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The incidence rate of lung cancer is 10 to 25 times higher than that of smoking. About 85% of lung c

People who smoke know what is marked on the cigarette box: smoking is harmful to health. So can you really smoke less? After reading the following statistics, you may cherish your health more.

In January this year, the National Cancer Center released national cancer statistics. Statistics show that lung cancer ranks first in the incidence of malignant tumors in China. Among them, lung cancer ranks first in the incidence rate of male cancer, and 520 thousand cases are new cases every year. The incidence rate of women is only second, followed by breast cancer. Smokers are high-risk groups of lung cancer. Compared with never smokers, smokers have an average 10 times higher risk of lung cancer, and heavy smokers can reach 10 to 25 times. The risk of lung cancer in smokers who have quit smoking is lower than those who continue to smoke, but it is still nine times higher than that of never smokers. With the extension of quitting smoking time, the risk of lung cancer gradually decreases. At the same time, many non-smokers, including women, also suffer from lung cancer, because in addition to smoking, the incidence factors of lung cancer are also related to environmental pollution, occupation, genetics, tuberculosis, emphysema lesions, radon and other factors. " Recently, Xu Jianping, deputy chief physician of internal medicine of National Cancer Center and Cancer Hospital of Chinese Academy of Medical Sciences, said in an interview with our reporter.

People who have smoked for 20 to 30 years have a significantly increased risk of lung cancer

Xu Jianping pointed out that there is a clear causal relationship between smoking and lung cancer. People who smoke more than 20 cigarettes a day for 20 to 30 years have a significantly increased risk of lung cancer. The younger the age of smoking, the longer the time of smoking and the higher the amount of smoking, the higher the incidence rate and mortality rate of lung cancer.

According to the survey of authoritative institutions, about 85% of lung cancer patients have a history of smoking, including smokers and those who have quit smoking. At the same time, smoking is not conducive to the treatment of lung cancer, and will lead to more serious complications. The degree of postoperative recovery of smokers is lower than that of smokers who quit smoking. Smokers undergoing laryngeal cancer surgery are more difficult to recover their normal voice. Therefore, quitting smoking can avoid the possibility of secondary cancer.

Why do many non-smoking women also suffer from lung cancer? Xu Jianping explained that indoor exposure to soot and its incomplete combustibles are risk factors for lung cancer. Fuel combustion can produce carcinogens. The oil fume released by heating during cooking is also a carcinogenic factor that can not be ignored, especially for female glands. At the same time, passive smoking in indoor environment can cause cancer, and exposure to ionizing radiation can also cause cancer. Medical research shows that the incidence rate of bronchioloalveolar carcinoma is increasing among young women who do not smoke.

The American Cancer Society lists tuberculosis as one of the risk factors of lung cancer. The risk of lung cancer in people with tuberculosis is 10 times higher than that in normal people. The main histological type is adenocarcinoma. Some chronic lung diseases, such as chronic obstructive pulmonary disease, sarcoidosis, idiopathic pulmonary fibrosis, scleroderma, virus infection and mycotoxin infection, may also be related to the occurrence of lung cancer.

Xu Jianping stressed that in recent years, attention has been paid to the correlation between genetic factors and lung cancer. For example, relatives with a family history of early lung cancer (before the age of 60) have a two-fold increased risk of lung cancer; At the same cigarette exposure level, the risk of lung cancer in women is higher than that in men. Lung cancer may be caused by external causes and internal causes. External causes can induce malignant transformation and irreversible gene changes, including activation of proto oncogenes, inactivation of tumor suppressor genes, activation of self feedback secretory loop and inhibition of apoptosis. The occurrence of lung cancer is a multi-stage gradual evolution process, involving a series of gene changes. The accumulation of multiple gene changes will cause the disorder of the control mechanism of cell growth and differentiation, and make the cell growth out of control and carcinogenesis.

There are many carcinogens in the working environment of some occupations. The confirmed carcinogens include asbestos, arsenic, dichloromethyl ether, chromium, mustard gas nickel, polycyclic aromatic hydrocarbons, radon and radon produced during the decay of radioactive substances such as uranium and radium, ionizing radiation and microwave radiation. These factors can increase the risk of lung cancer by 3 to 30 times. Because the formation of lung cancer is a long process, and its incubation period can reach more than 20 years, many patients develop lung cancer after stopping contacting carcinogens for a long time.

Early detection is the key to prolong the life of lung cancer patients

"Early detection, early diagnosis and early treatment of lung cancer play a decisive role in the survival time of patients." Xu Jianping stressed that at present, the five-year survival rate of patients with early lung cancer can be close to 100%, the three-year survival rate of patients with phase I can reach 70% to 80%, the two-year survival rate of patients with phase III is about 50%, the life of patients with phase IV can be maintained for about one year, and about 75% of patients with lung cancer are in advanced stage at the time of diagnosis. Everyone should adhere to the annual physical examination. If there is a shadow in the lung, it should be diagnosed in time to avoid delaying the condition.

Xu Jianping said that patients with primary tumors will have symptoms such as cough, sputum, hemoptysis, shortness of breath, wheezing, chest pain, fever and weight loss. After local expansion of the tumor, they will have chest pain, hoarseness, dysphagia, pleural effusion, pericardial effusion, superior vena cava obstruction syndrome and Horner syndrome. Lung cancer can metastasize to any organ and system, and the involved parts have corresponding symptoms and signs. Pathological anatomy showed that more than 50% of patients with squamous cell carcinoma had extrathoracic metastasis, 80% of patients with adenocarcinoma and large cell carcinoma, and more than 95% of patients with small cell carcinoma. Brain metastasis of the central nervous system can cause symptoms of increased intracranial pressure such as headache, nausea and vomiting. It can also show symptoms such as vertigo, ataxia, diplopia, personality change, seizures, or weakness of one limb or even hemiplegia. When the spinal cord is compressed, there will be back pain, lower limb weakness, sensory abnormalities, and out of control bladder or intestinal function. Bone metastasis is characterized by local pain and tenderness, as well as pathological fractures. The common parts are ribs, spine, pelvis and long bones of limbs, mostly osteolytic lesions. Abdominal metastasis can be transferred to the liver, pancreas and gastrointestinal tract, which is characterized by anorexia, liver pain or abdominal pain, jaundice, hepatomegaly, peritoneal effusion and pancreatitis. Adrenal metastasis is also common. Lymph node metastasis supraclavicular fossa lymph nodes are common sites. They are mostly located at the posterior and lower part of the attachment of sternocleidomastoid muscle. They can be single or multiple. The fixation quality is hard, gradually increases and increases, and can be fused. Most of them have no pain and tenderness. In addition, retroperitoneal lymph node metastasis is also more common. " The treatment of lung cancer includes surgical treatment, drug treatment and radiotherapy. " Xu Jianping said that the treatment effect of lung cancer is closely related to the stage and its histological type. For example, the cure rate of small cell lung cancer is much lower than that of other types of lung cancer. Surgical treatment is the best treatment for early lung cancer. It is divided into radical and palliative surgery. Radical resection should be strive to reduce tumor metastasis and recurrence.

Chemotherapy can be used for the treatment of patients with advanced or recurrent lung cancer, as well as the comprehensive treatment of postoperative patients with adjuvant chemotherapy, preoperative neoadjuvant chemotherapy and combined radiotherapy. Chemotherapy should strictly grasp the indications, fully consider the patient's disease stage, physical condition, self will, adverse drug reactions, quality of life and other factors, and avoid excessive or insufficient treatment.

Targeted therapy takes the driving gene variation of tumor tissue or cell and the specific molecules of tumor related signal pathway as the target, uses molecular targeted drugs to specifically block the biological function of the target, selectively reverse the biological behavior of tumor cells from the molecular level, so as to inhibit tumor growth and even regress the tumor. At present, targeted therapy is mainly used in patients with adenocarcinoma in non-small cell lung cancer.

"Radiotherapy plays a potential role in all stages of non-small cell lung cancer, whether radical or palliative." Xu Jianping said that all patients with stage III non-small cell lung cancer, early patients who cannot tolerate surgery due to their general conditions, patients who refuse surgery, high-risk surgical candidates and stage IV patients may benefit from local treatment. Radical radiotherapy is used for patients with limited focus, inconvenient operation for anatomical reasons or unable to operate for other reasons. If it is supplemented by chemotherapy, the curative effect can be improved; The purpose of palliative radiotherapy is to inhibit the development of tumor, delay tumor diffusion and alleviate symptoms. It has a positive effect on intractable cough, hemoptysis, atelectasis and superior vena cava obstruction syndrome caused by lung cancer. It can also alleviate the symptoms caused by bone metastatic pain and brain metastasis; Adjuvant radiotherapy is suitable for patients with preoperative radiotherapy and postoperative positive margin; Prophylactic radiotherapy is suitable for whole brain radiotherapy in patients with small cell lung cancer.

Stick to the first line of defense that prevention is more important than treatment

Xu Jianping stressed that the initiative to prevent cancer lies in everyone's own hands. Only by adhering to the first line of defense that prevention is more important than treatment, developing a healthy lifestyle and avoiding known risk factors of lung cancer can we effectively prevent lung cancer.

The World Health Organization believes that one-third of malignant tumors can be prevented, one-third can be treated and one-third can be cured. The American Society for cancer research points out that the simplest way to prevent lung cancer is to quit smoking as soon as possible and eat more fruits and vegetables. It is recommended that people eat at least 5 portions of fruits and vegetables (about 85g per portion), reduce animal fat intake, maintain standard weight and exercise for at least 30 minutes a day.

Medical research shows that people's intake of fruits and vegetables in adulthood is low, and the risk of lung cancer is increased; Serum & beta- People with low carotene levels have a high risk of lung cancer; Moderate and high intensity physical activity reduces the risk of lung cancer by 13% to 30%.

Xu Jianping said that at present, most people think that lung cancer brain metastasis has reached an advanced stage and can not be treated or even give up treatment. In fact, with the progress of medicine, the development of radiotherapy and chemotherapy, especially the improvement of surgical technology and the development of minimally invasive technology, the trauma of surgery is minimal, the treatment means are more and more, and the effect is better and better.