Today, cancer patients are getting younger. How does it feel to be diagnosed with cancer at a young age?
The 8th episode of the medical documentary observation program "My White Coat" tells such a lamentable story.
In early April, a 22-year-old girl sat in a conference room at Shenzhen People's Hospital with some uneasiness.
Wang Guangsuo, chief physician of thoracic surgery on the opposite side, solemnly told the girl: "This was found in January, there are 12 mm, if this is the case, it is necessary to operate..."
Hearing this, the girl cried uncontrollably and kept wiping her tears.
Dr. Wang Guangsuo sincerely and resolutely advised her: "Don't worry, find a way to overcome difficulties, do it!" ”
The girl is a nurse named Xiao Liu (pseudonym). Because her hospital admitted COVID-19 patients, all medical staff were given lung CT screenings in January.
Unfortunately, she was found to have a large shadow in the eighth segment of her right lower lung during screening and was diagnosed with a right lower lung nodule.
A lung nodule is a smaller than 3 cm, rounded, densely dense shadow of the lungs, caused mainly by inflammation and tumors, and can occur single (only 1 nodule) or multiple times (with multiple nodules).
Among them, those with a diameter of less than 1 cm are called "small lung nodules", and those with a diameter of less than 0.5 cm are called "tiny nodules".
(Isolated lung nodules)
A mainland china study used multi-slice spiral CT to screen healthy people over the age of 40 [1] and found that 3.13% of people had isolated small nodules in the lungs (less than 1 cm), and in these people, the probability of pulmonary nodules being malignant (i.e., lung cancer) was 5%.
This data shows the importance of early screening on the one hand, but also reminds us:
Even in the seemingly "healthy" people without any symptoms, there are a small number of people who may have been targeted by lung cancer.
In China, lung cancer is the first of all cancers, both in terms of morbidity and mortality.
In recent years, more and more people have developed lung cancer due to the aging of the population, air pollution and smoking. Some experts predict that by 2025, the number of people suffering from lung cancer in the mainland will reach 1 million!
Although treatments have been advancing, most lung cancers are already advanced when they are discovered, and the 5-year survival rate (the proportion of patients who are still alive within 5 years after treatment) is only about 12%.
However, in patients with early detection of lung cancer, the survival rate of 5 years after surgery can be improved to 60% to 70%.
Therefore, lung cancer must be detected early and treated with surgery early in order to achieve a longer survival time [2].
Screening small lung nodules with low-dose spiral CT in the early stage is the first step in the detection of lung cancer.
The larger the diameter of the lung nodule, the higher the likelihood of malignancy.
Of course, there is no need to panic too much about "lung nodules". Many people are nervous when they get the diagnosis results, worried about "whether it is cancer or not.".
But in fact, most of the lung nodules found on the first examination are benign, and the probability of malignancy is less than 20%.
Source: Stand Cool Helo
Taking a step back, even if the lung nodules are really found to be lung cancer, the vast majority of them are also early lung cancers, and as long as they are treated correctly, it will hardly affect the normal life of the patient.
Here are some suggestions for you, but the specific operation should still follow the doctor's advice:
(1) Nodules ≤ 4 mm, there is no great threat in half a year to one or two years, and a low dose of CT is done once a year.
(2) The diameter of the nodule is 4-6 mm, which should be re-evaluated within 12 months, and if there is no change, a low-dose CT is done once a year thereafter.
(3) The diameter of the nodule is 6-8 mm, which should be rechecked once in 6-12 months, and if there is no change, it will be re-examined within 18-24 months, and once a year thereafter.
(4) The nodule > 8 mm, if there is no change, it will be reviewed once every 3, 6, 12, 24 months, and once a year thereafter.
(5) Nodule ≥ 10 mm should be diagnosed and treated as soon as possible, if the diagnosis cannot be confirmed, multidisciplinary consultation (MDT) is recommended.
In this episode, Nurse Liu's lung nodule has reached 12 mm, near the pleura, which is most likely lung cancer, but it cannot be conclusive.
After repeated confirmation of imaging data and comprehensive assessment of multiple aspects, doctors still cannot determine the benign or malicious nature of the nodule. In the end, there is only one way left: to confirm the diagnosis by surgical biopsy.
She said that she was "afraid of relapse", and the doctor gently advised her not to superstitiously believe in the information on the Internet, which would invisibly increase a lot of pressure on herself.
She heard that it would take half a month to a month to recover after surgery, but she was thinking about how to pay the leave slip, and frankly said that she was "very worried about affecting her work."
But as Dr. Wang Guangsuo said, "health is the core." All efforts now are made for the future life and work without any influence.
Dr. Wang believes that for a long time in the future, the proportion of tumors found in the population will not be low.
And Xiao Liu only found out relatively early, from another point of view, it is also a blessing in misfortune to be able to get diagnosis and treatment at an early stage and save his life.
Although the incidence of lung cancer is getting higher and higher, many young people seem to be unprepared and feel that "they have nothing to do with themselves."
Just like this little nurse Liu, even if she will be afraid and cry, she will not forget to glue a double eyelid sticker to herself before the operation, and also tell the doctor to "don't tear it off".
Probably deep down, she also felt that she "wouldn't get lung cancer at such a young age."
But in the face of disease, there has never been a fluke.
During the operation, at the beginning, the doctor found that there were no obvious dark spots on the girl's lungs, indicating that her living habits were good.
But soon, doctors found a lesion of a highly suspected tumor on a piece of lung tissue, and the initial judgment was cancerous.
Young people with cancer, and the mentality of the elderly is not the same, their lives have just begun.
Suddenly suffered such a major blow, but they are worried that their work and hobbies will be affected.
For example, Xiao Liu is worried that after the operation, he will affect himself to run and swim.
Considering her concerns, even if the possibility of benignness is small, the doctor chose to respect her wishes - first quickly send part of the diseased tissue for examination, and then decide how to cut the lobes of the lungs after the results are released.
Soon, director Hu of the Department of Pathology gave the results of the examination: Xiao Liu confirmed that he had lung cancer and needed to do surgery to remove the lesion as soon as possible! Fortunately, it is early carcinoma in situ or micro-infiltrates, which can basically meet the criteria of cure.
The doctor told Xiao Liu's aunt the basic situation, and then immediately underwent lobectomy.
Fortunately, lung cancer was found early, and Xiao Liu's surgery went smoothly and the tumor was successfully removed.
This case not only makes people lament that lung cancer has come quietly, but also sounded the alarm bell for thousands of young people.
Don't be so young that you can squander your body unscrupulously!
Source: Stand Cool Helo
You know, lung cancer likes these types of people the most [3]:
1. Be over 40 years old.
2. Smoking ≧ 400 cigarette years (or 20 packs of years, such as 20 cigarettes per day/1 pack of smoking for 20 years); or 400 cigarettes (or 20 packs of years) of smoking ≧, smoking cessation time
3. Have a history of environmental pollutants or high-risk occupational exposure (such as asbestos, arsenic, chromium, nickel, beryllium, cadmium, silica, radon, etc.).
4. History of chronic lung diseases, such as chronic obstructive emphysema, pulmonary fibrosis, tuberculosis.
5. People who have previously had malignant tumors or have a family history of lung cancer, especially those who have had lung cancer in first-degree relatives (parents, children and siblings).
6. Long-term passive smoking or inhalation of automobile exhaust, coal smoke generated by coal combustion, smog, cooking fumes, etc. (the risks are different).
If you meet the first point (40 years of age), plus any other point, you are at high risk of lung cancer, and it is recommended to do a low-dose spiral CT once a year.
Then young people under the age of 40, is there no need to screen?
Of course not.
Although the guidelines do not mention that "non-high-risk groups need to do low-dose spiral CT", routine physical examination is a must.
If you are over 30 years old, have never done a low-dose spiral CT, and are really not at ease, you can choose a low-dose spiral CT during the physical examination (some nodules may not be found on conventional X-ray chest x-ray). But don't do it every year, after all, CT is a thing that radiates more radiation than chest x-ray.
It is recommended that you listen to the doctor's advice and conduct appropriate screening based on your own situation.
Many people are very confused at the same time as regretting: why is Xiao Liu so young and will also get lung cancer?
In general, women who do not smoke have lung cancer, and the most likely is to inhale second-hand smoke for a long time.
But there were no dark spots on her beautiful lungs, which should not have been caused by smoke; there was no history of other lung diseases.
And she also loves to run, has the habit of exercising, and seems to have good living habits.
The more likely reason is that the girl's first-degree family may have had lung cancer or been inadvertently exposed to carcinogens (not mentioned in the tablets).
There may also be no reason for the girl to be mercilessly hit by the dice of fate - even if the habits are good and there is no family history, it may be difficult to escape.
But don't take any chances, and don't think that "healthy living is useless."
After all, at least one-third of cancers can be prevented. If controllable carcinogenic factors could have been avoided, the mainland could have reduced the number of cancer deaths by 45.2% [4].
After experiencing this epidemic, I believe that many people's concepts have changed, and they can better appreciate the preciousness of life.
I hope that Nurse Xiao Liu will recover as soon as possible and return to normal life, and I hope that more and more people can really put health first.
You are tense day and night in the city, you may wish to give yourself a buffer opportunity, let yourself breathe, and let your footsteps stop. You will find that the scenery around you is also beautiful.
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