At 2:14 a.m. on December 5, 2019, the China-Japan Friendship Hospital left us after more than a year of tenacious struggle with lung cancer. #Breeze Plan ##健康科普大赛 #
Beijing Shougang Basketball Club player Ji Zhe died of advanced lung cancer at the age of 33. Ji Zhe, born on October 14, 1986 in Shenyang, Liaoning Province, plays as a big forward, was loaned by the Liaoning men's basketball team to Beijing Shougang in 2007 to play in the CBA, serving as the captain of the Beijing Shougang team for a long time, and helped the team lift the CBA championship trophy three times.
As soon as this news came out, friends who cared about basketball and cared about Ji Zhe felt incredible and unbelievable. According to the Health Times, Ji Zhe was diagnosed with lung cancer last year when he was in advanced stages.
Professional athletes who are only 33 years old, have excellent physical fitness, and there are pre-competition tests and physical examinations every year, how can they get cancer, and it is advanced lung cancer. Today Dr. Zeng came to talk about this problem.
<h1>First, why do young people get lung cancer? </h1>
In fact, cancer is the result of the combination of genetic and environmental factors, lung cancer is more likely to occur in middle-aged and elderly people, but it is not uncommon for young people to suffer from cancer. Lung cancer in your 30s and even in your 20s can often be seen.
Ji Zhe's advanced lung cancer at such a young age is likely to be closely related to genetic factors, but cancer is the result of multifactorial action, and it is difficult to explain it with a single factor.
In fact, lung cancer is already the largest cancer in China, whether it is the number of patients or deaths, far more than other tumors. In 2015, there were 733,300 new lung cancer cases in China (509,300 males and 224,000 females), and the number of lung cancer deaths was 610,200 (432,400 men and 177,800 females), and the morbidity and mortality rate were very close, mainly due to the fact that most of the clinically diagnosed cases were advanced and the opportunity for surgery was lost. The prognosis of lung cancer is extremely poor, and the 5-year survival rate of lung cancer in China is only 16.1%.
Lung cancer is strongly associated with the following factors:
1. Smoking and passive smoking
Smoking is currently recognized as the most important risk factor for lung cancer. Cigarettes form more than 60 carcinogens during the ignition process. Nitrosamines, polycyclic aromatic hydrocarbons, benzopyrene, etc. in tobacco are highly carcinogenic substances for the respiratory system.
Passive smoking is also a risk factor for lung cancer, mainly in women. Studies have shown that the risk of lung cancer in non-smoking workers due to passive smoking in the working environment increases by 24%, while the risk of lung cancer in workers who are highly exposed to environmental tobacco smoke is 2.01, and the exposure time of environmental tobacco smoke is very strongly associated with lung cancer.
2. Indoor pollution
Indoor pollution mainly includes pollution caused by indoor fuel and cooking fumes. The incomplete combustion of indoor coal fuel and cooking fumes can produce a variety of carcinogens such as benzopyrene, formaldehyde, polycyclic aromatic hydrocarbons.
3. Indoor radon exposure
Radon is a colorless, odorless, odorless, odorless, inert gas that is radioactive. When inhaled into the body, radioactive particles that decay radon can cause radiation damage to the human respiratory system and cause lung cancer. The area around uranium-containing mines is high in radon, and building materials are the most important source of indoor radon. Such as granite, brick sand, cement and gypsum, especially natural stone containing radioactive elements. The results of three pooled analyses in Europe, North America and China showed that for every 100 Bq/m3 increase in radon concentrations, the risk of lung cancer increased by 8%, 11%, and 13%, respectively.
4. Outdoor air pollution
The carcinogens in outdoor air pollutants mainly include benzopyrene, benzene, some metals, particulate matter, ozone and so on. Chen et al. systematically reviewed 17 cohort studies and 20 case-control studies from 1950 to 2007 and found that for every 10 μg/m3 increase in fine particulate matter (PM2.5) in the air, the risk of lung cancer death increased by 15% to 21%.
5. Occupational factors
A variety of special occupational exposures can increase the risk of lung cancer, including asbestos, quartz dust, nickel, arsenic, chromium, dichloroethyl ether, mineral oil, dichloromethether and so on. The attribution of occupational factors for men and women in our country is 10.6 per cent and 7.0 per cent.
6. Family history and genetic predisposition of lung cancer
Familial aggregation is present in lung cancer patients. These findings suggest that genetic factors may play an important role in populations and/or individuals susceptible to environmental carcinogens. The results of the systematic review by Matakidou et al. showed that the relative risk of lung cancer family history versus lung cancer was 1.84.
All in all, lung cancer is not the patent of middle-aged and elderly people, and young people may also suffer from cancer, which needs to be paid attention to!
<h1>Second, the annual physical examination, why can not detect early lung cancer</h1>
Year after year, why can't early lung cancer be found? It is likely that the means of examination are not correct, most of the units are to choose chest x-ray to check the lungs, in fact, chest x-ray is not the best means of screening, chest x-ray is difficult to find early lung cancer.
If you want to screen for lung cancer and detect early lesions, a low-dose spiral CT of the chest is the preferred test to detect tiny nodules that are only 2 mm in diameter.
<h1>Who needs to have a CT test regularly and when do they start? </h1>
Screening for lung cancer is recommended for patients without symptoms: Individuals aged 55 to 74 years who smoke for 30 packs of years (if quitting smoking, quitting for no more than 15 years) are recommended for low-dose CT lung cancer screening. Screening may also be indicated if certain lung cancer risk factors include radon exposure, occupational exposure to carcinogens (e.g., asbestos, radiation, silica, etc.), personal tumor history, family history of lung cancer in immediate family, history of lung disease (e.g., chronic obstructive pulmonary disease or pulmonary fibrosis), long history of exposure to secondhand smoke, and long history of inhalation of fumes.
The recommended interval between screenings is 1 year, and for those who are normal, it is recommended to continue screening every 1 to 2 years.
If you develop the following symptoms, you should also be careful about lung cancer and should be treated as soon as possible.
(1) Cough, sputum cough: cough is the most common symptom of lung cancer patients, early often manifested as irritating cough, if the tumor enlargement affects sputum drainage, can be secondary obstructive pneumonia.
(2) Sputum blood and hemoptysis: because the blood vessels of tumor tissue are often relatively rich, some patients can have sputum blood in tumor necrosis, and if the tumor invades larger blood vessels, it can cause hemoptysis.
(3) Stridor, chest tightness, shortness of breath: the stenosis formed by the pressure or partial obstruction of the breathing air flow through the trachea can cause stridor. It is especially important to be vigilant against repeated local stridor of unknown causes. Tumor compression may lead to a decrease in the respiratory area of the lungs and even a pleural effusion, which can manifest as worsening chest tightness and shortness of breath. Patients with sudden chest tightness and shortness of breath should be excluded from pulmonary embolism.
(4) Weight loss, fatigue and fever: tumors may cause consumption, loss of appetite, etc., resulting in fatigue and weight loss in patients, and fever in tumor patients is more common with intermittent medium and low fever, and high fever may occur when co-infected.
(5) Chest pain: when the tumor invades the parietal pleura, muscle nerves or bone tissue, the pain can be aggravated, persistent and fixed. Suprapulmonary sulcus tumors are highly positioned and may cause persistent pain in the shoulder, chest and back, or radiation pain in the armpits.
In summary, at present, lung cancer has become the first cause of cancer death in China, and the prognosis is extremely poor. Everyone should develop a healthy lifestyle, quit smoking, reduce exposure to toxic and harmful substances, participate in physical examinations regularly, and prefer low-dose CT examinations of the lungs!
Key References:
1. Diagnosis and Treatment Specifications for Primary Lung Cancer (2018 Edition)
2. Guidelines for clinical diagnosis and treatment of lung cancer of the Chinese Medical Association (2018 edition)[J]. Oncology Research and Clinical Medicine, 2018, 30(12):793-824.
3. Guidelines for screening low-dose spiral CT for lung cancer in China (2018 edition)[J]. Chinese Journal of Lung Cancer.