Compared with other cancers, lung cancer is more like a “latent killer”. Most patients are diagnosed with lung cancer at an advanced stage, that is, the cancer cells have spread to other parts of the body. If diagnosed at an early stage, nearly 70% of patients can survive for more than 5 years, and some of them even have the hope of being cured. However, there are still many misconceptions about lung cancer among the general public: Misconception 1: Lung cancer is a disease of the elderly and young people are not allowed to have it. Last month, our hospital diagnosed two cases of lung cancer in young people, one patient was 17 years old male and the other was 24 years old female, both of them were non-smokers. Some young people have a family history of cancer, and these young people have a special sensitivity to carcinogenic stimuli, creating the conditions for a younger cancer. Young people have a high level of cell division and reproduction and are vulnerable to attack by carcinogenic substances. It is true that the history of smoking is a high incidence factor of lung cancer, but this does not mean that if you do not smoke, you will not get lung cancer. In recent years, industrialization (chemical pollution) urbanization (car exhaust) has caused serious air pollution, such as the current hazy weather, PM2.5 particles and other toxic substances inhalation, and even EBV infection, tuberculosis scarring are often overlooked causes. Myth 2: Lung discomfort does not require examination? Chest pain, cough or blood in sputum are common symptoms of lung cancer or “basic symptoms”. In the early stage of lung cancer, chest pain and cough may not be so obvious, so many people do not take it seriously and think that it will be fine after a few days, or think that it is inflammation and it will be fine after taking some anti-inflammatory drugs. As a result, they do not go to the hospital for examination, resulting in many cases of “carelessness”. The central type of lung cancer cough is characterized by a high-pitched metallic sound. Alveolar cancer coughs up a lot of mucus sputum. According to some data, only 20% of the diagnosed lung cancer patients are in the early stage of the disease, while 80% of the patients have developed to the middle and late stage of the disease. In fact, if early examination, early diagnosis and early surgical treatment can be achieved, the 5-year tumor-free survival rate of lung cancer can reach 60% to 90%. Therefore, once suspicious symptoms appear in the lung, it is very necessary to go to hospital for timely diagnosis and treatment. Myth 3: Surgery is not necessary for elderly lung cancer and advanced lung cancer? In clinical practice, it is often heard that “the tumor is too big to be operated, the patient will not live for a few days” or “the old man is too old and weak to be operated”. This actually involves the indications for lung cancer surgery. Indeed, not many patients have the chance to have surgery once lung cancer is diagnosed, mainly because there are too few lung cancers detected in early stage. Many lung cancers are already too large to be operated immediately when they are found; some are not large but have distant metastases. In fact, for patients who cannot undergo surgery immediately, chemotherapy can be used to shrink the tumor to achieve lower stage, and then seize the opportunity to perform radical resection. As with the treatment principles of many solid tumors, only by undergoing radical surgery can lung cancer patients have the possibility of long-term survival. Clinical experience shows that age is not a contraindication to lung cancer surgery, and even elderly people in their 80s can obtain good treatment results through surgery and comprehensive treatment. Myth 4: There is no need to treat lung cancer in the middle and late stages? Because some lung cancer patients are not treated in time, when they are diagnosed, the disease has already developed to the middle and late stages, and many of them have already involved the heart and large blood vessels. Therefore, some people think that since the disease has developed to the middle and late stage, it is the same whether to treat or not to treat. In fact, it is not. Statistics show that patients with advanced lung cancer can only survive for 3-4 months without treatment, but after comprehensive treatment such as surgery, the quality of survival is significantly improved, and some patients can even survive for 3-5 years. It can be seen that the outcome is very different between treatment and no treatment. Especially for those patients with non-small cell lung cancer, if there is no distant lymphatic metastasis and the lesion only invades the adjacent organs (such as heart, large blood vessels, esophagus, etc.), radical surgery of varying degrees can maximize life extension and improve the quality of survival. Myth 5: It’s okay to take a chest X-ray Nowadays, many people have a chest X-ray project during physical examinations, thinking that a normal chest X-ray is okay. In fact, otherwise, from the perspective of a specialist, it is recommended that people over 40 years of age, it is best to do a CT physical examination once a year. Because the ordinary chest X-ray, the heart, muscles, bones, etc. are layered together from front to back, if the physician is not experienced enough, it is impossible to detect the lesion. The CT examination, similar to cutting a carrot, is a layer of performance, the results are more accurate and reliable. Myth 6: Small lesions are early stage lung cancer Many patients think that small lesions are early stage lung cancer when they have preliminary examinations. In fact, some lung cancers are more prone to metastasis, such as small cell lung cancer, adenocellular lung cancer, etc. The cancer cells can easily metastasize to many parts such as head, liver and bones. In contrast, squamous cell carcinoma is less metastatic. Therefore, the stage of lung cancer cannot be judged by the size of lesions. Myth 7: Surgery is useless Lung cancer patients are most afraid of open-heart surgery, and sometimes they would rather choose chemotherapy than surgery, or even easily believe in the “theory of uselessness of surgery” and miss the best time for surgery. For early stage lung cancer, thoracic surgery is a recognized better measure, and the 5-year survival rate can reach about 70%. If surgery is abandoned, the 5-year survival rate may be only 5-10%. Many of the so-called knives nowadays are actually radiotherapy. For example, radio-wave knife, gamma knife, gyroscope knife. It is a means of treatment for advanced tumors or early stage patients who cannot tolerate surgery, and in no way they can replace surgery. Myth 8: Chinese and Western medicine are not mutually exclusive Some patients think that Western medicine anti-tumor drugs are highly toxic and harmful to human body, while Chinese medicine has little side effects, thus rejecting Western medicine. Some patients think that Chinese medicine treatment is purely ineffective and psychological comfort. In fact, people have misconceptions. They should cooperate with TCM on the basis of western medicine surgery and drug treatment to support and regulate body functions and immunity, which often have unexpected gains in treatment effect. Myth 9: Never disclose the disease to patients? As long as lung cancer is treated properly, it is possible for patients to achieve long-term survival or even cure. Experts suggest that, with the consent of patients’ family members, if patients are given an open and honest account of their condition and told that lung cancer is curable, most patients can quickly calm down and face it positively after a short period of panic, pushing the treatment in a good direction. As for those patients who are kept in the dark, it is difficult to establish trust between doctors and patients, and patients either do not cooperate with the treatment or speculate about their own condition indiscriminately and have serious psychological problems, which is ultimately detrimental to the treatment. Myth 10: Is it necessary to have chemotherapy? In fact, chemotherapy is an important part of comprehensive treatment for lung cancer, and has been proven to be better than the best supportive treatment for advanced lung cancer by evidence-based medicine. How effective it is depends on how it is used. The optimization of chemotherapy should be based on a comprehensive diagnosis. Some patients are found early enough that surgery can be preferred without chemotherapy at all; some patients need chemotherapy first to create an opportunity for surgery; and some patients need additional chemotherapy after surgery to consolidate the efficacy. The specific situation of patients varies, and the application and specific implementation plan of chemotherapy are diverse. With the development of molecular target diagnostic technology, through molecular typing of lung cancer, screening mutated lung cancer genes and selecting more effective chemotherapy drugs, the traditional so-called “tied chemotherapy”, which is nearly 70% ineffective, can be avoided to a certain extent, thus obtaining twice the effect with half the effort. The emergence of new targeted therapies in recent years has indeed provided clinicians with new options and ideas, but it should be emphasized that no drug should be deified. No single targeted drug can be suitable for all patients, and its application should follow a strict range of indications, i.e., patients must have “molecular targeted drug targets” in the body by molecular biology testing before the drug can work.