Bronchogenic carcinoma, also known as lung cancer, is a common malignant tumor of the lungs. In recent years, both its incidence and mortality rates have shown an upward trend. The disease is associated with factors such as air pollution, occupational exposure to carcinogens, smoking, and recurrent lung infections. It poses a serious threat to human health, and improving early diagnosis and treatment outcomes is a key focus for medical professionals.

bubble_chart Diagnosis

1. Medical History and Symptoms:

The onset is slow and insidious, mostly occurring after the age of 40, but there has been an increasing trend of incidence among young and middle-aged individuals in recent years. Symptoms and signs vary depending on the tumor type, location, size, presence of metastasis, or complications. Respiratory symptoms often include cough, bloody sputum, chest pain, chest tightness, and shortness of breath. If the tumor compresses the bronchus, dyspnea may occur. Obstructive pneumonia may develop after infection, accompanied by symptoms such as fever and purulent sputum.

2. Physical Examination Findings:

Early-stage and peripheral lung cancer may show no positive findings. Central lung cancer may present with localized wheezing, hoarseness, diaphragmatic paralysis, Horner syndrome, superior vena cava syndrome, or dysphagia due to tumor compression or invasion of adjacent tissues, bronchi, recurrent laryngeal nerve, or phrenic nerve. Non-small cell lung cancer may manifest with clubbing of fingers (toes) or hypertrophic osteoarthropathy, while small cell lung cancer may exhibit extrapulmonary symptoms such as neuroendocrine disorders. Distant metastasis leads to corresponding clinical symptoms and signs.

(1) Sputum Cytology: The positive rate depends on the number and quality of specimens submitted, generally reaching 70–80%. The positive rate of cytological examination via bronchial brushing is higher than that of sputum examination.

(2) Chest X-ray: Central tumors may show lobulated hilar masses, while peripheral tumors may appear as solitary nodules or masses, possibly lobulated or with fine spiculations. Bronchioloalveolar carcinoma may present as small nodules or diffuse small patchy shadows. Pleural invasion may reveal pleural effusion. Obstructive pneumonia may exhibit inflammatory X-ray findings. Chest CT or MRI (magnetic resonance imaging) is highly valuable for determining tumor location, size, and the presence of mediastinal or lymph node metastasis.

(3) Fiberoptic Bronchoscopy: Brush smears or biopsies can be performed, with a positive rate of 50–95%, depending on the examiner’s experience and skill. Cytological examination of bronchoalveolar lavage fluid and detection of tumor markers such as carcinoembryonic antigen (CEA) can also aid in diagnosis.

(4) Other Examinations: Radionuclide lung scans, thoracoscopy, and pleural fluid cytology may assist in diagnosis.

4. Differential Diagnosis:

This disease should be distinguished from pulmonary subcutaneous nodules, obstructive pneumonia, and mediastinal lymphoma.

bubble_chart Treatment Measures

Generally, a comprehensive treatment approach is adopted, including surgery, radiation, chemotherapy, and immunotherapy.

1. Surgical Treatment:

It should be performed before the disease reaches stage II. For patients highly suspected of having lung cancer, thoracotomy may be considered. For those in the intermediate or advanced stages, lesion resection can also be performed to alleviate symptoms and reduce suffering, provided the patient's physical condition permits.

AD

TCM's treatment of atopic dermatitis is more comprehensive, fundamental, non-toxic and effective than Western medicine's symptomatic treatment

It is highly effective for small cell lung cancer but less effective for non-small cell lung cancer. Typically, a combination of 2–3 anticancer drugs with different mechanisms of action is used, such as cyclophosphamide, doxorubicin, etoposide (VP-16), cisplatin, carboplatin, and vincristine. Blood tests should be regularly monitored during treatment. Common regimens include: for small cell carcinoma, PE (cisplatin + etoposide) or COE (cyclophosphamide + vincristine + etoposide); for non-small cell carcinoma, CAP (cyclophosphamide + doxorubicin + cisplatin) or CAM (cyclophosphamide + doxorubicin + methotrexate).

3. Radiation Therapy (Radiotherapy):

It is suitable for cases with localized lesions and no peripheral metastasis, where surgery is not feasible, to alleviate symptoms, reduce suffering, or enhance surgical outcomes. Radiotherapy is more effective for small cell lung cancer, followed by squamous cell carcinoma, and less effective for adenocarcinoma.

4. Other Treatments:

These include immunotherapy using transfer factor, interferon, immune RNA, or anti-lung cancer monoclonal antibodies. For localized lesions without peripheral metastasis, bronchial stirred pulse interventional therapy may be employed. Traditional Chinese medicine can also be selected based on the condition. Additionally, nutritional support and symptomatic treatment should be emphasized.