A 39-year-old woman, who does not smoke or drink, has a stable and comfortable work life, and has no history of lung cancer in her family, but she came to do CT because of repeated attacks of cough and asthma, and found a large amount of pleural effusion (left picture):
The gray area on the left is a large amount of pleural fluid, which squeezes and displaces the heart, and also closes the lung tissue and loses the lung.
After being hospitalized, the doctor gave her a puncture, which drained a large amount of pleural fluid, and after the lung tissue was re-inflated, a small tumor was revealed (inside the aperture of the right picture).
This small lung cancer is less than 2 cm, is a solid lung nodule, due to the location of occurrence close to the pleura, poor differentiation, early occurrence of pleural metastasis and rib metastasis, causing a large number of pleural effusions, unfortunately.
Later, punctures were done, and the pathology was invasive lung adenocarcinoma.
This happened more than 5 years ago, this lady is still alive, relatively lucky, sensitive to chemotherapy and targeted therapy, in recent years due to repeated hospitalizations due to lesions, spending a lot of money.
The incidence of lung cancer in young people under the age of 40 is not high, why do some people not smoke, drink alcohol and have no family history, why do lung cancer still occur? Let's get a quick answer today.
Lung cancer is known to be the most common cancer, and smoking is the most common risk factor. But many people do not agree that smoking is related to lung cancer, based on the fact that many people smoke all their lives and still live to 90 to 100 years old, and some people do not smoke and insist on exercising, and they also have lung cancer.
We answer this question from two perspectives:
1. What are the risk factors for lung cancer?
2. Why do people who don't smoke also get lung cancer?
First, the high risk factors for lung cancer
The chart below shows people at high risk of lung cancer, which have a higher incidence than others:
These people recommend that over 40 years of age, a low-dose spiral CT physical examination once a year, can timely detect early lung cancer (see CT film as malignant lung nodules), early can be cured, does not affect life expectancy.
Let's take an example:
The patient was a mixed ground glass nodule found on physical examination, marginal lobes, microvascular signs, already 2.9 cm, is an invasive lung adenocarcinoma (the most common type of lung cancer), has been operated on for many years.
A careful reader looking closely at the first picture may find that lung cancer can also occur in people who do not smoke, for what reason?
We answer the second question, why do people who don't smoke also develop lung cancer?
Frequent exposure to carcinogens in the work environment, or a history of malignant tumors, or an immediate family member with a history of lung cancer, the incidence of lung tumors is also high, and health examinations should also be paid attention to.
According to the literature, about two million people worldwide are diagnosed with lung cancer every year. Most of these patients have a history of smoking, but 10%-25% of patients have never smoked.
In an article published in Nature Genetics, by analyzing the whole genome sequencing data of 232 lung cancer patients without a history of smoking, it was found that most of the patients' tumors were caused by the accumulation of naturally occurring genetic mutations in the body.
In simple terms, lung cancer patients who smoke and lung cancer patients who do not smoke may have differences in pathogenesis, and there are differences in genomic characteristics.
Picture from the network, thanks, invasion and deletion
The researchers found that 46 percent of the 232 lung cancer patients with no smoking history had mutational features associated with reactive oxygen species damage and 13 percent had mutational features associated with defects in nucleotide excision repair, suggesting that the majority of lung cancer patients without a history of smoking had oncogenic mutations derived from natural biochemical processes in the body.
So, how should this group of people prevent lung cancer?
The method is still the same as above: over 40 years old, pay attention to regular chest examination, and one point is that any lung symptoms do not disappear in the short term, and go to the hospital in time.
In recent years, many units will organize annual physical examinations for employees, and the chest examination has also been changed from the previous X-ray to low-dose spiral CT, which is a good progress!
This patient was the lung cancer found through physical examination (with different stages), and two at the same time, both of which were ground glass nodules, and had surgery together for more than two years.
I am Dr. Imaging Kehao, thank you for reading and paying attention!