Talking about the topic of lung cancer prevention and treatment today, some netizens proposed: close the tobacco factory and completely eliminate first-hand and second-hand smoke.
Well, according to this method, no car accidents, as long as all vehicles are prohibited from the road.
Moreover, some lung cancers are not closely related to smoking.
So what should be done?
To solve this problem, we must first understand the evolution of lung cancer.
We take the most common lung adenocarcinoma as an example, and its progression process is roughly as follows:
Adenocarcinoma in situ AIS micro-invasive adenocarcinoma MIA invasive adenocarcinoma IAC.
Among them, carcinoma in situ and micro-invasive adenocarcinoma stage do not metastasize, can be cured surgically, and do not recur after surgery.
Invasive lung adenocarcinoma is divided into early, intermediate and advanced stages, and the early treatment effect is also very good, but there is already a risk of recurrence and metastasis, and a detailed comprehensive examination is often required before surgery.
If cancer could be detected before the micro-invasive cancer, then cancer would not be terrible.
Below we use CT image classification as an example:
1. Adenocarcinoma in situ mostly do not require surgery
In situ adenocarcinoma and atypical adenomatous hyperplasia of the lungs are pre-invasion lesions, have no ability to metastasize and recur, can be observed first, and many people do not progress for life.
This is a 67-year-old man, coughing for 2 weeks, CT found 8 mm pure ground glass nodules (left arrow), the density is very light, preferred regular review.
He was very stressed and anxious, and after three months of re-examination of the CT nodules, he required surgical resection, and the postoperative pathology was adenocarcinoma in situ.
Lung nodules like this one near the periphery are less difficult to operate on, and some people are willing to be a little more aggressive to eliminate panic.
According to literature statistics, this pure ground glass nodule has been tracked for 4 consecutive years, and the proportion of increased is only 6.6% (a set of data from Japan), and many people do not need surgery.
2. Micro-invasive adenocarcinoma Most should not be shelved for a long time
The picture below is an elderly woman coughing for a week, CT found 9 mm ground glass nodules, three months of re-examination without change, the surgical pathology is micro-invasive adenocarcinoma.
This type of resection does not recur and does not require postoperative chemotherapy.
Micro-invasive adenocarcinoma is at risk of progressing to invasive adenocarcinoma and most require surgery, so its CT features are particularly important:
(1) Most of them are mixed ground glass nodules, and the solid components of less than 5 mm can be seen inside; a small number of pure ground glass nodules.
(2) Mostly about 1 cm, CT value is about -450Hu, there can be 1 to 2 malignant signs (such as lobe, burrs, vacuole signs, pleural depression signs, air bronchial signs).
3. Invasive lung adenocarcinoma should be operated on in time
Many patients with lung adenocarcinoma are asymptomatic in the early stage, or the symptoms are mild and easy to be neglected, which can be detected by physical examination, and some patients are accidentally found due to other disease examinations.
This is a middle-aged male, 1.4 cm mixed ground glass nodule (left), surgical treatment is recommended.
He initially refused surgery and went back to take some home remedies, which increased to 3.4 centimeters during the 10-month re-examination (right panel).
Later, he underwent minimally invasive surgery, and the pathology was invasive lung adenocarcinoma.
The earlier the lung cancer treatment, the higher the 5-year survival rate, the above figure is the 8th edition of the guidelines of the data statistics, you can refer to it.
In summary, to do a good job in the prevention of lung cancer, in addition to quit smoking and stay away from second-hand smoke, avoid air pollution and work environmental pollution, etc., regular health examination is a feasible method, which helps to find malignant lung nodules in time when there is no symptom.
Especially in the smoker group, or the group with a history of malignant tumors and a family history of lung cancer, it is beneficial to have a low-dose spiral CT examination of the chest once a year.
I am Dr. Imaging, welcome to follow.