
(2) Chronic respiratory disease with change in the nature of cough, especially cough with metallic tone;
(3) Persistent or repeated blood in the sputum;
(4) Recurrent pneumonia infection in the same area;
(5) unexplained lung abscess on chest radiograph, but lack of toxic symptoms such as fever, loss of appetite, or cough without large amounts of pus sputum, or regular antibiotic treatment with poor efficacy;
(6) Unexplained joint pain in the extremities and pestle-like fingers (mallet-like changes at the end of fingers/toes); male breast enlargement or hypertrophy; skin tanning or dermatomyositis, etc;
(7) limited emphysema or segmental or lobar atelectasis on x-ray;
What are the chest imaging manifestations of lung cancer?
Plain X-ray chest film
Chest X-ray is less costly and often used as the first choice for suspected diagnosis. Lung cancer has one or more of the following features on chest X-ray: mass shadow (often with burrs at the edges, lobar signs, some appear eccentric cavities), pulmonary dysplasia, obstructive pneumonia, limited emphysema, diffuse small nodular shadow, pleural effusion, etc.
CT
Has a similar presentation as a normal chest X-ray, but can detect small nodules as low as 5 mm in diameter, as well as nodules that cannot be shown on a chest X-ray such as those behind the heart, in hidden areas such as the parasternal spine, and those masked by pleural fluid. It also shows more details of the mass: to determine whether there are enlarged lymph nodes in the hilum and mediastinum, and whether the tumor has directly invaded the adjacent organs; enhanced CT combined with 3D imaging can clarify whether the mass is rich in blood supply and which bronchial artery supplies nutrition to the surrounding tissues.
MRI
MRI is significantly better than CT in showing the relationship between tumor and large blood vessels; it is not as good as CT in finding small lesions; MRI is mainly applied to understand the tumor site, scope, relationship with large blood vessels of heart and bronchial chest wall to evaluate the possibility of surgical resection.
What tests can be used to obtain specimens to determine if it is lung cancer?
The gold standard for lung cancer diagnosis is cytology and pathology to determine the presence of tumor cells. Pathologic staging is critical to lung cancer treatment selection. So, how do you obtain cells and biopsies? Depending on the situation, the following tests are chosen, with the caveat that each invasive test has corresponding indications and contraindications, and is not 100% conclusive.
1. Cytological examination of sputum, especially sputum with blood, is non-invasive and simple. Note that it should be sent for examination within two hours.
2. Extraction of pleural fluid for exfoliative cytology.
3.For tumors growing in the lumen, especially the masses growing in the mediastinum and hilum, biopsy or brush examination can be obtained by fiberoptic bronchoscopy;
4.For those close to the lung margin, percutaneous lung aspiration biopsy can be done; for those considered to have lymph node, liver or bone metastasis, puncture or biopsy of corresponding parts can be done.
5, mediastinoscopy and thoracoscopy, open chest biopsy if necessary.