Traditional Culture Encyclopedia - Traditional stories - Lung cancer treatment and its dietary attention

Lung cancer treatment and its dietary attention

Treatment of lung cancer:

I. Selection of treatment plan for lung cancer

Stage Ⅰ Ⅱ Ⅲa Ⅲb Ⅳ non-small-cell lung cancer surgical treatment, the opinion on whether it is appropriate to give chemotherapy after surgery is not yet unanimous, but adenocarcinoma favors the use of chemotherapy for the postoperative period, and it is recommended that chemotherapy be used after the surgery. Postoperative chemotherapy is recommended for adenocarcinoma, and postoperative radiotherapy can be considered for those who have the condition.

①After chemotherapy, try to get radiotherapy or surgery.

② radiotherapy, for surgery + chemotherapy.

③ Meet the expanded surgical indications / or radiotherapy, surgery + radiotherapy + chemotherapy, chemotherapy, radiotherapy-based selective chemotherapy and general internal medicine treatment of small cell lung cancer surgery + chemotherapy chemotherapy + surgery + chemotherapy chemotherapy radiotherapy-based on the therapeutic effect of the person can be added to the surgical and postoperative chemotherapy chemotherapy, radiotherapy-based, selective chemotherapy and general internal medicine treatment.

Surgical treatment of lung cancer, except for stage Ⅲb and Ⅳ, surgical treatment should be the leading one, and radiotherapy, chemotherapy and immunotherapy should be added according to different stages and types of pathological tissues, while the indications and programs of small-cell lung cancer should be revised and perfected in clinical practice. Regarding the survival of lung cancer after surgery, it has been reported that the three-year survival rate is 40%-60%; the five-year survival rate is 22.9%-44.3%, and the mortality rate of surgery is below 3%.

(A) case selection with the following conditions, generally can be used as the choice of surgical treatment.

1. No distant metastasis (M0), including parenchymal organs, such as liver, brain, adrenal glands, bones, extra-thoracic lymph nodes.

2. Cancer tissue has not spread to neighboring organs or tissues in the chest, such as the aorta, superior vena cava, esophagus and cancerous pleural fluid.

3. No paralysis of the recurrent laryngeal nerve or phrenic nerve.

4. No severe cardiopulmonary hypoplasia or recent angina pectoris.

5. No severe liver, kidney disease and severe diabetes. If you have the following conditions, you should be careful with the surgery or need further examination and treatment:

(1) Old age and body failure, heart and lung function is not good.

(2) Small cell lung cancer, except for stage I, should be treated with chemotherapy or radiotherapy before determining whether surgery is possible.

(3) In addition to the primary foci, there are several suspected metastases in the mediastinum on x-ray.

(2) Indications of thoracotomy Where there is no contraindication to surgery, and the diagnosis of lung cancer is clear or highly suspected, the choice of operation can be made according to the specific situation and the first section of this chapter, if the lesion is found to have exceeded the scope of resection, but the primary cancer can still be removed, it is appropriate to remove the primary foci, which is known as a reduction surgery, but in principle, total lung resection will not be performed, so as to assist other treatments after the operation.

(III) Nomenclature and meaning of surgical resection of lung cancer

1. Palliative resection (P): Where there is still residual cancer in the chest cavity at the time of surgical resection (confirmed by pathology and histology), or where the resection is considered to be complete at the time of surgery, such as the bronchial stumps which are normal to the naked eye, but there are residual cancer cells under the microscope, it is called palliative resection. Where there are suspicious residual cancer tissues in the thoracic cavity, all of them are marked with metal markers during the operation so as to be supplemented with radiation therapy after the operation.

2. Radical resection (R): Radical resection refers to the complete removal of the primary cancer and its metastatic lymph nodes. Radical resection of lung cancer not only requires the operator to achieve cure under the naked eye, but more importantly, the lymph nodes are completely removed and the bronchial stumps are free of cancer cells under the microscope, in order to achieve this purpose, radical resection of lung cancer is categorized into four grades as follows. Root 1 (R1): primary cancer and 1 station lymph node dissection. Root 2 (R2): primary cancer and 1 or 2-stage lymph node dissection. Root 3 (R3): primary cancer and lymph node dissection at stations l, 2, and 3. Root 4 (B4): primary cancer and lymph node dissection at stations l, 2, 3 and 4. It should be noted that the above four grades of radicalization refer to the extent of surgical removal of lymph nodes and do not represent the outcome after radicalization.

(4) According to the 1985 International Staging Method of Lung Cancer, surgical treatment can be used for stage I, II and III lung cancer cases without contraindications to surgery. The principle of surgical resection is to completely remove the primary foci and lymph nodes in the thoracic cavity that are likely to metastasize, and to preserve normal lung tissue as much as possible, and total pneumonectomy is recommended to be done cautiously.

3. Local resection: it refers to wedge-shaped lumpectomy and segmental resection, i.e., for primary cancer with small volume, poor lung function in the old and weak, or well-differentiated cancer with low malignancy, local resection of lung can be considered.

4. Lobectomy: For isolated peripheral lung cancer confined to one lobe without obvious lymph node enlargement, lobectomy is feasible; if the cancer tumor involves two lobes or the middle bronchus, it is feasible to perform upper, middle lobe or lower, middle lobe lobectomy.

5. Sleeve lobectomy and wedge sleeve lobectomy: this type of operation is mostly applied to right upper and middle lobe lung cancer. If the tumor is located in the lobe bronchus and involves the lobe bronchial openings, it is feasible to perform sleeve lobectomy; if it does not involve the lobe bronchial openings, it is feasible to perform wedge sleeve lobectomy.

6. Total lung resection (generally try not to do right total lung resection): Where the lesion is extensive, with the above methods can not be resected foci, can be carefully considered for total lung resection.

7. Lumpectomy and reconstruction: when the lung tumor exceeds the main bronchus and involves the lump or the lateral wall of the trachea, but does not exceed 2 cm:

① Lumpectomy and reconstruction or sleeve total pneumonectomy can be performed;

② If one lobe of the lung is still retained, then it will be retained, and the surgical procedure can be determined according to the prevailing situation. Anesthesia: generally endotracheal intubation, general anesthesia is appropriate, if there is more bleeding and secretion, should be double lumen tube intubation, to ensure that the airway is open.

(5) Surgical treatment of recurrent or recurrent lung cancer

8. Treatment of multiple primary lung cancers: if the diagnosis is multiple primary lung cancers, the principle of treatment is according to the second primary focus.

9. Management of recurrent lung cancer: the so-called recurrent lung cancer refers to the cancer foci occurring within the scope of the original surgical scar or the recurrence of intrathoracic cancer foci related to the primary foci, which is known as recurrent lung cancer, and the principle of treatment should be based on the patient's cardiac and pulmonary functions and whether it can be resected or not to decide the scope of surgery.

Radiation therapy

(1) The principle of treatment: radiotherapy is the best for small cell carcinoma, squamous cell carcinoma is the second, adenocarcinoma is the worst. However, small cell carcinoma is prone to metastasis, so it adopts the irradiation of large irregular field, and irradiation area should include mediastinal region of primary foci, bilateral supraclavicular region, and even the liver and the brain, and it should be supplemented with drug treatment. Squamous cell carcinoma has moderate sensitivity to radiation, local invasion is the main lesion, and metastasis is relatively small, so it is mostly treated with radical therapy, while adenocarcinoma has poor sensitivity to radiation and is easy to be metastasized in blood tracts, so it is less likely to be treated with simple radiation therapy. The sensitivity of the tumor to radiation is not only affected by the pathological type, but also affected by the size of the tumor, the degree of differentiation of the tumor cells, the proportion of tumor cell groups, and the situation of the tumor bed. Therefore, the development of radiotherapy plan should be carefully analyzed before weighing the pros and cons comprehensively, and should not be easy to draw conclusions.

(2) According to the purpose of treatment, radiotherapy is divided into radical treatment, palliative treatment, preoperative radiotherapy, postoperative radiotherapy and intracavitary radiotherapy, etc.

These two types of radiotherapy can be divided into two categories: radical treatment, palliative treatment and intracavitary radiotherapy.

11. Scope of radical treatment

(1) Early cases with contraindications to surgery or refusal of surgery, or petri dish a cases with lesions limited to 150cm2.

(2) Cardiac, pulmonary, hepatic, and renal functions are basically normal, and the blood leukocyte count is greater than 3×109/

12. Hemoglobin is greater than 100g/1. (3) KS ≥ 60 points, the plan should be carefully formulated beforehand and strictly implemented, do not easily change the treatment plan, even if there is a radiation response, should be the goal of eradicating the tumor.

13. Palliative care: The purpose of palliative care varies greatly, there is palliative care close to radical treatment to reduce the patient's pain, prolong the life and improve the quality of life; there is only to reduce the symptoms of patients with advanced stage and even cause comforting effect of the decompensation treatment, such as pain, paralysis, coma, shortness of breath, and hemorrhage, and the number of irradiation of the palliative care can be from a few to dozens of times, which should be determined according to the specific circumstances and conditions of equipment, but it must be done in a way that does not increase the patient's risk of cancer. The number of irradiations in palliative care can range from several to dozens of times, depending on the specific circumstances and equipment conditions, but must not increase the patient's pain as a principle, the treatment of a large radiological response or a decrease in the KS score may be appropriate to modify the treatment program, the treatment of decompensation of the irradiation of symptomatic areas, usually available in large doses less divided treatment.

14. Preoperative radiotherapy: aiming to improve the surgical resection rate and reduce the risk of tumor dissemination during surgery, for patients who have no difficulty in surgical resection, preoperative high-dose and low-division radiotherapy can be used; for patients who have huge tumors or invasive tumors, and who have difficulty in surgical resection, conventional segregated radiotherapy can be used, and the time between the surgery and the radiotherapy is usually around 50 days, and the maximum duration should not be more than three months.

15. Post-operative radiotherapy: used for preoperative underestimation and incomplete surgical resection of the tumor, the local residual foci should be marked with silver clips, so that radiotherapy can be accurately positioned.

16. Endoluminal short-distance radiotherapy: It is suitable for cancer foci limited to large bronchial tubes, and it can be used as a back-loading technique by placing the catheter in the bronchial foci through ciliopathic bronchoscopy, and then iridium (192Ir) is used for proximity radiotherapy, which can improve the therapeutic effect in conjunction with extracorporeal irradiation. In the past twenty years, chemotherapy has been developed rapidly and applied widely. From the current data at home and abroad, the therapeutic effect on small cell lung cancer, no matter in early or late stage, is more certain, and there are even a few reports of radical cure, and there is a certain therapeutic effect on non-small cell lung cancer, but it is only for palliative effect, which needs to be further improved, and in the recent years, chemotherapy's role in lung cancer is no longer limited to inoperable advanced lung cancer, and is often used as systemic treatment included in the comprehensive treatment of lung cancer. In recent years, the role of chemotherapy in lung cancer is no longer limited to inoperable advanced lung cancer, but often included in the comprehensive treatment of lung cancer as systemic treatment. (Due to the biological characteristics of small cell lung cancer, it is now recognized that chemotherapy should be preferred except for a few patients without intrathoracic lymph node metastasis.

17. Indications (1) Patients with small cell lung cancer diagnosed by pathology or cytology. (2)Those with KS score above 50-60. (3)Those with expected survival time of one month or more. (4) Those with age ≤70 years.

18. Contraindications (1)Those who are old and frail or malignant. (2)Those with serious dysfunction of heart, liver and kidney. (3)Those with poor bone marrow function, white blood cells below 3×109/L and platelets below 80×109/l (direct count). (4) With complications and infections fever, bleeding tendency, etc..

19. Commonly used program: except for special circumstances, monotherapy is generally not used, the international and national collaborative group in the clinic recommended more effective programs are: (1) CAO (Shanghai Chest Hospital). Cyclophosphamide 1000mg/m2 intravenously, Adriamycin 50-60mg/m2 intravenously on the first day, Vincristine 1mg/m2 intravenously on the first day, every three weeks on the first day, and every 2-3 weeks as a course of treatment (2) COMVP (National Society of Chemotherapy Collaborative Program) Cyclosporine 500-700mg/m2 intravenously on days 1, 8 Vincristine 1mg/ m2 intravenously on days 1 and 8 methotrexate 7-14mg/m2 intravenously or intramuscularly on days 3, 5, 10, and 12 onychoside 100mg/m2 intravenously on days 3-7 repeated every three weeks, 2-3 cycles for a course of treatment

20.ECHO (M, D, Auderson Hospital and Tumor Research Institute) onychoside 100mg. IV drip (3 hrs), days 3-5 cyclosporine 1000g/m2 IV drip (1 hr) day l adriamycin 60mg/m2 IV drip (15-30 min) day l vincristine lmg/m2 IV drip (15-30 min) days 1,8 every 3 weeks for 3 cycles

21. CMC (NCI/VA Shanghai Chest Hospital) cyclosporine 500mg/m2 IV once weekly x3 or 1000-1500mg/m2 IV the next day CCNU 50-70mg/m2 orally on an empty stomach on the first night aminoglutethimide 10mg/m2 IV push 2x weekly x6 or 30mg/m2 day 2 every 3 weeks for a cycle of 2-3 cycles For a course of treatment

22. CV (I, ESmith, 1987) carboplatin 300mg/m

23. Intravenous drip, the first day of the onychomycetin 100mg/m

24. Intravenous drip, days 1 to 3 every 4 weeks for a cycle, 4 cycles for a course of treatment for the pre-operative, post-chemotherapy, for those who can Surgery or chemotherapy after the reduction of the mass of patients with surgical conditions, should be as far as possible to the primary focus of excision, to remove the possibility of local recurrence, preoperative chemotherapy is generally 2 to 3 courses of treatment is appropriate, to prevent the lesion treatment is insufficient and due to the course of treatment caused by excessive fibrosis caused by the difficulties of the operation, preoperative chemotherapy for all have been clear that there are intrathoracic lymph node metastases need to be used, for stage I without intrathoracic lymph node metastasis whether to need to use preoperative chemotherapy Whether preoperative chemotherapy is needed for stage I patients without intrathoracic lymphatic metastasis is yet to be explored. Postoperative chemotherapy has a greater impact on the long-term survival rate after surgery, and must be emphasized and applied, and is generally favored to be used for more than 4-6 cycles. If chemotherapy is effective, but it is estimated that the surgery can not be resected cleanly and the lesions found during the operation can not be cut cleanly, regional radiotherapy should be given as well. Chemotherapy for non-small cell lung cancer is effective for non-small cell lung cancer, although there are a lot of effective drugs, but the efficiency is low and seldom can achieve complete remission.

25. Indications: (1) Patients with squamous carcinoma, adenocarcinoma or large-cell carcinoma confirmed by pathology or cytology, but inoperable stage III and postoperative recurrence and metastasis, or patients in stage I and II who are ineligible for surgery for other reasons. (2) Those who have the following conditions in pathological examination after surgical exploration: (1) residual foci; (2) lymph node metastasis in the chest; (3) cancer embolus in lymphatic vessels or thrombus; (4) poorly differentiated carcinoma. (3) Local chemotherapy is needed for those with pleural or pericardial effusion.

26. Contraindication: same as small cell carcinoma

27. Commonly used regimen: the effective rate of single-agent treatment for non-small cell lung cancer is very low, so combination chemotherapy should be used, (1) CAP: cyclophosphamide 400mg/m2 intravenously, adriamycin 40-50mg/m2 intravenously on day 1, cisplatin 40-80mg/m2 intravenously on day 1, and then every three weeks for a cycle of 2 to 3 weeks. three weeks for a cycle, 2-3 cycles for a course of treatment before injecting cisplatin, give the patient infusion of 5% dextrose solution 500ml ten 5% glucose saline 500m

28. then cisplatin titrated in l to 2 hours, half an hour after the oral tachycardia 20mg, and continue to titrate the Ringer's solution 500mI and 10% potassium chloride 10m

29. in order to prevent and alleviate the vomiting, it can be Simultaneous drops of dexamethasone 5-10mg, intramuscular or intravenous methotrexate (total 40-90mg). (2) MFP: mitomycin 5-6mg/m

30. Intravenous drip, 1st, 15th, 29th day fluorouracil 500mg intravenous drip, 10th, 12th, 17th, 19th, 3lth, 33rd, 38th, 40th day cisplatin 30mg intravenous drip, 3rd to 5th day, 24th to 26th day every 6 weeks as a cycle, and every 2 to 3 cycles for one course of treatment (3) CAMB cyclophosphamide 500-700 mg/m

31. Intravenous, days l, 8, 15, 22, 29, 36 adriamycin 40 mg/m2 intravenous drip, days l, 22 aminoglutethimide 7-14 mg/m2 intravenous drip, days 10, 12, 17, 19, 31, 33, 38, 40 pingyangmycin 10 mg , intramuscular injection, day 3,

32.ll, 13, 17, 19, 24, 26, 31, 33, 38, 40 days every 6 weeks as a cycle, 2 to 3 cycles for - course of treatment. (4) PE: onychomycetin 100 mg intravenously, cisplatin (DDP) 80 mg/m on days l-5

33. Intravenously, hydrated on day l, every 4 weeks for a course of treatment. There is also a combination of adriamycin 50mg/m

34. Intravenous injection, the second day of the thoracic cavity and pericardial cavity injection, should be as much as possible to drain the fluid and then injected into the drug. However, in order to prevent mediastinal swaying, each pumping to not more than 1000m1 for proper, usually every 5 ~ 7 days pumping once, more than 3 times no effect to change the drug, moderate or more fluid should be made for occlusive drainage or inserted into a fine silicone tube with water to seal the bottle drainage, to be injected into the drug when the liquid is drained, and then clamped, 24 ~ 48 hours after the removal of the tube, the drugs can be selected are: (1) Immunomodulators: Corynebacterium shortum (CP) 7mg dissolved in saline 40~60ml, about 80% of patients can be effective after one injection. (2) Chemotherapeutic drugs: ①MBP: mitomycin 5~6mg/m

35. capacity in saline 20~40ml. Pingyangmycin: 10~20mg, dissolved in saline 20~40ml. Cisplatin: 50~80mg dissolved in saline 20~40ml. ② CP: CTX500mg/m

36. dissolved in saline 20-40ml. DDP50mg/m2 dissolved in saline 20-40ml. The above drugs can be injected into the thoracic cavity in combination or as a single drug, and when a single drug is used, the dose can be increased by l/

37. After injection, the patient should be instructed to rest in bed and change the position every 5 to 10 minutes so that the drug can be evenly distributed and in full contact with the pleura, and the drug injected into the pericardial cavity should be appropriately reduced by l/3 of the dosage, or choose the drug that has a milder local reaction, and the commonly used drugs are tiotropium 40-60mg/dose or DDP50mg/dose, which are often used in the treatment of the chest cavity. DDP50mg/time, many patients in the injection of drugs l ~ 3 times after the pleural effusion can be expected to control, the pericardial effusion can also have a certain effect.

(III) Precautions for chemotherapy of lung cancer

38. At present, chemotherapy of lung cancer generally cannot achieve radical cure, therefore, at a certain stage of chemotherapy, it should be combined with surgery or radiotherapy when possible, in order to strengthen the local or regional control of tumor, at the same time, chemotherapy should be given in higher doses as far as possible according to the patient's tolerance, and a certain degree of gastrointestinal tract reaction and bone marrow suppression are unavoidable in the case of chemotherapy of lung cancer. For lung cancer chemotherapy, a certain degree of gastrointestinal reaction and bone marrow suppression is unavoidable, and the number of courses of treatment should be increased appropriately according to the patient's response and therapeutic efficacy, in order to achieve complete remission as far as possible.

39. The interval of treatment course, because the toxic effect of existing drugs can be continued for several weeks after stopping the drugs, each week should be carried out at intervals of 4-6 weeks from the beginning of chemotherapy, but the toxic effect of the drugs must be disappeared before using the next course of treatment.

40. Indications for stopping or changing drugs during chemotherapy.

(1) The lesion is still progressing after 1 or 2 courses of treatment, or has stabilized but deteriorated again during the rest period.

(2) Toxic reactions of grade 3 to 4, a certain threat to the patient's health.

(3) Complications occur, such as fever >38 degrees, or bleeding tendency.

(4) Rapid deterioration of the patient's general condition with malignancy.

Fourth, chemotherapy for complications of lung cancer

(1) Chemotherapy for superior vena cava syndrome, if surgery can be performed, every effort should be made to strive for surgery, and the superior vena cava can be repaired or replaced, but unfortunately most of the patients are in the advanced stage and have lost the chance of surgery. If patients have acute superior vena cava obstruction, they should be given rapid and effective anticancer drugs immediately, and large-dose shock therapy is feasible, such as cyclophosphamide, nitrogen mustard, adriamycin, which can be used singly or in combination with chemotherapy, and radiotherapy should be carried out successively, and it should be noted that radiotherapy should not be carried out firstly in the acute stage and then followed by chemotherapy, because radiotherapy can cause tissue edema, superior vena cava obstruction aggravation, aggravation of symptoms and even asphyxiation. In the acute stage, adrenocorticotropic hormone can be used appropriately, such as hydrocortisone 100-200mg intravenous drip, or prednisone 5-10mg orally, and at the same time, diuretics can be given, most patients can be relieved, but the median survival is only 2-5 months.

(2) Chemotherapy for brain metastasis of lung cancer: The best treatment for brain metastasis is local radiation therapy, but if there is no metastasis in other parts of the body and the intracranial metastasis is a single lesion, then craniotomy can be performed with chemotherapy and radiotherapy, and there is a case of brain metastasis in a postoperative patient of lung cancer, who was operated to resect the metastasis after the operation, and has now been survived for 18 years with chemotherapy and radiotherapy. The systemic medication for brain metastasis also depends on the cell type, but it depends on whether the drugs can pass through the blood-brain barrier, such as bis-chloroethylnitrosourea, cyclohexylnitrosourea and other fat-soluble drugs can pass through the blood-brain barrier, which has therapeutic effect on brain metastasis, and the use of corticosteroids can alleviate the symptom of cerebral edema, but the continuous use of the drugs may influence the patient's survival time, if the metastasis is unilateral, the patient may be treated with the cannulation of the internal carotid artery (via superficial carotid or superior thyroid artery). If the metastasis is unilateral, the internal carotid artery can be cannulated (via superficial carotid artery or superior thyroid artery) for drip infusion of fast-acting anticancer drugs.

(3) Chemotherapy for pleural effusion caused by lung cancer: 1% of patients with lung cancer have pleural effusion at the time of diagnosis, and there is no surgical indication, at this time, only chemotherapeutic drugs can receive temporary curative effect, and the more commonly used drugs are as follows:

41. Nitrogen mustard: under aseptic operation, the fluid in the chest cavity is drained as much as possible (there is also a fine catheter placed), and the fluid is diluted with 200m1 of saline at 0.4mg/kg and injected into the chest cavity at one time, the maximum amount of which is not more than 20mg at one time, and the patient is allowed to change the position in many directions immediately after injection for about 15 minutes to ensure that the drug is evenly distributed to all the internal surfaces of the chest cavity.

42. adiponectin: its response rate of about 64% to 88%, the drug can make the pleural cavity inflammation adhesions, gap disappearance, the beginning of the available 50 to 100mg dissolved in lomI saline injected into the chest, if the patient's reaction is not heavy, every 2 to 5 days and then injected into the 100 to 200mg until the liquid is reduced, but also can be used to 600 to 800 mg single injection, the main reactions are The main reactions are fever, localized pain, and hypotension in some patients.

43. Tetracycline: Tetracycline is used as a sclerosing agent in the treatment of carcinoma pleural effusion, generally in the thoracic cavity to place a closed catheter, 500 mg of tetracycline dissolved in 30 ml of saline injected into the thoracic cavity, and then injected into the cleaning tube with 10 m1 of saline, clamped closed catheter for 6 hours and at the same time, constantly change the position, and then the drain tube for about 4 hours to determine the absence of fluid before removing the drain tube. It was reported that when the patient was ineffective on other drugs (nitrogen mustard, etc.), the fluid growth was successfully controlled by this method for 3 to 19 months, and Satoru Kitamura also reported that the fluid could be completely disappeared by using doxycycline 500mg, intrapleural injections 2 to 3 times within 2 weeks.

44. Others: Zithromax is more effective for pleural effusion caused by adenocarcinoma, and the amount of one time of intrapleural injection is 6~12mg, in addition, it can also be used as 30~40mg/time of tumor eliminating mustard, 750~1000mg/time of 5-fluorouracil, and there are also colloidal gold (198Au), colloidal phosphorus (32P), and polio vaccine, Ⅱ, Ⅲ cowpox vaccine, and so on. Prognosis: Although great progress has been made in the treatment of lung cancer, such as the integrated treatment of surgery, radiotherapy and chemotherapy, and the introduction of new anticancer drugs, the prognosis of lung cancer is still poor, the 5-year survival rate of treated lung cancer patients is 14%, while it was 11% 30 years ago, the high mortality rate of lung cancer is mainly due to the lack of early diagnosis and effective treatments, and even if it is an early-stage patient, most of the patients at the time of the initial diagnosis are already for systemic diseases. Factors affecting the prognosis of lung cancer include age, location, staging and typing, while the effect of surgery and chemotherapy on the tumor is a human-controlled factor. Early-stage lung cancer that is central or invades the dirty pleura has a poorer prognosis, and it is currently believed that, since lung cancer most often recurs 2-3 years after surgery, the number of follow-ups should be increased in this period, and within the first two years after surgery, on average, the patient should be rechecked 3-4 times with X-ray chest radiography, and within the following 2-3 years, the patient should be In the next 2 to 3 years, 2 follow-ups with X-ray chest radiographs should be performed, and usually blood CEA, bronchoscopy, CT and bone scanning should be used only when clinically indicated.

Other diseases (complications) caused by lung cancer surgery:

Certain complications often occur after lung cancer surgery, which are closely related to the factors of the patient's own body and the scope and mode of surgery. Common post-surgical complications and their prevention and treatment methods are as follows:

(1) Respiratory complications: such as sputum retention, pulmonary atelectasis, pneumonia, respiratory insufficiency and so on. In particular, the morbidity rate is higher in the old and weak, the original chronic bronchitis and emphysema. Due to postoperative wound pain, patients cannot cough effectively, and sputum retention causes airway obstruction, pulmonary atelectasis, and respiratory insufficiency. Prevention lies in the patient's full understanding and cooperation, active preparation for surgery, encouragement and supervision of deep breathing and coughing after surgery in order to effectively expel sputum, if necessary, nasal catheter sputum or bronchoscopic sputum aspiration. If the patient has pneumonia, he should be actively treated with anti-inflammatory therapy, and when respiratory failure occurs, he often needs mechanical assistance in breathing.

(2) post-surgical hemothorax, pyothorax and bronchopleural fistula: its incidence is very low. Post-operative hemothorax is a serious complication that requires emergency treatment, and if necessary, should be promptly re-opened to stop bleeding. During lung surgery, bronchial or intrapulmonary secretions contaminate the chest cavity and lead to pus chest. At this time, in addition to choosing effective antibiotic treatment, timely and thorough thoracocentesis pus extraction is extremely important. If the effect is not good, closed chest drainage can be considered. After lung resection, the bronchial stump can be retained by cancer, hypoproteinemia and improper surgical operation, which may lead to poor healing of bronchial stump or fistula formation after surgery. In recent years, the occurrence of such complications has been greatly reduced.

(3) cardiovascular system complications: old age and frailty, the mediastinum and pulmonary portal pulling stimulation, low potassium, low oxygen and hemorrhage during surgery often become its triggers. Common cardiovascular system complications include postoperative hypotension, arrhythmia, pericardial tamponade, and heart failure. For the elderly patients, cardiac disease before surgery, cardiac function is low surgical indications should be strictly controlled. The surgeon should pay attention to the gentle operation. After surgery, keep the airway open and give sufficient oxygen, closely observe the blood pressure and pulse changes, and replenish blood volume in time. After surgery, the infusion rate should be slow and balanced to prevent too fast and too much induced pulmonary edema. At the same time for cardiac monitoring, once found abnormal, according to the condition of timely treatment. Elderly patients are often associated with hidden coronary artery disease, surgical trauma of a variety of stimuli can be prompted by an acute attack, but in the clinical division of close supervision and timely treatment can be turned into a safe.

Dietary care for lung cancer:

(1) Honey Lung Cough Pill: Lupus, stiff silkworms, honey. The 3 flavors of the medicine is powdered, and the honey is made into pills. 2 times a day, 6 grams each time.

(2) licorice, pear and pig lungs: licorice 10 grams, pear 2, pig lungs about 250 grams. Pear peeled and cut into pieces, pig lungs washed and cut into slices, squeeze the foam, and licorice with the casserole. Add a little rock sugar, water, moderate amount of small fire simmers 3 hours after taking. 1 time a day.

(3) rock sugar almond paste: 15 grams of sweet almonds, 3 grams of bitter almonds, 50 grams of round-grained rice, rock sugar. Sweet almonds and bitter almonds with water soaked soft peel, pounded with round-grained rice, water and rock sugar cooked into thick porridge, every other day.

(4) white fruit date porridge: 25 grams of white fruit, 20 jujubes, 50 grams of glutinous rice. Fruit, jujube, glutinous rice *** with porridge into. Morning and evening fasting warm service, have detoxification and swelling.

(5) dahurica stewed bird's nest: 9 grams of dahurica, bird's nest 9 grams, rock sugar. The dahurica, bird's nest stewed in water until extremely rotten, filtered slag. Add an appropriate amount of rock sugar seasoning and then stew for a few moments into, 1 ~ 2 times a day. It has the effect of tonifying the lung and nourishing yin, stopping cough and stopping bleeding.

(6) ginkgo steamed duck: 200 grams of white fruit, white duck 1. Fruit shell, boiled in boiling water, peeled, pistil, and then blanched in boiling water and mixed into a good kill boneless duck. Add broth, steam for 2 hours until the duck is cooked and eaten. It can be consumed regularly, with the function of replenishing deficiency, calming asthma, inducing diuresis and reducing swelling. It is suitable for those who have advanced lung cancer with wheezing and weakness, generalized weakness and much phlegm.

(7) Stewed meat with Schisandra chinensis: 50 grams of Schisandra chinensis, duck meat or pork lean meat in appropriate amount. The schizandra and meat steamed or stewed together, and add seasonings as appropriate. Meat, medicine and soup are served to replenish the lung and benefit the kidney, relieve cough and asthma, which is suitable for patients with kidney deficiency type of lung cancer.

(8) Lotus seed chicken: 15 grams of lotus seed ginseng, chicken or duck, pork, appropriate amount. Lotus seed and meat *** stewed, add seasoning appropriately. Taken regularly, it replenishes the lung, benefits qi, and generates fluids. It is suitable for people with insufficient qi and blood in lung cancer.

(9) winter melon skin broad bean soup: 60 grams of winter melon skin, 60 grams of winter melon seeds, 60 grams of broad beans. The above food into the pot with 3 bowls of water fried to 1 bowl, and then add the appropriate seasoning that is, slag drink. Effective in removing dampness, inducing diuresis and reducing swelling. It is suitable for people with pleural fluid in lung cancer.

What kind of food is good for lung cancer patients:

(1) Eat more food with the function of enhancing body immunity and resisting lung cancer, such as Job's tear grains, sweet almonds, lozenge, oyster, jellyfish, yellow croaker, sea turtles, crabs, horseshoe crabs, arkshells, sea cucumber, Poria, Chinese yam, jujubes, otoro, green soybeans, shiitake mushrooms, walnuts and turtle.

(2) cough and phlegm should eat white fruit, radish, mustard, almonds, orange peel, loquat, olives, orange cake, jellyfish, water chestnuts, kelp, nori, winter melon, loofah, sesame seeds, figs, pine nuts, walnuts, tamarind, rosella, peaches, oranges, pomelo and so on.

(3) fever should eat cucumber, winter melon, bitter melon, lettuce, eggplant, hairy greens, lily, amaranth, chestnut, water spinach, water spinach, stone cauliflower, amaranth, plum, watermelon, pineapple, pears, persimmons, oranges, lemons, olives, mulberries, water chestnuts, ducks, mackerel.

(4) hemoptysis should eat plums, lotus root, sugar cane, pears, cotton, jellyfish, sea cucumber, lotus seeds, diamonds, kelp, mustard wheat, black beans, tofu, chestnuts, eggplant, milk, crucian carp, turtles, carp, squid, yellow croaker, snapper, oysters, tamarind.

(5) eat to reduce the side effects of radiotherapy, chemotherapy food: goose blood, mushrooms, shark, cinnamon, eel, walnuts, turtle, turtle, kiwi, Brasenia schrebergeri, golden broccoli, jujubes, sunflower seeds, apples, carp, mung beans, soybeans, adzuki beans, shrimp, crabs, silver beans, loach, pond lice, grass carp, mahi-mahi, green tea, snails.

(6) Eat fruits, vegetables, and coarse cereals daily;

Foods avoided for lung cancer:

(1) Quit smoking, which is the most effective way to prevent lung cancer.

(2) Drink less strong alcohol.

(3) Do not eat moldy and spoiled food, and eat less pickled food.

(4) When eating, chew and swallow slowly, do not eat too hot food.

(5) Avoid spicy and irritating foods: onion, garlic, chives, ginger, pepper, chili, cinnamon, etc..

(6) Avoid frying, barbecue and other hot foods.

(7) Avoid greasy, sticky phlegm-producing food.

(8) fat intake is not too much, intake control in the intake of total calories below 30%, that is, the daily diet of animal and plant fat 50g ~ 80g; eat more fresh vegetables and fruits, the daily supply of 10g of fiber and general level of vitamins.

(9) eat less smoked food.