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Jimu News reporter Yan Wen
Photojournalist Wang Yongsheng
Correspondents: Luo Junhua, Wang Fang
April 15-21, 2024 is the 30th National Cancer Prevention and Treatment Publicity Week. Chutian Metropolis Daily Jimu News, together with Hubei Provincial Cancer Center and Hubei Provincial Anti-Cancer Association, jointly launched a large-scale medical live broadcast column "323 Tackling Tough Problems - Cancer Prevention and Control Expert Talk", and talked to leading experts and scholars in the field of oncology in the province, hoping that through experts to explain cancer prevention and control knowledge in an all-round, multi-angle and different levels, so that people will no longer talk about "cancer".
According to the latest Hubei Cancer Annual Report, the incidence and mortality rate of lung cancer still rank first on the list, and the status of "cancer boss" remains unchanged. Therefore, early diagnosis and early treatment of lung cancer is also an urgent question that must be answered in front of lung cancer experts.
In recent years, have there been any obvious changes in the incidence of lung cancer? How should early lung cancer be screened for the general population? What are the effective screening methods or techniques at present? What is the most important thing for patients after being diagnosed with lung cancer? On April 15, the first session of the "323 Tackling Difficulties - Cancer Prevention and Control Expert Talks" column was fortunate to invite people who have been engaged in cancer work for more than 20 years and are good at thoracic tumors such as lung cancer. Wang Sheng, deputy director of the Department of Thoracic Surgery, Hubei Provincial Cancer Hospital, who is in charge of minimally invasive surgical treatment of esophageal cancer and comprehensive treatment of locally advanced tumors, came to popularize the knowledge of lung cancer prevention and treatment.
Lung cancer is increasing in women, and adenocarcinoma far exceeds squamous cell carcinoma
"In recent years, there has been a gradual increase in the number of female lung cancer patients, which is indeed a trend that cannot be ignored. In the past, lung cancer was mostly smoked by men, and the vast majority of pathological types were squamous cell carcinoma, but now there are more and more young women who do not smoke, and the type of clinical cases is mainly adenocarcinoma, and the proportion of adenocarcinoma in clinical practice now accounts for more than seventy or eighty percent. At the same time, the detection rate of early-stage lung cancer is also increasing. When talking about the changes in the clinical disease spectrum of lung cancer in recent years, Director Wang Sheng said.
According to Wang Sheng, lung cancer is mainly divided into non-small cell lung cancer and small cell lung cancer according to the pathological type, and more than 95% of lung cancer belongs to non-small cell lung cancer. Non-small cell lung cancer includes adenocarcinoma, squamous cell carcinoma, large cell carcinoma, adenosquamous cell carcinoma, etc., of which adenocarcinoma accounts for more than 80% of them.
According to the epidemiological statistics of malignant tumors in China in 2022, lung cancer ranks first in the incidence and mortality of malignant tumors in both men and women, with 1,060,600 new cases of lung cancer in the year, accounting for 22.0% of all malignant tumors, and 733,300 deaths, accounting for 28.5% of all malignant tumor deaths. Lung cancer has surpassed breast cancer to become the number one cancer that seriously threatens women's lives and health. But fortunately, in recent years, lung cancer drugs have made very rapid progress, especially for lung adenocarcinoma, advanced lung adenocarcinoma, lung adenocarcinoma with gene mutations accounts for more than half, this part of the population can have a better response through targeted therapy drugs, the rest of the patients without gene mutations, in recent years, the progress of medical drug treatment is also advancing by leaps and bounds, especially immunotherapy.
For lung cancer screening, be sure to replace chest x-ray with CT
"At present, the most effective lung cancer screening tool is CT, which is 4-10 times more sensitive than conventional chest X-ray to detect early lung cancer, and can detect peripheral lung cancer at an early stage. In this case, 70%-80% of patients have reached the local advanced or advanced stage that cannot be resected by surgery, and the opportunity for surgical cure has been lost. Stage I lung cancer is lung cancer below 3 cm, the overall cure rate is more than 85%, of which stage 1A1 lung cancer below 1 cm is the earliest lung cancer, most of which can be cured, especially those under 1 cm of ground glass components, the cure rate can basically reach 100%, to stage II, the overall cure rate is less than 50%, and the overall long-term survival rate of stage III is less than 30%. "Therefore, if we want to improve the overall cure rate and survival rate of lung cancer, the only way is early detection, early diagnosis and early treatment. ”
"Chest x-rays have limited resolution and are difficult to detect small lung cancer lesions. Therefore, it is highly recommended that people over the age of 35, especially those at high risk of lung cancer, such as those with a long-term smoking history, chronic obstructive pulmonary disease or a history of lung cancer in first-degree relatives, have an annual low-dose spiral CT or CT screening, which is the most effective way to detect early lung cancer. Wang Sheng explained that data from the International Early Lung Cancer Action Plan show that 85% of stage I peripheral lung cancer can be detected by annual screening of low-dose spiral CT, and the expected survival rate is 92% at 10 years after surgery. The U.S. National Lung Cancer Screening Trial has proven that low-dose spiral CT is currently the most effective lung cancer screening tool. Although chest X-ray is a preliminary screening tool, it is difficult to detect tiny lung cancer foci due to limited resolution, resulting in missed diagnosis of lung cancer. Upgrading the screening method to low-dose spiral CT or CT can detect early lesions of lung cancer, and can further determine the location and extent of the lesion, as well as distinguish between benign and malignant lesions.
It is important to clarify the diagnosis and staging of the first diagnosis and treatment
"Lung cancer patients must cherish the opportunity of the first diagnosis and treatment! Lung cancer is not only the 'cancer boss', but the treatment of lung cancer is more complex than all other tumors, and there are many treatment methods, whether it is direct surgery or neoadjuvant therapy first? Sometimes even a small decision-making deviation may cause irreparable losses to patients. Director Wang Sheng introduced that for patients diagnosed with lung cancer, accurate diagnosis and staging are the basis for formulating effective treatment plans. Through a variety of tests, such as imaging, pathology, and genetic testing, the medical team can fully assess the patient's condition. "In order to standardize the diagnosis of lung cancer, especially complex lung cancer patients, our hospital has started the diagnosis and treatment of lung cancer MDT since 2012, and our thoracic surgeons, as well as thoracic medicine, thoracic radiotherapy, radiology, and pathologists will get together regularly to discuss the patient's situation and develop a personalized comprehensive treatment plan for the patient." ”
In terms of surgery, for early and mid-stage lung cancer, surgery has now entered the era of minimally invasive, from the previous traditional large thoracotomy to the current era of single-port thoracoscopic and even robotic surgery, and the overall surgical strategy is to remove the tissue suffering from lung cancer as much as possible, while trying to retain the normal lung tissue, and dissect the lymph node tissue that may metastasize as a whole.
With the development of medicine, new concepts, new technologies and new drugs for cancer diagnosis and treatment are constantly emerging, especially in the field of lung cancer diagnosis and treatment. A number of international and domestic large-scale phase III clinical studies have also confirmed that the combination of immunotherapy and chemotherapy in the perioperative period has also improved the long-term survival benefits for more and more patients with advanced lung cancer, and the adjuvant targeted therapy for lung cancer has also brought long-term survival to some patients with sensitive gene mutations.
(Source: Jimu News)
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