Only 0.0012 percent of people worldwide develop lung cancer at age 36, and Paul Carani is one of them.
A graduate of Stanford University, a master's degree from Cambridge University, and a Ph.D. from Yale University School of Medicine, Paul Carani is a gifted surgical neurologist and has received the American Association of Neurosurgeons' Highest Award. Just as he was about to take his career to the next level, a cancer ruthlessly disrupted everything.
In 2013, he went from a doctor to a cancer patient, and in the last stage of his life, he recorded his life and wrote the book "When Breath Turns into Air", a thin book that weighs a thousand junks.
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<h1 class="pgc-h-arrow-right" data-track="51" > one, 36 years old terminal cancer, face death</h1>
"The lungs are full of countless tumors, a whole lung has been severely eroded by cancer cells, and the spine has been deformed..." Paul has seen countless CT scans of this, the difference is that this is his examination results, and this information all indicates that lung cancer has metastasized bone. Spine is the most common bone metastasis site of lung cancer, accounting for about 50% of lung cancer bone metastasis, lung cancer is not controlled, some cancer cells will enter the blood circulation, reach bone tissue, even if the bone is very hard, but it is difficult to resist the erosion of cancer cells, under the erosion of cancer cells, bone metastases can show lytic metastasis, osteogenesis metastasis, mixed and other 3 characteristics.
About 6 months ago, Paul lost weight inexplicably, and the back pain was unbearable, as a doctor, he clearly remembered a knowledge point, "a 35-year-old person, inexplicable weight loss, sudden back pain, there is a possibility of cancer." However, Paul thought that he might just be too tired from work, and did an X-ray, which showed nothing unusual.
At this time, Paul did not know that cancer cells were already raging in the lungs, the resolution of X-rays was not high, only large lesions could be detected, and the probability of X-rays detecting early lung cancer was only 0 to 15%. Because he did not think about the cancer, the X-ray also checked normally, Paul did not have further examination, and only used ibuprofen every day to relieve pain.
After a few more weeks, Paul began to realize that things were not simple because the symptoms were getting worse. He coughed incessantly, often had chest pain, and even woke up suddenly at night and sweated heavily. And the whole person quickly lost weight, and the weight dropped from 175 pounds to 145 pounds. Coughing, chest pain, unexplained weight loss... These are typical lung cancer symptoms.
Paul vaguely felt that he might actually have cancer, and in disbelief, he called his best friend, was admitted to the ward of his friend's hospital, and was eventually diagnosed with advanced lung cancer.
<h1 class="pgc-h-arrow-right" data-track="52" > two, tenacious anti-cancer for six months, back to the operating table</h1>
Because it is already advanced cancer, it is impossible to perform surgical resection, the doctor gave him two choices, one is chemotherapy, the other is targeted therapy, if the EGFR mutation is detected, you can not use chemotherapy, for lung cancer patients with EGFR gene mutations, targeted drugs have been the preferred treatment method, drugs can directly kill cancer cells with certain gene mutations, prevent the development of tumors.
While waiting for genetic testing, Paul took his wife, Lucy, to the sperm bank to give himself an extra way back if he wasn't being treated. In case he didn't hold on to his death, maybe he could have left a child for Lucy.
After returning home from the sperm bank, Paul gets a call, and the doctor on the other end of the phone excitedly tells him the good news that there is an EGFR mutation that can be targeted therapy!
After six weeks of follow-up after receiving targeted therapy, the condition improved, the tumor was greatly reduced, and the largest tumor in the right lobe of the lung was only about 1 centimeter.
After six months of being diagnosed with cancer and getting better, he even returned to work, and Lucy became pregnant through IVF technology, and work and family seemed to be freed from the shadow of cancer, and everything seemed to be back on track, but Paul knew that his body was always hiding an untimely bomb.
<h1 class="pgc-h-arrow-right" data-track="53" > third, new birth and death, two years of anti-cancer regret to pass away</h1>
After returning to work for 7 months, Paul conducted a re-examination, and the results were desperate, a huge new tumor appeared in the right middle lobe of the brain, the condition deteriorated, and the brain metastasis. This means that the next treatment will be more difficult, painful, and the hope of continuing to survive is even slimmer. Patients with lung cancer brain metastases have a poor prognosis and a natural average survival time of only 1 to 2 months.
To survive, he left work again, left the operating table, and underwent intimidating chemotherapy. The doctor developed a chemotherapy plan for him, and he received chemotherapy every three weeks. After the end of the first chemotherapy, Paul has side effects, the essence of chemotherapy is actually to kill fast-growing cells, because of the characteristics of cancer cells growing fast, chemotherapy is very useful, but there are also many rapidly growing cells in our human body, and chemotherapy drugs do not distinguish between the enemy and me, but also kill the normal cells of the human body, resulting in the phenomenon of "killing a thousand enemies and self-destructing eight hundred".
The day after chemotherapy, Paul felt fatigue deep into his bone marrow and his appetite slowly vanished. On the day of the graduation ceremony, Paul had to be absent because of severe vomiting, and he was admitted to the hospital and into the ICU, while Lucy rushed forward and backward with a big belly. When Paul is rescued from death by the doctors, a new life also arrives, and Lucy gives birth to their daughter, Cady, and Paul is so weak that he can't even reach out and hold his daughter.
One life is thriving, the other is quietly withering, Paul's condition is getting worse, his medicine has no effect, and on March 9, 2015, 22 months after being diagnosed with lung cancer, Paul passed away in the company of his family.
As soon as Paul is gone, his experience as a doctor is lamentable. Lung cancer is the cancer with the highest mortality rate in the world, according to the World Health Organization, in 2020 alone, a total of 1.8 million people died from lung cancer worldwide, ranking first in the number of deaths, almost twice as many as the second colorectal cancer death toll! Lung cancer mortality rates remain high, and a big reason is that when many people find lung cancer, they are in a terminal state like Dr. Paul.
<h1 class="pgc-h-arrow-right" data-track="24" > fourth, lung cancer is mostly found to be advanced, remember 4 symptoms</h1>
Gu Yong, chief physician of the Department of Thoracic Surgery of the First Affiliated Hospital of Sun Yat-sen University, said that the early symptoms of lung cancer are very inconspicuous, and when patients come to the doctor for hemoptysis, weight loss, chest pain and other reasons, 70-80% have reached the middle and advanced stages.
In the early and advanced stages of lung cancer, the cure rate is very different, if it can be found in the early stage (stage 0, stage 1) and surgical resection, the cure rate can even reach 100%, and there is no need for radiation therapy and chemotherapy after surgery. Advanced lung cancer can only be subjected to radiotherapy, chemotherapy, targeted therapy, etc., losing the opportunity for radical cure, and the 5-year survival rate does not exceed 5%.
How can we know about the arrival of lung cancer earlier? Remember the following 4 symptoms:
1. Cough
More than half of lung cancer patients have cough at first, characterized by an irritating dry cough, which can have no sputum or a small amount of white sticky sputum, and some people will also hemoptysis and blood in the sputum.
2. Shortness of breath
Shortness of breath is most easily overlooked, mistakenly thought to be caused by old age, if you often feel shortness of breath in daily activities, breathing difficulties, if there is no cardiovascular disease, you should focus on the lungs.
3. Shoulder, back, chest and arm pain
Lung tumors may compress nerves, causing pain in the shoulder, chest, back, or arms, especially when coughing and breathing.
4. Others
Sometimes even seemingly unrelated symptoms are associated with lung cancer, such as fatigue, decreased appetite, unexplained weight loss, and even the onset of depression.
Of course, if you want to detect lung cancer early, you can't rely on symptoms alone, but also take the initiative and have regular physical examinations. Chest CT is the best way to detect early lung cancer, and low-dose, low-dose spiral CT is more accurate than X-ray ct, and it is very sensitive to even a few millimeters of tiny lesions. The Netherlands' NELSON study showed that receiving low-dose spiral CT can significantly reduce mortality in lung cancer patients, with a 26% reduction in men and a 61% reduction in women!
For everyone, it is necessary to include low-dose spiral CT of the chest into the routine physical examination, if the first result is negative, according to their age and risk factors (smoking, previous malignant tumor history, family history of lung cancer in first-degree relatives, chronic obstructive pulmonary disease and pulmonary fibrosis history, as well as radon, cadmium, asbestos, coal soot, diesel exhaust and other toxic and harmful substances exposure history) to reasonably arrange future physical examination.
1. For people less than 50 years old, the interval between receiving low-dose spiral CT examination of the chest can be extended to 5 to 10 years.
2. People in 50 to 60 years old, if there are no risk factors, they can have a low-dose spiral CT examination of the chest every 5 years, and if there is at least one risk factor, then at least once every 3 years, a low-dose spiral CT examination is performed.
3. People aged 60 to 70 years old are recommended to have a low-dose spiral CT examination every 2-3 years, and people older than 70 years old, regardless of whether there are risk factors, are recommended to have a low-dose spiral CT examination every 2 years.
The incidence of lung cancer is rising, the high mortality rate is frightening, if Paul can find lung cancer earlier, insist on doing chest CT every year, it may not be such a regrettable ending, his experience is worth everyone's reflection. Lung cancer is not unpreparable, maintaining a good lifestyle, smoking less, and adhering to the correct physical examination is the best way to resist lung cancer. #健康明星计划 #
Resources:
[1] "@ Everyone, stay away from lung cancer This screening strategy "lungs" can not see". Affiliated Cancer Hospital of Fudan University.2020-11-20
[2] "These 5 symptoms of early lung cancer, we must be vigilant!" 》. Medical Oncology Channel.2015-12-09
[3] "When Breath Turns into Air". Paul Caranish
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