There are many rumors about cancer, such as "radiotherapy and chemotherapy will accelerate the death of patients", "cancer will recur sooner or later after surgery", "cancer is not treated, and in the end it is empty of money", such rumors are very common, but also let many people fall into confusion.
Why do many people believe these false views? How did the rumors come about?
Dr. Hao shared a batch of lung cancer cases today, and everyone will understand after reading it.
What will happen to lung cancer that abandons treatment?
The consequences of abandoning treatment, many people can think, cancer will hardly heal itself, it will only get more and more serious.
But some elderly patients are also helpless, old and weak, can not withstand surgery and radiotherapy and chemotherapy, this time to see the progression rate of cancer cells.
Some lucky "lazy cancers" have a longer survival period due to slower proliferation of cancer cells:
This old lady belongs to the "lazy cancer", at the age of 83, she was hospitalized for coronary heart disease and was diagnosed with lung adenocarcinoma (left), which is an irregular solid lung nodule with vascular cluster signs, lobe signs, and pleural depression signs.
Because of their age, the elderly did not take therapeutic measures and were regularly reviewed.
He is 88 years old this year, and the CT tumor has more than doubled in size (right panel) and occasionally has symptoms such as cough, sputum blood, and chest tightness, which can be tolerated.
If all lung cancers could be so slow, it wouldn't be scary!
But this is a rare situation, which can be encountered but not sought.
And the old man came back again last week to review, and there are already signs of accelerated progress.
Fortunately, the elderly and their families are more calm, saying that God has given 5 years more life, grateful!
If the old man happens to have used any folk remedies in the past 5 years, it may be considered the credit of the folk remedies, but it is not.
Here to add: most ground glass nodules are inert lesions, and you can choose to review them regularly, and you can not progress for many years.
Like this ground glass nodule, 9mm in diameter, many can go years without progress. Statistics have been made in the literature, and for 5 consecutive years, the number of cases with progress is about 8%, including increased density or volume increase.
Such nodules are found to progress and then re-operated, and the effect is often the same.
However, some ground glass nodules are located near the periphery of the lungs (in this case, they are located under the pleura outside the lungs), the operation is less difficult, and some people are willing to be aggressive, minimally invasive surgery to cut them off and eliminate anxiety, which is understandable.
Many of these nodules are adenocarcinomas in situ and microinvasive adenocarcinomas, which do not recur after resection and do not require other treatment after surgery.
However, a chest examination is still recommended every 1-2 years after surgery, as studies have found (long-term prognosis after surgery in patients with pulmonary in situ adenocarcinoma and microinvasive adenocarcinoma (JTO, IF:13.357)), and some patients will also develop malignant lung nodules again, with the estimated incidence of heterogeneous secondary lung cancer in situ adenocarcinoma and micro-invasive adenocarcinoma 10 years after surgery of 5.6% and 7.7% (p = 0.45), respectively.
Having seen lazy cancer, let's look at a fast-growing one:
This is an old smoker, chest pain cough diagnosed lung squamous cell carcinoma (left), refused further treatment, the result is only 4 months later, the tumor increased several times, larger than a goose egg.
What are the results of aggressive surgery, radiotherapy and chemotherapy for lung cancer?
1. Early lung cancer can be cured
The 3 patients in the figure below, all of whom were lung nodules found on physical examination, and did not disappear after follow-up observation, all underwent minimally invasive surgical resection:
Surgical pathology is micro-invasive adenocarcinoma, belongs to the early stage, does not metastasize, does not recur after surgical resection, and the cost is not high.
Many of these patients with early-stage lung cancer are found on asymptomatic physical examinations or accidentally detected in hospital for other diseases. Therefore, now that the living conditions are better, it is beneficial for the middle-aged and elderly to attach importance to regular physical examinations, and early treatment of the disease can prolong life.
2. Patients who can be removed but are at risk of recurrence should receive adjuvant therapy after surgery to reduce the risk of recurrence.
The picture below is a middle-aged man, hospitalized with diabetic nephropathy, and a 3.0 cm solid lung nodule was found, with burrs and pleural depressions, suggesting lung adenocarcinoma:
Surgical pathology is acinoma of the lung adenocarcinoma dominated by acinar and papillary growth, which is equivalent to medium differentiation, but the pathological section found that there is a micropammonal growth component (low differentiation) in the tumor and a violation of the visceral pleura, indicating a certain risk of recurrence.
Referring to his test results, doctors recommended postoperative adjuvant therapy to reduce the risk of recurrence.
It has been more than 6 years now, and last month I came back to check that everything is normal:
3. Some patients are in the advanced stage of the first examination, and they can do what they can and choose some treatment methods to alleviate symptoms and prolong life.
Many people say that lung cancer over the age of 70 should not be cured, just go with the flow, so as not to run out of money.
Some people may not know that the field of lung cancer treatment has undergone tremendous changes, surgical trauma is getting smaller and smaller, the precision is getting higher and higher, and the field of internal medicine treatment has also made great progress, the treatment methods have been far more than radiotherapy, chemotherapy, with the iteration of targeted drugs, the progress of immunotherapy, and anti-vascular therapy, etc., the treatment of lung cancer has been pushed to a new height.
A study was published in 2018 in a leading journal on lung cancer.
The authors included 110 ALK-positive lung cancer patients, using targeted targeted therapy, and finally the average overall survival time was 81 months, and nearly half of them could live more than 7 years!
Of course, back to specific individual cases, each person's specific situation is different, and it is necessary to do what you can.
This year, many places have abolished the approval system for off-site medical treatment, which makes it much more convenient for patients.
If you have the ability, wait until the epidemic is under control, you may wish to take patients or detailed information to chest hospitals in first-tier cities to receive more cutting-edge information and treatment plans.
I am a doctor of imaging, thank you for reading, welcome to pay attention!