Uncle Li is 71 years old this year, when he was young, he did more physical work, he has always had the old problem of waist soreness and leg pain, and when the pain worsened, he went to the massage shop in front of his home to do massage massage, which can alleviate a lot every time. To this end, Uncle Li is convinced of the craftsmanship of the nearby tuina shop master, and has been an old customer in the store for more than ten years. However, in the second half of last year, Uncle Li actually had a weak walk on two legs after a massage, and gradually aggravated, and finally could not walk and needed to use a wheelchair. The family panicked, quickly sent Uncle Li to the hospital for examination, did lumbar magnetic resonance, found that the lumbar vertebral body was damaged, and it was highly suspected that it was malignant tumor metastasis.
After further systemic examination, it was finally found that the primary lesion was in the lungs, only 1.5 cm in size, and the pathology of lung puncture biopsy confirmed to be small cell lung cancer. In advanced stages of small cell lung cancer, bone metastasis, the prognosis is relatively poor. Moreover, the broken vertebral body cannot be repaired, and the spinal cord nerve damage cannot be reversed, which means that Uncle Li has paraplegia, can only be bedridden for a long time, life is completely unable to take care of himself, it is difficult to urinate and defecate, and it is necessary to conduct urinary and enemas.
Many people wonder how the primary lesion is only 1.5cm, and how bone metastasis has already occurred. You know, small lesions, large metastasis, early metastasis, is the characteristics of small cell lung cancer, many small cell lung cancer patients have been metastasized before being diagnosed, small cell lung cancer "evil" is unimaginable.
The "evil" of small cell lung cancer is reflected in three aspects:
1. Fast growth
There is an indicator of the growth rate of cancer cells called doubling time, that is, the size range of the tumor, the time required to double. Among all lung cancer cells, small cell lung cancer has the shortest doubling time, about 30 days. Lung squamous cell carcinoma is about 3 months and adenocarcinoma is 4-6 months. Small cell lung cancer is more manifested as solid nodules in the early stages, and some patients with small cell lung cancer will increase from a few millimeters to 2-3 cm in less than a year.
2. Transfer early
The cancer cells of small cell lung cancer have completely different characteristics from squamous cell carcinoma cells, it is very "lively", and when the primary lesion is very small, some cancer cells will detach from the mother and enter the blood vessels and lymphatic vessels, causing distant organ metastasis or lymph node metastasis. Distant metastases are common, including the brain, bones, liver, and adrenal glands. Once distant metastases, it means that there is no chance of radical cure, and any treatment can only prolong survival.
3. Poor treatment effect
Small cell lung cancer has a low degree of differentiation or even undifferentiated cancer cells, and although sensitive to radiotherapy and chemotherapy, this effectiveness lasts for a short time, and many patients have relapsed metastasis less than half a year after the end of treatment. In addition, unlike lung adenocarcinoma, which has many targeted drugs available, small cell lung cancer has almost no particularly effective targeted drugs, and currently only anlotinib, a multi-target anti-angiogenic targeted drug, is used as a third-line drug choice. In terms of immunotherapy, only the PD-L1 immune checkpoint inhibitors devalumab and atezizumab are currently approved for small cell lung cancer. The overall treatment effect is still relatively poor.
Small cell lung cancer is closely related to smoking, so to reduce the probability of occurrence, smoking cessation is the first thing to do. Secondly, small cell lung cancer has a chance of cure after limited time surgery and chemoradiation, so early detection is the most critical, and the annual low-dose spiral CT physical examination of high-risk people over 40 years old is very necessary.