Source: Voice of Hangzhou
The 63-year-old Uncle Qian (pseudonym)'s favorite host is Teacher Zhao Zhongxiang, because he likes Teacher Zhao's voice, and he deliberately practiced speaking when he was young. Regrettably, Teacher Zhao passed away on January 16, 2020 due to "squamous cell carcinoma", which made Uncle Qian sad for a long time, and whenever Teacher Zhao was mentioned, his heart still could not be calmed for a long time.
One morning, Uncle Qian went to the park as usual to walk birds and exercise in the morning, unlike in the past, Uncle Qian obviously had a little cough and some white sticky phlegm that morning, but Uncle Qian did not care very much, and still lived a dashing retirement life. But after two or three days of cough or did not get better, the family was a little worried, accompanied by Uncle Qian to the local hospital for bronchoscopy, biopsy pathological test prompt: "squamous cell carcinoma."
Unexpectedly, the closest time Uncle Qian was "to" idol Teacher Zhao Zhongxiang was because of lung cancer... At this time, Uncle Qian was a little panicked, and the diagnosis of lung cancer was like a thunderbolt on a sunny day, which made Uncle Qian "confused the second monk". The so-called "fans of the authorities", Uncle Qian's family told the truth, it turned out that Uncle Qian had to smoke more than two packs of cigarettes every day for more than 30 years, and no one advised him would work.
The family took Qian Dabo to the cardiothoracic surgery specialist clinic of the First People's Hospital of Hangzhou City with great anxiety, and Feng Xing, the deputy chief physician of the reception, carefully looked at Uncle Dabo's CT, and immediately explained to Qian Dabo's family that the huge tumor in the upper right lung, close to the size of a fist, is closely related to the hilar artery vessels, and has obstructive pneumonia, and it is somewhat risky to take direct surgery, and it is very likely that open surgery is needed. "However, although the tumor is larger, we will take the latest treatment methods to let the tumor lose weight first, and then use single-hole extremely minimally invasive surgery to completely remove it." Dr. Feng's comforting words rekindled Uncle Qian's hopes.
Uncle Da's family accepted Dr. Feng's advice and immediately completed the hospitalization procedures for Uncle Qian. After admission, Uncle Dabo quickly completed a comprehensive examination, chest enhancement CT showed a huge mass lesion of the upper lobe of the right lung with right upper bronchial truncation and occlusion, and the clinical diagnosis was central lung cancer of the right upper lung with peripheral obstructive pneumonia (about 72×51 mm in size), ct4n0m0 iiia stage.
"But Uncle Qian's tumor is central, the tumor is large, and it is extremely closely related to the branch of the right upper pulmonary artery, and the right lower lung is partially violated, and the operation may not be so simple." Deputy Chief Physician Feng Xing led the team members to comprehensively analyze Uncle Da's condition, "If direct surgery is not easy to cut, and it is very likely that the traditional open chest and large incision may be required to complete the operation." "How to optimize the treatment plan for Uncle Qian and solve this problem?" Feng Xing's deputy chief physician team decided to take the latest combination immunotherapy method, and after two cycles of neoadjuvant immunotherapy, the chest CT results were reviewed.
The tumor shrank by nearly half
Uncle Qian successfully completed the two cycles of treatment, and the CT of the review after treatment suggested that the lesion was reduced by nearly half compared with before, no distant metastasis of the lesion was seen, and there was no surgical contraindication to various examinations. After 4 weeks of treatment, Qian Dabo was led by Feng Xing, deputy chief physician with rich surgical experience, and Feng Xing led the team to take extreme single-hole minimally invasive surgery, and took about 3 cm incision on the right anterior chest wall of Qian Dabo to successfully complete radical resection of right upper lung cancer. On the 4th day after the operation, Uncle Dabo was successfully discharged from the hospital, and the postoperative pathology suggested that the lesions were not found to have tumor residues after all the materials were taken, and the effect of complete pathological relief was achieved.
What tests can detect lung cancer?
Feng Xing introduced that the gold standard for diagnosing lung cancer must be to get cancerous cells or tissues, such as finding cancer cells through sputum, and various puncture biopsies are often used to diagnose lung cancer. Like Uncle Da, a bronchoscopic puncture biopsy is taken, and under the guidance of CT, b ultrasound, etc., the doctor uses a special puncture fine to puncture the tumor, removes the specimen and observes it under the microscope, and there is a more advanced magnetic navigation bronchoscopic system for puncture biopsy of the lung nodules.
However, lung aspiration biopsy also carries the risk of pleural hemorrhage, pneumothorax, tumor needle passage dissemination and tumor puncture failure, and some early lung cancers are small and special, close to blood vessels and located deep in lung tissue, and the puncture faces the dilemma of not being able to penetrate accurately. Therefore, in the case of difficult diagnosis, if necessary, the tumor should be cut out for testing through minimally invasive surgery. The more minimally invasive method is thoracoscopic operation, of course, there are more auxiliary methods, such as sputum telomerase detection, detection of blood tumor markers and so on.
It should be emphasized that the easiest and most efficient way to screen for lung cancer is to do a low-dose spiral CT scan.
What are the early symptoms of lung cancer?
There are many early-stage lung cancers without any symptoms, except for the chest CT screening found by physical examination, which is difficult for us to catch. However, the following symptoms are recommended for a physical examination.
Coughs that persist for several weeks or that have previous cough symptoms have worsened significantly.
There is blood in the sputum, and it is often bright red blood.
Sudden appearance of hoarseness.
Abnormal shortness of breath, especially if it persists for several weeks without change or gradually worsens.
• New persistent chest pain that does not improve or gradually worsens over a few weeks, or that previously chronic chest pain suddenly worsens.
The newly emerging body is weak and unable to complete daily work and life.
Weight loss without a planned diet or weight loss without a reason is particularly noteworthy, especially when weight loss exceeds 15 kg in 3 months, often suggesting malignant tumors.
Correspondent: Liu Qi
Editor: Wang Jie
Editor-in-charge: Zhou Qinhan