Eighty-seven percent of lung cancer deaths are related to smoking (including passive smoking); people who live with smokers for long periods of time are 25% more likely to develop lung cancer, and being forced to breathe secondhand smoke at work for long periods of time also increases the risk of lung cancer. In recent years, it has also been found that third-hand smoke can also be harmful to human health, especially to the health of infants and children. Hu Mu, Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University
Through years of health education, the public has become familiar with the dangers of “first-hand smoke,” but awareness of the health risks of “second-hand smoke,” especially “third-hand smoke,” is still far from adequate. Therefore, on the one hand, we should continue to increase the publicity of tobacco control, and on the other hand, we should legislate to ban smoking in public places as soon as possible. Not enough, the protection of non-smokers from second-hand and third-hand smoke is still not strong enough. In addition, the high rate of smoking among parents of students, school teachers, and health workers, especially male physicians, plays a negative role in education and tobacco control efforts on the harmful effects of smoking, so doctors and teachers are urged to take the lead in quitting.
Recent studies have found that lung cancer caused by smoking is treated significantly less effectively than lung cancer in non-smokers, and the prognosis is often poorer. Therefore, increasing tobacco control efforts to keep the public away from first-, second- and third-hand smoke and to prevent lung cancer is fundamental to maintaining good health.
Lung cancer has few early symptoms in its early stages, and those who seek medical treatment due to symptoms are mostly in the middle and late stages with poor efficacy. With the emergence of a series of new anti-cancer drugs, the survival period of more patients with intermediate and advanced non-small cell lung cancer has been significantly extended. In particular, the introduction of molecular targeted drugs in the last decade has enabled lung cancer patients not only to obtain survival efficacy, but also to significantly improve their quality of life.
Targeted individual and human-centered
Currently, the main treatment for advanced lung cancer is chemotherapy-based combination therapy. Effective chemotherapy can improve patients’ survival, but it is accompanied by obvious toxic side effects, such as nausea, vomiting, hair loss, leukopenia, reduced resistance, weakness, neuropathy, etc. Moreover, intravenous treatment is required, and patients often need to be hospitalized, which seriously affects patients’ quality of life. The clinical application of oral targeted drugs has made the pursuit of higher quality of life for lung cancer patients a reality.
In the treatment of advanced non-small cell lung cancer, individualized molecular targeted therapy given according to specific biomarkers has brought outstanding efficacy to more lung cancer patients. The reason why targeted therapy is called targeted is that these drugs are designed to destroy only tumor cells as much as possible when they are developed, avoiding accidental injury to normal human tissue cells.
With the development of targeted therapy, the latest clinical studies have confirmed that there are significant ethnic and individual differences in advanced non-small cell lung cancer. The response to oral targeted therapies differs significantly among different ethnic groups of lung cancer patients. In patients of Asian descent with advanced non-small cell lung cancer who have returned to treatment, oral targeted agents are more effective than chemotherapy in controlling tumors. Long-term survival has also been observed in Asian patients with non-small cell lung cancer on oral targeted agents, with some advanced patients having survived for more than 5 years. This is very rare in the past when chemotherapy was the only treatment available.
In general, oral molecular targeted drugs are well tolerated. For patients with advanced cancer that cannot be completely cured, treatment should not only aim at tumor elimination as the only goal, but also pay attention to patient’s quality of life in addition to observing tumor size changes, and advocate the use of least toxic drugs under the premise of being effective. The orally administered molecular targeted drugs are precisely adapted to this requirement. Some patients can even maintain normal work and enjoy life by participating in activities such as travel while taking oral molecular targeted drugs.
Changing the old concept of lung cancer and creating a new treatment pattern
In the traditional treatment mode, patients often have the question of “chemotherapy and chemotherapy, when should we forget about chemotherapy?” is the question. Long-term chemotherapy and repeated hospitalization were once the only options for patients with advanced non-small cell lung cancer to control their tumors and prolong their survival. What’s more, even the most effective chemotherapy regimen can only result in tumor shrinkage in about 30-35% of patients. The remaining 60% to 70% of patients are suffering so much without any significant effect, just like being “tied down” to treatment. These patients need another option to enjoy every moment of life as normal in the face of advanced tumor threat.
Individualized targeted therapy makes this treatment model a reality. With the rapid development and widespread clinical application of molecular targeted therapies, their safety and tolerability are relatively good, and they have more definite clinical efficacy for specific beneficiary groups, so that the treatment of advanced non-small cell lung cancer patients is converted into a chronic lifestyle disease treatment model, making the “survival with tumor” that we have advocated and expected for decades possible. This makes the “survival with tumor” that we have advocated and hoped for for decades possible.
In the face of the latest scientific research results, more doctors and patients need to realize that there is another and better option for tumor treatment, to break away from the inherent concept of single chemotherapy, and to take an important step to try something new.
With the application of oral targeted therapies and the emergence of strong clinical research data, the traditional treatment mindset and paradigm of advanced non-small cell lung cancer has been changed. Chemotherapy is no longer the only option for patients. With the application of more effective drugs in the clinic, the survival time of patients with advanced non-small cell lung cancer has been significantly extended. I believe that with the progress and development of medicine, the treatment mode of advanced non-small cell lung cancer will become more humane and individualized. It may even be that in the near future, non-small cell lung cancer will be successfully controlled and will no longer be an intimidating killer, but a chronic disease that can be controlled in a stable state for a long time, just like hypertension and diabetes. In this way, people will no longer be “afraid of cancer.”
Individualized targeted therapy will change the traditional treatment paradigm.