Interview topics: lung cancer early detection and treatment strategies
invited guests: Capital University of Medical Treatment of Lung Cancer Center Director, Professor Zhi Xiuyi following interview
Record *
2008 National Cancer Prevention and which projects will be?
Moderator: Good afternoon, friends, Welcome to Sohu health interview room. April is the month we tumor Sohu health, the National Cancer Prevention Week has just ended, this year's theme, or focus on tobacco control to start smoking may be all that most likely think of lung cancer. Well, today we go to the well-known experts in tobacco control and cancer prevention science professor Zhi Xiuyi guest expert interview room to talk with netizens early lung cancer detection and treatment strategies!
Professor in the capital expenditure Medical Treatment of Lung Cancer Center, Thoracic Surgery, Xuanwu Hospital, Capital University of Medical Director. in lung cancer diagnosis, clinical stage before treatment, standardized treatment, surgical treatment, perioperative management and the field of multimodality therapy of lung cancer, especially in the advanced non-small cell lung cancer and surgical treatment for elderly lung cancer patients, non-small cell lung cancer neoadjuvant chemotherapy and postoperative adjuvant chemotherapy, molecular targeted therapy, CT-guided radiofrequency ablation therapy and multidisciplinary treatment has a wealth of clinical experience.
interviews begin, first tell us you support the National Cancer Prevention and Professor of weeks, as well as in cancer prevention and treatment of late there will be publicity which projects?
Zhi Xiuyi: the third week of April each year, the National Cancer Prevention Week, this year is the fourteenth session of the theme Day theme is young people away from tobacco, combined with these two themes, the Chinese Anti-Cancer Association, solicited members of the council as well as the views of various provinces and cities, and ultimately determine the main subject is tobacco control, and this is the first time the National Cancer Prevention Week use and tobacco control for two consecutive years on the subject.
good this year about a background of tobacco control: first, the Chinese government has signed the international Framework Convention on Tobacco Control. Second, the upcoming Olympic Games in Beijing, Premier Wen Jiabao also the World Health Organization Director-General undertaking that should the Olympic Games into the green Olympics, the Olympic Games should smoke into the green Olympics, Beijing Olympic Organizing Committee has been promoting a smoke-free Olympic run. This year on May 1 After the formal implementation of the Beijing Amendment will also be a good smoke-free legislation.
April 13 this year, the World Health Organization, some representatives of international tobacco control, the Chinese Anti-Cancer Association, the Ministry of Health Disease Control Bureau and the Tianjin Municipal Committee leadership so held in Tianjin, Galaxy Plaza, a National Cancer Prevention Awareness Week launch ceremony, and issued a written proposal and hope that through this National Cancer Awareness Week, the number of cancer prevention and control knowledge, and knowledge of tobacco control to tell you. Then, 4 15 held in Beijing, also very pleased to be working again and Sohu Health Channel to promote scientific knowledge of cancer information throughout the year.
Prevention Week, in Beijing, Shanghai and various provinces and cities, all around the promotion of the whole people quit smoking, so that the theme of tobacco away from children a series of activities to do. From the feedback we received, nearly 50 hospitals nationwide, nearly 50 different cities around the theme of Cancer Awareness Week-related activities done.
4 �� 19 ��Tumor week ended, we held in Beijing, media experts, the consensus will be, please quit smoking expert, lung cancer, smoking cessation and cancer prevention experts say. In this week's Cancer campaign, or play a pass to the Cancer Society and smoking cessation The role of knowledge.
Moderator: Why did you choose For example, lung cancer, we had a lack of diagnosis, the cancer is diagnosed in a late stage by the loss of surgical treatment, a five-year survival rate is very low. the international five-year survival rate of lung cancer is about 15%, China 8% so. we do a series of work, radiotherapy, chemotherapy, physical, most of them closely around the treatment of advanced cancer. to a large number of Internet users and the people still left the impression that fear of cancer.
This time we want the community know, although many patients with advanced, but early cancer patients also considerable. whether it is breast, lung, stomach, colon, and so, patients after treatment, five, ten, even fifteen years a lot of people live, Some has also been on the job. We hope to add a message to everyone that through early diagnosis of cancer through scientific standard treatment so patients can live very well, had not died of cancer. In recent years, with the high-tech use in various fields, these high-tech means are in the cancer field has been completely done, but people do not know, especially in elderly patients, we are to give people a message of hope, casting from a common line of defense Cancer .
What are the symptoms of lung cancer mean?
Moderator: Today we talk about how to focus on early detection of lung cancer. a lot of friends asked, What are the symptoms appear when it should be wary of lung cancer?
Zhi Xiuyi: I have engaged in the treatment of lung cancer 25 years from the development of medical knowledge and perspective of cancer, including treatment of the effect of view, the earlier the cancer, the treatment effect is better. So is the eternal topic of cancer prevention, early detection is the eternal the topic of how the early detection of lung cancer
? First, the government and medical institutions concerned, to do the screening is very important high-risk groups, such as smoking 20 years, more than 20 cigarettes per day in person, give him lateral chest X-ray film to do is scan and chest CT, a considerable part of the ratio could be early detection of lung cancer.
Second, if there are symptoms of the patients after treatment must be timely. high-risk groups, especially in smokers, if way to change your cough, cough nature of cough sound changes, such as phlegm if you have not, there are sputum, it is necessary to the hospital for tests. And if the same parts of the repeated lung inflammation, lung cancer should also consider possible.
third, non-smoking healthy subjects, began irritating cough, bloody sputum, then also go to the hospital.
colleagues clinicians should also strengthen the understanding of lung cancer, lung cancer doctor is engaged in the real thoracic surgery, respiratory and oncology doctors, but some patients with lung cancer have bone metastases that he would go to orthopedic treatment, chest pain, patients will see the Department of Cardiology, all clinicians should be concerned about the early symptoms of lung cancer I think the more the task is in Cancer General Hospital, Capital Medical University, has been prepared to set up in late May of Clinical Oncology.
Moderator: That is the medical workers must guard against these diseases early signal? < br> Zhi Xiuyi: There are some delays in cancer diagnosis, is under doctor's observation of delay, if the doctors believe that patients with only lung inflammation, and review a month later the patient, but may not review the patients themselves, or after review The doctor has not been tracked, may be delay in diagnosis. So I think to make more early detection of lung cancer, early treatment, should be allowed to non-tumor General Hospital doctors have the training to come to this area.
what needs to be done early detection of lung cancer check?
Moderator: For lung cancer, early detection of what kind of inspection methods?
Zhi Xiuyi: First, for high-risk groups, or suggested a low dose chest spiral CT, from the perspective of health economics are more cost-effective. Second, if you already have bloodshot sputum, should do inspections. other tumor markers must be high although not cancer, but should at least remind the doctor check .
sometimes is due to bone metastasis of lung cancer or brain metastasis discovered, many of thoracic surgeons turn patients come from brain surgery. easy to brain cancer, bone metastasis, the associated orthopedic and surgery, if found The words of metastatic cancer, can also be found in the lungs of factors, at least we caught an early opportunity for treatment.
What are the treatment of early lung cancer?
Moderator: support received by the previous introduction, we have friends The symptoms of lung cancer have some understanding. If caught and treated early, the result is better. can tell us about the treatment of early lung cancer which means?
Zhi Xiuyi: lung cancer in four of the early lung cancer as I lock period and phase II, I was divided into IA of the IB of the period. for I and II, of the patients, and now advocate surgery, international and domestic data show that, IA and IB in the five-year survival rate can reach 90%. II patients can be achieved on 50% to 80%, III for more than five-year survival rate of less than 50%. Calculation of the survival of early lung cancer five-year survival rate is, in units of years, survival for advanced lung cancer was calculated in months, so early treatment of lung cancer is very important.
the clinical symptoms of early lung cancer as a local, with the partial solution to the first is surgery, if the patient can tolerate surgery, liver and kidney function is also very good, surgical treatment is preferred. surgery There are many ways, a lobectomy, pneumonectomy, the removal of us require sweeping the corresponding along the lymph nodes, because lung cancer is easy lymph node, and then sent to pathology. Clinical think I of the patients, there are some II, or III, Surgery is the first choice.
Second, some patients can not be operated on, for example, has just had myocardial infarction, diabetes was not well controlled, the patient inoperable, or refused surgery. We have a lot of ways, including our some physical methods. now for radical local treatment, mainly in recent years in the international and domestic promotion of CT guided radiofrequency ablation, the needle probe into the tumor of a tumor, by heating the electrode, heated to 60 degrees 90 degrees to kill the tumor, as the saying is patients, local treatment can be a very good therapeutic effect. Also by radiofrequency ablation can play the other role. such as the relatively large tumor, radiation can not kill all to be first through most of radiofrequency ablation to kill cancer cells, and then then through a thorough treatment of radiotherapy and chemotherapy.
staging of lung cancer must first be treated? What indicators can be clearly detected lung cancer staging?
Moderator: Lung cancer is also the stage, all the patients before treatment , should be accurate staging before treatment?
Zhi Xiuyi: This is a must, so many years, the Chinese Anti-Cancer Association and the Chinese Medical Association have repeatedly called for, had cancer, we must first re-treatment stage . because the sub-one thousand two hundred thirty-four cancer, different treatment of different level, the situation is different prognosis. If not done in phases to surgery, which is not allowed. The patient not only suffers with their money, the effect is not Good.
a number of doctors willing to give the countdown, suspected bone metastasis, said patients live for three months at most, the last patient lived more than a year, the bones do not matter, just before the signs of healing hurt. so early in the late is not who says it. decision must be before the first stage treatment program. There are some areas of lung cancer on the operating table is not set, this is ridiculous. We request must be clear before surgery is not lung cancer, lung cancer if it is I, surgery is about 90% five-year survival rate, if it is four lung cancer, it can not easily cut out.
easy to systemic metastasis of lung cancer, we should first present the general treatment of lung cancer chest CT, chest, upper lobe, lung under Leaves are to be done. This is the analysis of the important criteria for staging of lung cancer. Second, brain and bone metastases. for brain metastases previously used brain CT, brain magnetic resonance imaging is now replaced by brain CT. for the easy case of bone metastasis Before treatment, to conventional whole body bone scan, so you can see there is no transfer. Third, we need to do regular abdominal ultrasound or abdominal CT. As for tumor markers, etc., may later come into our lives slowly, it is not as routine.
Moderator: patients diagnosed with lung cancer, be sure to do some stage check?
Zhi Xiuyi: Yes.
Moderator: Good points after the next period step of the treatment.
Zhi Xiuyi: We remind patients, if it is lung cancer, treatment options before the decision stage must be good. Now this idea has learned to clinical health care workers taught to go.
all of lung cancer will need chemotherapy after surgery you?
Moderator: Is not all patients require postoperative chemotherapy?
Zhi Xiuyi: We called the absolute IA patients with early stage of the patient, the patient is a local problem, Surgery solved. If II period, with hilar lymph node metastasis, it is not a local problem. we have two or more non-small cell lung cancer and small cells, as a systemic disease, only surgery not need treatment to local and systemic treatment combination.
from the eighties of last century, centers around the world began to carry out lung cancer adjuvant chemotherapy after surgery to do clinical research, now has the people into the clinical research project. II, more than many patients from adjuvant chemotherapy has been beneficial. adjuvant therapy, there are two, the first is the radiotherapy and the second is chemotherapy. the current II, and III of non-small cell adjuvant therapy after surgery is done. We want to avoid too light therapy, but also to avoid excessive treatment. postoperative chemotherapy should be four to six cycles, typically four cycles, if you do individualized clinical treatment can be done for six cycles.
last ten years, has undertaken a number of international and domestic neoadjuvant chemotherapy studies. such as III of the disease itself, except for patients already had hilar lymph node metastases, and have mediastinal lymph node metastases, is not a local problem. We can use the effective preoperative chemotherapy, the lesions reduced the number of lymph nodes are reduced, another surgery to control of the lesion, but also to bring operations to avoid surgery the operation of the spread. now generally requires two cycles of neoadjuvant chemotherapy.
present, most of the postoperative adjuvant chemotherapy is blind. who do not know after the program has no use. analogy, for example, I have this medicine is for A, if A in an effective, but if A is taken away, that is, the existence of the disease should not have chemotherapy, do not know if valid or not valid. to another aspect, the use of four to six cycle, not necessarily useful, the insurance just to make a needle.
Now we can look at the tumor by preoperative chemotherapy response, and sometimes only one cycle of chemotherapy, there are significant changes in symptoms, give the patient an operation. The program also used after surgery do four cycles. If this option has no effect before surgery, completed two cycles of chemotherapy, lesions were not small, but large, and this proves he did not use the program on, we change the program.
There are some patients after myocardial infarction, inoperable within three months, unstable diabetes, in particular, can not be operated on. can not wait three months, simply with two cycles of chemotherapy, both control the disease, and no delay treatment progress. but also conducive to surgery.
what needs to be done after lung cancer surgery to avoid recurrence or metastasis check? how should I do if relapse?
Moderator: adjuvant chemotherapy to do very important aspect is to prevent disease recurrence and transfer. If the transfer case, he faces what condition changes?
Zhi Xiuyi: We emphasize that all surgeons to patients after surgery to strengthen the follow-up. The first annual review once every three months to the hospital the second year, review once every six months, and then check once each year. must be done each chest CT, small lesions can be found to have no transfer.
because the cancer is characterized by easy transfer, easy to relapse, so after surgery , but also enhance secondary prevention. If the periodic review, a problem found in the film, we should be treated. especially the III stage patients, but also to regular review. If it is to adjuvant chemotherapy after surgery, usually twenty- One day a plan to do four to six times. each time the course of chemotherapy, have to do check, if you find a local recurrence, to local processing. if not only local recurrence, the current experience is that more and more patients with local recurrence less, more of a bone metastasis to bone metastasis according to the method, fracture prevention, bone emergence of drug use. If tumor recurrence after five years, and you follow the method of medical treatment on it.
side effects of chemotherapy you can stop the chemotherapy?
Moderator: Some users have mentioned some side effects of chemotherapy after surgery, such as a hair loss, nausea. Can they ask only two weeks of postoperative chemotherapy, coupled with Chinese medicine, is it possible to achieve normal results?
Zhi Xiuyi: We do not claim to do so, or because of recurrence of cancer caused by the growth of cancer cells, cancer itself is logarithmic growth. Different cells have different growth cycle, the early patients the cube of ten cells, it is possible within six months, about eight square into ten. According to cell cycle and the metastatic spread of the laws of view, we recommend four to six cycles. by My theory is that cancer cells are killed all over again. If the body can not bear to four cycles, six cycles can be tolerated as much as possible.
According to the present situation, for the side effects of chemotherapy, there good approach. general hospital in the formal treatment, the patient is not to suffer, but can not be two cycles of chemotherapy to stop, since the standard treatment to treatment is necessary.
a pleural effusion of advanced lung cancer are you?
Moderator: Once the pleural effusion of lung cancer mean that to late?
Zhi Xiuyi: I touch medicine in 1978, when the concept is that once the lung cancer patients with pleural effusion is late. Now, with the development and progress of medical treatment and equipment to improve the means of progress, update, especially the emergence of electronic thoracoscopy, we found that a considerable portion of the pleural effusion was not malignant, found nearly one-third by thoracoscopic pleural effusion is benign effusion.
If pleural effusion is benign, no cancer cells found that II,, II positive effect of surgery on patient well. For unexplained pleural effusion Do not presume to It is a malignant pleural effusion. In my opinion, unexplained pleural effusion thoracoscopy should be used for routine examination, if the pleura is very clean, just get into the water, must not give up treatment. is indeed a malignant pleural effusion If repeated puncture, repeated drainage, pleural fluid protein loss, the patient will lose nutrients. So, even if malignant pleural effusion, thoracoscopy can also be used to treat, so the lung and pleura paste, called pleurodesis, pleural effusion that will not further into, when combined with radiation therapy, targeted therapy to better governance of the.
In addition, pleural puncture to the organization rarely, if taken by thoracoscopy will be more pathological, pathological laboratory tests will be very satisfied. From this point on, not just e-thoracoscopy in the diagnosis of malignant pleural effusion, the area in the treatment of malignant pleural effusion has a very good role.
why lung cancer multidisciplinary therapy ?
Moderator: multidisciplinary treatment What is the significance?
Zhi Xiuyi: The current treatment of lung cancer in medicine - drug therapy, surgery - surgical treatment, as well as physical therapy - Radiofrequency ablation, Gamma Knife Chinese medicine treatment, targeted therapy, psychological treatment and so on. is clinically a very strange phenomenon, is clearly not an operation, but the hands of the patient to the surgeon to cut out. clearly is surgery, to the physician hands to chemo.
I had lung cancer five years ago, advocated the establishment of centers, which have both medical surgery, radiation therapy have both traditional Chinese medicine, there are psychological treatment the doctor. multidisciplinary multi-disciplinary treatment must sit with the doctors. Now the experience, I and Phase II, stage IIIA non-small cell patients, the use of the surgical treatment based comprehensive treatment. III and VI of the adoption of the comprehensive medical treatment based on surgery . all doctors should be jointly discussed for a case where the patient is on, and then develop a comprehensive treatment plan.
multidisciplinary treatment is the future trend, not simply focus on surgery or drugs, each treatment has limitations, so we Now local treatment and systemic therapy emphasizes the combination of the combination of physical and chemical, physical therapy and psychological treatment combination. for the local lung cancer early age, we stress the importance of local physical treatment, coupled with biological targeted therapy combination to achieve the unity of the local with the body, the combination of physics and chemistry.
users following questions *
secondhand smoke equivalent to active smoking
Moderator: friends asked, he and his leadership in a office, leading to smoke ten cigarettes a day, when the office has a basket can purify the air, he asked how to prevent such cases of lung cancer?
Zhi Xiuyi: This involves another topic of smoking. If the field, I think the first is to advise you of the leadership not to smoke in the office to smoke outside, to the health of others, do not let other people second-hand smoking. I do not know how much time you work with the leadership If you are passive, you have to participate in regular annual medical examination must be according to chest.
Host: 73-year-old father of users, in October 2007 found that lung tumors. has now been done six times chemotherapy, tumor shrinkage, but the WBC is not stable, the decline is half and half. how about this treatment?
Zhi Xiuyi: we get from TV and the Internet are very limited data, the information provided from the users point of view He should be the IIIB non-small-cell therapy of. from the effects of view, the tumor shrunk, cells were also less, the program is still valid. as it has done 6 cycles of chemotherapy, his treatment should no longer continue. this time, symptomatic treatment of Chinese medicine can do. Second, topical treatment or need to do. I think these patients, six cycles of chemotherapy if you have done, and reduce the number of local matter, because there is not much to write tumor the tumor was 6-8 cm, narrow half there are 4 cm, this time to do treatment, do local processing, radio frequency ablation Ye Hao, radiotherapy Ҳ��. Third, there are other parts to investigate the transfer, if metastasis, we need to do second-line chemotherapy.
Host: 73-year-old man found in January 2008 of lung cancer.'ve done 25 days of radiotherapy, but also did two courses of chemotherapy. now how to do ?
Zhi Xiuyi: 73-year-old patient in elderly patients or young inside, we must first find out what causes weakness, we have to distinguish, if it is caused due to illness certainly need to do some treatment, if is a factor of chemotherapy, to strengthen the side effects of chemotherapy response, enhancing adjuvant chemotherapy. Meanwhile, give him a score, and if the patient can not do treatment, targeted therapy can be done.
Moderator: Today interviews almost time. Finally, please support teach some suggestions of our users, while to us about the time and place of your visits.
Zhi Xiuyi: I especially want to tell users, early detection of cancer after treatment very good, also good if we pay attention to the clinical stage of lung cancer to develop better treatment programs, combined with surgery, radiotherapy, chemotherapy, targeted drugs such as combined therapy, there will be a good therapeutic effect, it should pay attention to the clinical stage and overall treatment.
my clinic hours are every Monday morning, to take different time periods for treatment, every ten minutes to fifteen minutes to see a patient, I hope that friends no matter where patients see a doctor you must take the good with the disease-related information. Booking hotline: / 8151.
Moderator: This concludes today's interview, Professor Xie Xiezhi the visit. netizens question if there is lung cancer support can visit the professor's blog (
Zhi Xiuyi: I hope Cancer to more knowledge, spread to more users, so that we know more scientific knowledge, let us not fear cancer cancer patients, cancer patients can we standardized and scientific treatment of cancer.
Interview Record ends *
experts:
Zhi Xiuyi Capital University of Medical Oncology, Professor, deputy director of Capital University of Medical Treatment of Lung Cancer
director of the Center of Thoracic Surgery, Xuanwu Hospital, Capital University of Medical Director
China's well-known experts in thoracic surgery and lung cancer prevention and cancer control
famous science of tobacco control experts
1983 graduate of Capital University of Medical Health Department. in Beijing Chest Hospital Thoracic Surgery for 20 years, in October 2002 from Miami After returning to the University Cancer Center training Xuanwu Hospital, Capital Medical University, transferred to any director of thoracic surgery in April to create the establishment of .2003 Capital University of Medical Center of lung cancer treatment center and served as director of .2008 Capital in April appointed Deputy Director, Department of Medical Oncology. < br> In the lung cancer diagnosis, clinical stage before treatment, standardized treatment, surgical treatment, perioperative management, and multidisciplinary treatment of lung fields, especially in advanced non-small cell lung cancer and surgical treatment for elderly lung cancer patients, non- small cell lung cancer neoadjuvant chemotherapy and postoperative adjuvant chemotherapy, molecular targeted therapy, CT-guided radiofrequency ablation therapy and multidisciplinary treatment of clinical experience with extensive variety of .20 years to complete more than 3,000 cases of lung cancer, writing academic more than 30 papers, editor and coauthor of 10 professional books and textbooks remnants.
currently serves as the Chinese branch of Thoracic Surgeons Medical Association Executive Vice President and Director-General, Chinese Medical Association of Thoracic and Cardiovascular Surgery Branch Deputy Secretary General Office of the director of the China Tobacco Control and Lung Cancer Foundation, director of the work, the work of Chinese Anti-Cancer Association, the Minister of Science Popularization, Beijing, Health Education Association executive vice president. more than 10 academic journals as an associate editor, managing editor and editorial board. regular consultations throughout the country to go to surgery and academic lectures and in-mission abroad in recent years led a delegation to take part in the field of thoracic surgery and lung cancer international academic conferences. footprints all over the United States, Britain, France, Canada, Switzerland, Japan, Ireland, Italy, , Spain, Malta, Malaysia, Thailand, South Korea and more than 20 domestic provinces and municipalities.
recent years, active participation of Professor Zhi Xiuyi tobacco control and lung cancer prevention and treatment of cancer science and advocacy. in hospitals, communities and kinds of media in more than 100 health education talks.
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