This type of disease can be described as the "number one cancer killer"
Mortality is high and morbidity is increasing year by year
There are also various risks of recurrence and metastasis
How to break?
Please accept the tips given by the experts
Lung cancer is a malignant tumor that ranks first in The incidence and mortality rate in China, which can be called the "number one cancer killer", and the incidence rate is increasing year by year. Among them, about 85% of lung cancers are non-small cell lung cancers (NSCLC), which poses a serious health hazard.
Although lung cancer has a non-negligible incidence, with the development of society and the popularization of health knowledge, people's awareness of physical examination, especially tumor screening, has been significantly enhanced, and a large number of asymptomatic early and middle lung cancers have been detected and radical minimally invasive surgery has been carried out.
However, due to the fact that malignant tumors have the characteristics of "easy recurrence" and "easy metastasis", it is very common for early and medium lung cancer to recur after surgical resection, which has also become an invisible stone in the heart of early and medium lung cancer patients.
The data show that nearly 50% of patients diagnosed with stage I.B and nearly 80% of patients diagnosed with stage III.A experienced recurrence within 5 years. At the same time, about 68% of patients with early and intermediate lung cancer have the risk of lesions metastasizing to other organs after surgery, such as brain metastasis and bone metastasis.
So how should patients with early and medium-term lung cancer delay or reduce the possibility of disease recurrence and metastasis after surgery? Clinical experts generally believe that patients can help achieve the goal of postoperative prevention of recurrence and cancer cell metastasis through comprehensive management through scientific and effective measures, such as early adjuvant therapy, post-hospital scientific follow-up, and lifestyle improvement.
Tips 1
Systemic therapies such as adjunctive targeted therapy
"Sharpshooters" who reduce the risk of postoperative recurrence and metastasis
Early and medium-term lung cancer is not as simple as "one-size-fits-all", and adjuvant therapy after surgery is not only suitable for more advanced lung cancer, but also an important part of early and medium-term lung cancer treatment.
Postoperative adjuvant therapy for early- and intermediate lung cancer mainly includes adjuvant chemotherapy, adjuvant targeted therapy, and adjuvant immunotherapy. Chemotherapy and other adjuvant therapy can help improve the survival of lung cancer patients and improve the prognosis, but the side effects of adjuvant chemoradiotherapy are larger, which can be said to be the treatment mode of "killing a thousand enemies and self-destructing eight hundred", only 5% to 15% of patients can benefit from adjuvant chemotherapy, patients still face a high risk of local recurrence or distant metastasis, and long-term survival rate is difficult to be guaranteed.
Seeking more efficient, low-toxic, and increasing the probability of cure has always been a doctor's dream, and adjuvant targeted therapy is one of the best treatment options for gene-positive patients at this stage. Unlike adjuvant chemotherapy, adjuvant targeted therapy, especially adjuvant third-generation targeted drugs, is like a "sharpshooter", which can act precisely on certain specific sites of tumor cells, killing tumor cells highly selectively, without killing or rarely damaging normal cells, which can significantly reduce the risk of disease recurrence, brain metastasis and death.
As a novel treatment option for early- and medium-term lung cancer, adjuvant targeted therapy is suitable for long-term use in patients with positive mutations after EGFR testing, and can benefit significantly.
Tips 2
Regular post-hospital follow-up
A "good helper" to reduce the risk of postoperative recurrence and metastasis
If adjuvant targeted therapy is a "new type of vanguard" to reduce the risk of postoperative recurrence and metastasis of lung cancer, then the strict implementation of an individualized follow-up plan after surgery is a "good helper" for early and medium-term detection and treatment of tumor recurrence and metastasis or second primary tumors, which can help improve the quality of life of patients and improve prognosis.
The "Consensus of Chinese Thoracic Surgery Experts on Postoperative Follow-up of Non-Small Cell Lung Cancer" points out that medical history consultation and physical examination are the basic requirements for disease diagnosis and treatment, and also the basic requirements for postoperative follow-up of non-small cell lung cancer patients, which is helpful to systematically understand the patient's condition and initially find whether there is a recurrence or other changes. Among them, the detection of tumor markers has extremely important clinical significance for the prognosis of lung cancer.
Cancer cells are like outlaw molecules, once they appear, they will clash with normal cells in the human body, and other abnormal signals such as casualties and economic damage that occur from them can be regarded as tumor markers.
For patients with early and intermediate lung cancer, the frequency of follow-up every 3 months should be maintained after surgery, and the high incidence of distant metastasis throughout the body, such as abdomen, brain, and bone, should be the focus of review.
CT is the most commonly used clinical imaging review method after lung cancer surgery. Major guidelines recommend postoperative patients with a chest CT review, or a systemic PET-CT scan. Lung function testing can be used as a test index for postoperative lung function surplus and exercise recovery, and patients can make choices according to their condition and economic ability.
At the same time, due to the possibility of changes in the condition, the follow-up time and the scheme of re-examination and testing indicators will also change, and patients need to communicate with their attending doctor in time to avoid the occurrence of worsening conditions, which is also the significance of insisting on follow-up.
Tips 3
Good lifestyle
A "caring bodyguard" to reduce the risk of postoperative recurrence and metastasis
In addition to systemic treatment such as adjuvant targeted therapy and good follow-up, lung cancer patients also need to pay special attention to diet after surgery, and should eat more light and digestible foods, timely hydration and improve immunity. Another meal can not be overeaten, in addition to the main meal also need to supplement vitamin A and vitamin C.
In addition, appropriate exercise is also essential, such as swimming, jogging and other low-intensity exercises, which have certain help for enhancing immunity, preventing cancer and fighting cancer. Especially in patients in the postoperative recovery period, good metabolism contributes to the recovery of the body after surgery.
At the same time, it is also important to maintain a healthy and optimistic attitude. However, due to their different conditions, different patients need to reasonably arrange their own exercise plans under the guidance and advice of professional doctors.
While it is important to prevent recurrence and distant metastasis of cancer cells after early and medium lung cancer surgery, early and medium-term screening for lung cancer is also important. For lung cancer patients detected and treated in the early to medium term, the 5-year survival rate can be improved to more than 70%.
At present, there are many clinical means of early screening for lung cancer, conventional chest x-ray has been basically not used for lung cancer screening, should be screened through low-dose spiral CT and other ways, especially for people over 40 years old, with a family history of tumors, long-term smoking, long-term exposure to soot or oil smoke and other high-risk groups must include lung CT examination in the annual health examination.
The author ∣ Hu Bin
Review ∣ expert of the National Health Science Popularization Expert Database
Gao Shugeng, Director of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences
Planner ∣ Fang Tong Tan Jia
Editor∣ Hu Bin