Primary bronchogenic carcinoma, abbreviated as lung cancer or lung cancer, refers to malignant tumors originating from the trachea, bronchi, and lungs. Lung cancer is a bronchogenic carcinoma, including several main types such as squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and large cell carcinoma. Due to the vast majority originating from bronchial mucosal epithelium, there are fewer cases originating from bronchial glands or alveolar epithelial cells. The incidence rate and mortality of lung cancer are rising rapidly and are a worldwide trend.
1、 Symptoms
1. Cough
The cough symptoms vary depending on the location, mode, and speed of tumor growth. When the tumor cells grow in a large airway, they are paroxysmal irritating cough, no sputum or a little foam sputum. When secondary infection occurs, the amount of sputum increases and is mucopurulent.
2. Phlegm blood or hemoptysis
Central type lung cancer is more common, often with blood in sputum or intermittent blood sputum, occasionally with severe hemoptysis.
3. Asthma
Tumors can cause bronchial stenosis and partial obstruction, which can produce localized wheezing sounds.
4. Chest tightness and shortness of breath
Tumors can cause bronchial stenosis, compression of the airway, metastasis, fluid accumulation, diaphragmatic paralysis, superior vena cava obstruction, and extensive lung invasion, which can lead to chest tightness and shortness of breath.
5. Chest pain
When a tumor invades the pleura or chest wall, it may present as dull or dull pain, which worsens with breathing and coughing. When invading the ribs and spine, the pain is persistent and significant, and is not related to breathing or coughing. Continuous pain in the shoulder or chest and back often indicates the possibility of lung cancer invasion near the mediastinum on the inner side of the upper lung lobe.
6. Fever
When a tumor compresses or blocks the bronchi, causing pneumonia or atelectasis, it is often accompanied by fever and corresponding signs. Antibiotic treatment can be temporarily effective. If tumor necrosis causes fever, antibacterial treatment is ineffective.
7. Dyspnea
Tumor compression of the large airway can result in inspiratory dyspnea and three concave signs.
8. Dysphagia
Caused by tumor invasion or compression of the esophagus.
9. hoarseness
After the tumor directly compresses or metastasizes to the mediastinal lymph nodes, it compresses the recurrent laryngeal nerve and paralyzes the vocal cords, which can lead to hoarseness.
2、 Treatment
1. Drug Therapy
(1) Molecular Targeted Therapy Drugs
Targeting specific molecules in tumor tissue or cells, using molecular targeted drugs to specifically block the biological function of the target, thereby achieving the goal of inhibiting tumor growth or even causing tumor regression. For example, drugs such as gefitinib and erlotinib targeting epidermal growth factor receptors, bevacizumab targeting tumor angiogenesis, and crizotinib targeting anaplastic lymphoma kinase.
(2) Biological response regulators
Immunobiological therapy has become an important part of tumor treatment, such as interferon, interleukin-2, tumor necrosis factor, colony-stimulating factor, etc., which can increase the body's tolerance to chemotherapy and radiotherapy and improve efficacy in the treatment of small cell lung cancer.
2. Surgical treatment
(1) Surgical treatment
Surgical treatment is the best treatment method for early lung cancer. Lung cancer surgery is divided into radical surgery and palliative surgery. We should strive for radical resection to achieve optimal and thorough removal of the tumor, reduce tumor metastasis and recurrence, and perform final pathological TNM staging to guide postoperative comprehensive treatment.
(2) Video assisted thoracoscopic surgery
Video assisted thoracoscopic surgery is a minimally invasive surgical technique that has developed rapidly in recent years, mainly suitable for patients with stage I lung cancer. This technique has certain advantages over standard thoracotomy.
3. Radiotherapy
(1) Radical radiotherapy
Used for patients with limited lesions, inconvenient surgery due to anatomical reasons, or other reasons that cannot be operated on, supplemented by chemotherapy can improve the efficacy.
(2) Palliative radiotherapy aims to inhibit tumor development, delay tumor spread, and alleviate symptoms. It has a certain therapeutic effect on stubborn cough, hemoptysis, atelectasis, and superior vena cava obstruction syndrome caused by lung cancer, and can also alleviate bone metastasis pain and symptoms caused by brain metastasis.
(3) Adjuvant radiotherapy
Suitable for preoperative radiotherapy and postoperative patients with positive surgical margins.
(4) Preventive radiotherapy
Suitable for whole brain radiotherapy in patients with effective systemic treatment of small cell lung cancer.
4. Chemotherapy
Chemotherapy is divided into palliative chemotherapy, adjuvant chemotherapy, and neoadjuvant chemotherapy. Clinical indications should be strictly controlled, and patient disease staging, physical condition, adverse reactions, quality of life, and patient wishes should be fully considered to avoid overtreatment or undertreatment. Common chemotherapy drugs include platinum, gemcitabine, pemetrexed, paclitaxel, vinorelbine, etoposide, and camptothecin analogues. At present, the recommended first-line chemotherapy regimen is a two drug regimen containing platinum, while the second-line chemotherapy regimen mostly recommends monotherapy with docetaxel or pemetrexed.
In addition, lung cancer patients should supplement nutrition, arrange rest reasonably, take medication on time, and follow targeted guidance given by doctors.