Dry cough with no or little phlegm: It is mostly persistent, especially in the early stage, and may be the first symptom of lung cancer.

Irritant cough: It is often caused by tumors irritating the trachea and bronchial mucosa, and is aggravated by inhaling cold air or irritating gases.

Persistent cough: The cough lasts for a long time, and ordinary cough medicines are not effective. It may worsen as the disease progresses.

Changes in cough timbre: If a cough with metallic sound occurs, it may be caused by tumor compressing the trachea or main bronchi.

Blood in the sputum: The most common symptom is blood streaks in the sputum, which mostly occurs intermittently.

A small amount of hemoptysis: The amount of hemoptysis is generally small and can appear dark red or bright red.

Massive hemoptysis (rare): Once it occurs, it may be life-threatening. It is often caused by tumor invasion of larger blood vessels.

Irregular and dull pain in the chest: The pain varies in intensity and location, and can occur in any part of the chest.

Dull pain: The duration may be long or short, and may be aggravated by deep breathing, coughing, or changing body positions.

Stinging pain: usually brief, sharp pain that may be related to tumor invasion of the pleura or chest wall.

Aggravation with breathing and coughing: Breathing movements and coughing will stretch the chest tissue and stimulate the tumor site, causing the pain to worsen.

The location of chest pain is related to the location of the tumor: for example, peripheral lung cancer can cause localized pain on the chest wall, and central lung cancer can cause pain in the central part of the chest.

Aggravation after activity: In the early stage, it may only appear during strenuous activities. As the disease progresses, chest tightness and shortness of breath may also be felt during minor activities or even at rest.

Localized wheezing: When the tumor causes partial obstruction of the bronchus, wheezing can be heard locally and can occur both during inhalation and expiration.

Decreased breath sounds: When a tumor blocks the bronchus or compresses lung tissue, the breath sounds in the corresponding area will be weakened.

There are many types of dyspnea: it can present as inspiratory, expiratory, or mixed, depending on the location of the tumor and the degree of obstruction.

Low thermal: The body temperature is generally between 37.5 ° C -38 ° C, and it can sustain or repeatedly occur. It may be the absorption heat caused by tumor tissue necrosis absorption.

High fever (rare, caused by obstructive pneumonia, etc.): When a tumor blocks the bronchus, resulting in poor drainage of sputum, and secondary lung infection, high fever may occur, with the body temperature reaching above 39°C, accompanied by chills and worsening cough. and other symptoms.

Gradual weight loss: Continuous weight loss without deliberate dieting or increased exercise may be caused by tumors consuming body energy and affecting appetite.

Fatigue and fatigue: Patients often feel general weakness and fatigue, and their activity tolerance is significantly reduced, and it is difficult to fully recover even after rest.

Extreme weight loss: A large amount of body fat and muscle is consumed, and the body is reduced to skin and bones.

Anemia: pale complexion, pale lips, etc., due to long-term malnutrition and the impact of tumors on the hematopoietic system.

Life cannot take care of yourself: The body is extremely weak and cannot carry out normal daily activities.

Manifestations of Cushing's syndrome (moon face, buffalo back, etc., due to increased secretion of adrenocorticotropic hormone): the patient's face is as round as a full moon, and the fat on the back is thickened like a buffalo back. It may also be accompanied by symptoms such as purple lines on the skin and high blood pressure.

Syndrome of abnormal secretion of antidiuretic hormone (hyponatremia, water intoxication, etc.): Symptoms such as nausea, vomiting, drowsiness, and mental confusion may occur. In severe cases, it may lead to convulsions and coma, mainly due to abnormally elevated levels of antidiuretic hormone in the body. , leading to water retention and dilutional hyponatremia.

Gynecomastia: It may be related to the secretion of ectopic hormones by some lung cancer cells, which manifests as male breast tissue hyperplasia and swelling and pain.

Hypercalcemia (due to increased secretion of parathyroid hormone-related protein): can cause symptoms such as loss of appetite, nausea, vomiting, constipation, polyuria, thirst, and in severe cases, arrhythmia.

Clubbing of fingers (toes): The ends of fingers or toes are hypertrophic, hypertrophic, and enlarged in the shape of a club. The nails are arched from the root to the end. They often appear bilaterally symmetrically. This may be related to the stimulation of certain growth factors secreted by tumors.

Hypertrophic osteoarthropathy (joint pain, swelling, etc.): mainly affects the distal ends of long bones, such as wrist joints, ankle joints, etc., manifesting as joint pain, swelling, limited movement, and may be accompanied by periosteal hyperplasia, and blood circulation caused by lung cancer Abnormalities are related to endocrine changes.

Myasthenic syndrome (proximal muscle weakness in the upper limbs, etc.): Mainly characterized by muscle weakness, especially in the proximal muscles of the upper limbs, such as shoulders and upper arm muscles, and decreased activity tolerance. In severe cases, it can affect the normal movement of the limbs. Generally, the symptoms of the lower limbs are mild. , related to autoantibodies produced by tumors interfering with signaling at the neuromuscular junction.

Peripheral neuritis (paresthesias, numbness, etc.): Abnormal sensations at the end of the limbs, such as tingling, numbness, burning sensation, etc., may also be accompanied by muscle atrophy, affecting the sensory and motor functions of the limbs.

Psychiatric symptoms (in rare cases): such as depression, anxiety, hallucinations, etc., may be related to the tumor's impact on nervous system function or metabolic disorders.

Anemia: It can manifest as paleness, dizziness, fatigue, etc. The causes include tumor consumption, chronic blood loss, malabsorption of nutrients, and the inhibition of bone marrow hematopoietic function by tumor cells.

Purpura (caused by thrombocytopenia and other causes): Petechiae and ecchymoses appear on the skin and mucous membranes, often on the limbs and trunk. In severe cases, it may be accompanied by nose bleeding, gum bleeding, etc., which is caused by a decrease in the number of platelets or abnormal function.

Abnormal white blood cells: There may be an increase or decrease in white blood cells. The increase may be related to the inflammatory response caused by tumors, while the decrease may affect the body's immune function and increase the risk of infection.

Acanthosis nigricans (skin thickening, roughness, pigmentation, etc.): It commonly occurs in skin folds such as the neck, armpits, and groin. The skin is black, brown, or gray, thickened, and rough, with small papillary bulges on the surface. Certain substances secreted by tumors may irritate the skin.

Dermatomyositis-like changes: manifested as purple-red macules around the eyelids and orbits, accompanied by symptoms such as muscle weakness and pain. It can appear before symptoms of lung cancer. It is a skin and muscle disease related to tumors.

Skin itching: There is no obvious rash, but the skin itches severely, which may be related to tumor metabolites or immune response. Generalized or localized itching is possible.

Avoid active smoking and be aware of the dangers of smoking, including damage to lung cells caused by carcinogens.

Stay away from second-hand smoke and reduce exposure to passive smoking.

For those who work in asbestos, radon, arsenic, chromium, nickel, coal tar, mustard gas, isopropyl oil, mineral oil, dichloromethyl ether and other occupations, strictly abide by safe operating procedures and take protective measures such as wearing masks, protective clothing, etc. Conduct regular occupational health examinations.

Reduce air pollution, control industrial waste gas emissions, strengthen vehicle exhaust gas control, and promote the use of clean energy.

Keep the room well ventilated, avoid using polluting fuels, and install an air purifier.

Eat a balanced diet, consume more foods rich in vitamins (such as vitamins A, C, and E), minerals (such as selenium), and dietary fiber, such as fresh vegetables and fruits, whole grains, etc., and reduce the intake of high-fat and high-calorie foods.

Moderate exercise, at least 150 minutes a week of moderate-intensity aerobic exercise, such as brisk walking, jogging, swimming, etc., to enhance cardiopulmonary function and immunity.

Maintaining a regular schedule, ensuring adequate sleep, and avoiding staying up late and overexerting yourself will help the body repair and adjust itself.

Control your weight, maintain a reasonable body mass index (BMI), and prevent metabolic disorders and increased cancer risks caused by obesity.

To prevent respiratory infectious diseases, such as influenza, pneumonia, etc., you can get influenza vaccine, pneumonia vaccine, etc.

Pay attention to personal hygiene and wash hands frequently to reduce contact and transmission of pathogens.

Timely treatment of chronic inflammatory diseases of the lungs, such as chronic bronchitis, tuberculosis, etc.

For high-risk groups (such as long-term smoking history, family history of lung cancer, occupational exposure history, etc.), low-dose spiral CT examinations are performed regularly to detect lung lesions early.

Applicable people: People aged 50-74 years old, and meet at least one of the following risk factors: smoke ≥20 packs/year (or have smoked ≥20 packs/year and quit smoking <15 years ago) years); passive smoker; has a history of occupational exposure (asbestos, radon, uranium, nickel, chromium, arsenic, beryllium, coal tar, mustard gas, benzidine, polycyclic aromatic hydrocarbons, etc.); has a history of malignant tumors or a family history of lung cancer; has A history of chronic obstructive pulmonary disease or diffuse pulmonary fibrosis.

Screening method: Low-dose spiral CT, which can detect early-stage lung nodules and other lesions, has a relatively low radiation dose and high sensitivity.

If you have persistent cough (especially irritating dry cough), expectoration with blood or hemoptysis, chest pain, difficulty breathing, hoarseness, fever, weight loss and other symptoms, please seek medical attention promptly for further examination.

Lobectomy: Suitable for patients whose tumors are limited to one lung lobe. The diseased lobe and some surrounding tissue are removed, while normal lung tissue is retained to maintain lung function.

Pneumonectomy: Used when the tumor involves one side of the whole lung or when central lung cancer invades important structures such as the main bronchus, but the postoperative impact on lung function is greater.

Segmentectomy and wedge resection: For early-stage lung cancer, patients with small tumors located around the lungs can choose to resection part of the lung segment or wedge resection of the tumor tissue to preserve more lung function, especially for patients with poor lung function who cannot tolerate lung cancer. Those who underwent lobectomy.

Indications: Patients with stage I, stage II and some selected stage IIIA non-small cell lung cancer; some patients with small cell lung cancer may consider surgical resection if their tumors shrink after chemotherapy.

Contraindications: Severe cardiopulmonary insufficiency that cannot tolerate surgery; poor systemic condition, such as cachexia; distant metastasis (such as brain, liver, bone, etc.); extensive mediastinal lymph node metastasis that cannot be completely dissected, etc.

Radical radiotherapy: It is suitable for early-stage lung cancer patients who are unable or unwilling to undergo surgery due to physical reasons, as well as some patients with locally advanced lung cancer. It uses high-dose irradiation of tumor tissue to eliminate tumors and cure the disease.

Palliative radiotherapy: It is mainly used to relieve symptoms of patients with advanced lung cancer, such as pain caused by bone metastases, neurological symptoms caused by brain metastases, superior vena cava obstruction syndrome, etc., to reduce patients' pain and improve their quality of life.

Adjuvant radiotherapy: After lung cancer surgery, patients with high-risk factors for local recurrence (such as positive tumor margins, mediastinal lymph node metastasis, etc.) are given postoperative adjuvant radiotherapy to reduce the risk of local recurrence; radiotherapy after chemotherapy can enhance local control. Effect.

Three-dimensional conformal radiotherapy (3D-CRT): According to the shape of the tumor, the shape and dose distribution of the radiation field are adjusted from multiple directions to make the high-dose area consistent with the shape of the tumor target area and reduce the radiation dose to surrounding normal tissues.

Intensity-modulated radiotherapy (IMRT): Based on 3D-CRT, it further adjusts the dose intensity at each point in the irradiation field to achieve a more precise dose distribution, better protect normal tissue, increase the tumor irradiation dose, and thereby improve the treatment effect.

Stereotactic body radiotherapy (SBRT): Suitable for early-stage lung cancer or oligometastatic lesions. It uses high-dose, few-fraction irradiation to deliver high-dose irradiation to the tumor in a short period of time while causing less damage to surrounding normal tissue.

Chemotherapy drug classification

chemotherapy regimen

Chemotherapy indications and contraindications

Targets and drugs

Detection methods: Use genetic detection technologies, such as polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), etc., to detect relevant gene mutations or fusions in tumor tissue or blood to guide targeting Drug selection.

Efficacy evaluation and drug resistance treatment: Regularly evaluate the efficacy through imaging examinations (such as CT, etc.), and observe changes in tumor size and number. When resistance occurs, genetic testing is performed again, and subsequent treatment options are selected based on new mutations. For example, third-generation osimertinib can be used instead if T790M mutation occurs after resistance to a first-generation EGFR-TKI.

drug type

Applicable population and efficacy predictors: Mainly used for patients with advanced non-small cell lung cancer, especially those without driver gene mutations or those who have progressed after chemotherapy. Predictors of response include tumor cell PD-L1 expression levels; patients with high expression may benefit more from immunotherapy, but patients with low or negative expression may also benefit. In addition, indicators such as tumor mutation burden (TMB) can also be used as a reference.

Monitoring and treatment of adverse reactions: Immunotherapy may cause immune-related adverse reactions, such as immune pneumonia, hepatitis, enteritis, thyroid dysfunction, adverse skin reactions, etc. During the treatment period, the patient's symptoms, signs and related laboratory indicators need to be closely monitored. Once adverse reactions occur, corresponding treatment measures such as suspending treatment and using glucocorticoids and other immunosuppressants will be taken according to the severity. The patient will be evaluated after the adverse reactions are alleviated or recovered. Continue immunotherapy.

interventional therapy

Traditional Chinese Medicine Treatment

supportive care