Survival time for lung cancer patients depends on the type of lung cancer at the time of first diagnosis and how far it has spread. About one-third of patients in the early stages of non-small cell lung cancer can be cured with surgery alone. This rate is much lower than the cure rate for patients with small cell lung cancer – five percentage points lower. In most patients who are not likely to be cured, survival time ranges from a few months to several years, depending on how far the lung cancer has spread, the patient’s general condition, how well he or she responds to treatment, and how effective the treatment regimen is.
After treatment is completed, any chemotaxis may occur and the patient will still need to remain under the watchful eye of a health care provider because of the possibility of cancer recurrence. Follow-up appointments should occur regularly, every one to three months for the first year or two. The frequency of follow-up visits depends largely on the patient’s condition and his or her disease. At each follow-up, the patient must undergo a full body examination, a chest X-ray every few months, a CT chest X-ray and a bone scan once a year. The treatment of recurrent disease depends on the period of recurrence and the extent of the disease. Many patients are treated with the chemotherapy mentioned earlier. Radiation therapy may play a role in managing the painful and symptomatic areas where the cancer has spread. If the patient feels pain, there are many pain medications available to reduce the pain.
1. Sputum cytology: Sputum cytology (sputum examination) has been widely used in the diagnosis of lung cancer. Sputum examination does not require expensive equipment, is simple and easy to perform, painless for patients, and has a wide range of application. Sputum examination can also be used for the screening of high-risk groups of lung cancer.
2.X-ray examination: X-ray plain film of chest is the most important examination in the diagnosis of lung cancer.
3.CTPET examination: CT examination is largely superior to conventional X-ray examination, and PET examination is the safest and most effective means to determine the benignity and malignancy of lung cancer, which is non-invasive and has an accuracy rate of over 95%.
4.Magnetic resonance imaging (MRI): The contrast and resolution of MRI are better than CT, and it is easier to identify and clarify the relationship between substantial masses and blood vessels.
5.Magnetic resonance spectroscopy (MRS): This is an older technique, but now it is also used as a means to identify benign or malignant disease.
6.Bronchoscopy: Bronchoscopy is an effective means to diagnose lung cancer, which can observe the site and scope of tumor and obtain tissues for pathological examination, and can also speculate the possibility of surgical resection based on the condition of vocal cords, trachea and augmentation.
7.Mediastinoscopy: mediastinoscopy is an effective means to diagnose mediastinal lymph node metastasis of lung cancer.
Sputum cancer cell examination (sputum examination). Different steps should be taken according to different situations in the diagnostic workup.
I. Negative X-ray and negative sputum examination
1.Anyone who is asymptomatic but has three major high-risk factors (male, age ≥45 years old and smoking >400 cigarettes/year) should undergo 70-100mm fluorescence microscopic x-ray or chest fluoroscopy and sputum cytology examination half-yearly.
2. Anyone with hemoptysis or/and dry choking cough with three major high-risk factors should undergo repeated sputum cytology and be given regular anti-inflammatory treatment at the same time; fiberoptic bronchoscopy (fibronectomy) and televisual fluoroscopy can be considered. If repeated sputum examination or microscopy is still negative, it should be reviewed every two months and adhered to for one year.
II. Negative X-ray and positive sputum examination
1.Exclude upper respiratory tract and esophageal carcinoma.
2.Perform ciliary microscopy, strive to peer into sub-sub-segments, and if there is suspicious local mucosal thickening, roughness or blood stains, brush check, flush or puncture the mucosa of bronchial wall to look for cancer cells in the area. If local unevenness or roughness is found, a bite biopsy should be considered.
3.Conduct TV fluoroscopy and change the body position, focusing on small nodule foci in hidden areas.
4.If no lesion is found by the above examinations, sputum, electron microscopy and fibrinoscopy should still be repeated every two months. CT examination can also be performed, and subdivision can be made at suspicious places. Regular re-examination should be continued for not less than one year.
Third, positive X-ray and negative sputum examination
1. Those with segmental or lobar pneumonia or obstructive pneumonia and suspected central lung cancer should undergo fibrinoscopy, including trans-fibrinoscopic biopsy (TBB), or selective bronchography; and repeatedly strengthen sputum examination.
2. Local tomography should be performed for masses or nodular lesions. Trans-fiberscopic lung biopsy (TBLB), or percutaneous lung biopsy, or aspiration for cytological diagnosis can be performed if available.
3.Continuous sputum examination should be done at least twelve times.
4.If the sputum is still negative after repeated sputum examinations and the x-ray is highly suspicious of lung cancer, dissecting chest exploration and frozen section biopsy should be performed.
4. Positive X-ray and positive sputum test
1.Actively make preparations before surgery.
2. If regional lymph node enlargement is suspected, frontal and lateral oblique stratification films can be taken. For limited stage small cell lung cancer, CT and lateral tilt stratification film, liver ultrasound, bone isotope scan and bone marrow aspiration into biopsy smear should be routinely used in large hospitals to facilitate the formulation of treatment plan.
Prevention
According to the causes of lung cancer, the following preventive methods for lung cancer are proposed.
1.Prohibition and control of smoking
2.Control of air pollution
3.Occupational protection
4. Prevention and control of chronic bronchitis.
Dietary measures
1.Quit smoking, which is the most effective way to prevent lung cancer.
2.Less consumption of strong alcohol.
3.Do not eat moldy and spoiled food and less pickled food.
5. Chew slowly and do not eat food that is too hot when eating.
6, fat intake should not be too much, the intake of less than 30% of the total calorie intake, that is, the daily intake of animal and plant fat 50g-80g; eat more fresh vegetables and fruits, a daily supply of 10g of fiber and general level of vitamins.
7. eat less smoked food.
8.Do not abuse drugs, especially do not abuse sex hormone drugs and cytotoxic drugs to prevent the risk of drug carcinogenesis.
9. daily intake of fruits, vegetables and coarse cereals.
Environment
Pay attention to pollution in the kitchen and enhance kitchen ventilation.
Psychology
Cultivate an optimistic and open-minded personality.
Others
Exercise at least 3 times a day to avoid overweight.
The incidence of lung cancer is increasing, and many patients in the clinic will think their “death” time is coming once they are diagnosed. The following are some of the key questions that most patients ask.
1. Treatment plan for lung cancer
2. Considering lifestyle changes
3. Deciding on their quality of life and financial issues
Patients and their family members will ask their doctors about the prognosis (survival) of lung cancer. Patients in developed countries may look up the statistics of survival on the internet themselves, but in China, they are more likely to ask people around them who have similar experiences, which is obviously very unscientific.
What is prognosis?
”Prognosis” refers to a medical judgment of the future trend of the disease, in other words, prognosis refers to the chance of recovery or recurrence. Many factors affect the prognosis of lung cancer, including at least
1. the location and tissue type of the tumor.
2. the stage of lung cancer (that is, the extent of lung cancer itself and metastasis)
3. the degree of differentiation of lung cancer (the degree of difference between abnormal cancer cells and normal cells)
4. The patient’s age, physical condition and the sensitivity of the tumor to treatment.
Doctors determine a patient’s prognosis by carefully referring to all the factors that affect prognosis to try to anticipate what might happen. Over the years, physicians around the world have collected and are collecting information on the survival of thousands of lung cancer patients, and after rigorous statistical analysis, can essentially determine the survival of individual patients.
If the lung cancer is sensitive to treatment, we believe that survival is optimistic; if the lung cancer is difficult to control with treatment, the prognosis will be poor; however, it must be understood that prognosis is a “prediction” and not a fact, and physicians will not make an absolute statement about survival for an individual patient.
What are the factors that affect the prognosis of lung cancer?
In 2006, the American Cancer Society estimated that 174,470 patients (92,700 men and 81,770 women) would be diagnosed with lung cancer and 162,460 would die of lung cancer in the same period.
The prognosis of lung cancer is mainly based on.
1.The stage of lung cancer.
2.The tissue type of lung cancer.
3.The presence of symptoms (such as cough, dyspnea, etc.).
4.The health condition of the patient.
5.Whether the lung cancer is first diagnosed or recurrent.
Lung cancer with diameter less than 3cm, no external invasion, and no metastasis to the hilum or mediastinal lymph nodes is called “early stage lung cancer”.
Once the tumor invades the pleura or has metastasis to the hilar lymph nodes, we define it as “early to middle stage lung cancer”.
If the lung tumor metastasizes to the mediastinal lymph nodes, or if the tumor invades the chest wall, diaphragm, pericardium and mediastinum, we call it “locally advanced lung cancer”.
If a lung cancer patient has extra-pulmonary metastasis, such as cranial metastasis, bone metastasis, abdominal organ metastasis, then it is “advanced lung cancer”.