Elderly lung cancer

　　The occurrence of elderly lung cancer is related to smoking, occupation, air pollution, diet, and other factors, and its specific causes of onset are described as follows.

　　1. Smoking

　　It is currently believed that smoking is the most important high-risk factor for lung cancer, and there is a significant dose-effect relationship between the amount of smoking and lung cancer. The younger the age of starting smoking, the longer the duration of smoking, and the greater the amount of smoking, the higher the incidence and mortality rate of lung cancer. Passive smoking or environmental smoking is also one of the causes of lung cancer.

　　2. Occupational factors

　　In industrial production, exposure to special substances related to the occurrence of lung cancer includes asbestos, arsenic, chromium, benzopyrene, tar, trichloromethane, the heating products of tobacco, and radioactive substances such as radon and radon gas produced by the decay of radium and uranium, ionizing radiation, and microwave radiation, etc. These factors can increase the risk of lung cancer.

　　3. Air pollution

　　The incidence of lung cancer in developed countries is high, mainly due to the pollution of the atmosphere by harmful substances such as benzopyrene carcinogens produced by the combustion of oil, coal, and internal combustion engines in developed industrial and transportation areas, and the dust of asphalt roads. Air pollution and smoking may promote the incidence of lung cancer, and have a synergistic effect.

　　4. Diet

　　Some studies have shown that people with low levels of beta-carotene in serum have a higher risk of lung cancer.

　　5. Other risk factors

　　Certain lung diseases are related to the occurrence of lung cancer. For example, the incidence of lung cancer in patients with chronic bronchitis is twice as high as that in patients without the disease; adenocarcinoma may occur in scar tissue of healed tuberculosis foci. In addition, viral and fungal infections, genetic factors may also be related to the occurrence of lung cancer.

　　The main complications of elderly lung cancer include atelectasis, obstructive pneumonia, superior vena cava syndrome, and tumor associated syndrome, etc. The specific complications are described as follows.

　　1. Atelectasis:If lung cancer patients develop infection, it is easy to cause pleural adhesion, leading to atelectasis of the lung.

　　2. Obstructive pneumonia:The distal part of the terminal bronchioles (including respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli) are dilated, and there is also destruction of the air cavity wall.

　　3. Superior vena cava syndrome:It is a syndrome caused by the partial or complete obstruction of the blood flow returning to the right atrium through the superior vena cava, which is a common emergency of the tumor.

　　4. Tumor associated syndrome.

　　The clinical manifestations of elderly lung cancer patients are mostly related to the development process of the primary lesion and the location of the tumor, the size of the tumor, the influence on the bronchus, whether the adjacent trachea is invaded or compressed, whether there is metastasis to distant organs, and whether there is ectopic endocrine characteristics, etc., resulting in various different clinical manifestations. The specific manifestations are described as follows.

　　I. Symptoms

　　1. Cough:It is mainly caused by the stimulation of the bronchial mucosa by the tumor or its secretions, which is usually the first symptom of lung cancer, and is more prominent in central lung cancer. Paroxysmal刺激性cough occurs when the tumor grows infiltratively along the bronchial wall, also known as dry cough, without sputum or with a small amount of white frothy mucus. After mixed infection, the sputum may become purulent, and the amount of sputum may also increase. If the tumor is located on the mucosa of the small bronchus, there is often no cough or cough is not obvious, so there are fewer cases of peripheral lung cancer with cough as the first symptom than central lung cancer.

　　2. Hemoptysis and blood-tinged sputum:Hemoptysis is one of the initial symptoms of lung cancer, with 35.9% of patients having hemoptysis as the initial symptom. The characteristic is intermittent, recurrent, small amounts of blood-tinged sputum, often with more blood than sputum, bright red in color, and occasionally with massive hemoptysis, with varying durations, generally short, only a few days, but some can last for several months. In the course of the onset of central lung cancer, due to the tumor growing on the bronchial mucosa, the surface vessels are rich, and when there is a severe cough, the vessels rupture, so hemoptysis often appears in the early stage of central lung cancer. In peripheral lung cancer, hemoptysis is rare when the tumor is small, but when the tumor grows to a certain extent, the tumor center becomes ischemic and necrotic, accompanied by bleeding.

　　3. Fever:Lung cancer accounts for 21.2% of cases with fever as the initial symptom. Fever is divided into two types: one is inflammatory fever caused by bronchial obstruction or compression of the lumen, and central lung cancer often causes infection fever due to the blockage or narrowing of a large bronchus by the tumor, leading to retention of sputum secretions in the distal bronchus. Some lung cancer patients have difficulty explaining the cause of fever with the above reasons, even after anti-inflammatory treatment, the fever does not subside, which is what is called cancerous fever. Clinically, it is often seen that lung cancer patients present with fever or so-called infection, and are treated with the diagnosis of 'intrapulmonary infection' after X-ray examination, and temporary effects can be achieved, but when X-ray re-examination is performed, the intrapulmonary shadow will not completely disappear. In addition, if a patient has recurrent pneumonia in the same location, one should highly suspect the possibility of bronchial lung cancer.

　　4. Chest pain:In the early stage of lung cancer, there may be intermittent chest tightness, pressure, or dull pain, which may be due to the invasion of the tumor into the tissue. Bronchial obstruction leads to atelectasis, causing traction of the parietal pleura, which may cause reflexive chest pain. Among patients with peripheral lung cancer, 24% seek medical attention with initial symptoms such as chest pain, back pain, shoulder pain, upper limb pain, and intercostal neuralgia, so one should not easily treat it as periarthritis of the shoulder joint, cervical spondylosis, or neuralgic chest pain. It is necessary to be vigilant about the possibility of intrapulmonary lesions.

　　5. Chest tightness and shortness of breath:When the tumor is at the orifice of the lobar bronchus or main bronchus, the large bronchus is suddenly blocked. Although the disease is not in the advanced stage, symptoms such as chest tightness and shortness of breath may occur. Diffuse small bronchiole-alveolar carcinoma and bronchial disseminated adenocarcinoma also often present with shortness of breath, with the former being more severe, as the alveolar epithelium has become cancer cells, resulting in serious maladjustment of ventilation/blood flow ratio and diffusion dysfunction.

　　6. Lymph node enlargement on the clavicle and hoarseness:Lymph node metastasis on the same side or opposite side of the clavicle indicates extensive metastasis of lymph nodes in the mediastinum, undoubtedly belonging to the advanced stage. Paralysis of the vocal cords and hoarseness are due to mediastinal lymph node metastasis of lung cancer or direct invasion of the recurrent laryngeal nerve by the tumor. In the past, it was believed that such patients belong to stage III lung cancer and are not suitable for surgery. However, many scholars today advocate that surgery is still possible.

　　7, Superior vena cava syndrome:When the tumor directly invades the superior vena cava or metastatic lymph nodes compress the superior vena cava and the azygos vein, venous return is obstructed, which can cause symptoms such as dizziness, blurred vision, chest tightness, and edema of the head and neck. Physical examination may show swelling and edema of the face and neck, conjunctival congestion, edema, cyanosis of the lips, and dilatation of veins in the neck and chest wall.

　　8, Involvement of the cervical sympathetic ganglion and brachial plexus:It is more common in lung apex cancer. When the tumor invades the sympathetic ganglion near the lateral side of the 7th cervical vertebra and the 1st thoracic vertebra, it can cause Horner's syndrome, manifested as ptosis of the affected eyelid, indentation of the eye, constriction of the pupil, and narrowing of the palpebral fissure. At the same time, it can also produce symptoms of brachial plexus compression, with severe burning pain in the upper limb starting from the inner side of the armpit and radiating to the distal part, with abnormal skin sensation locally.

　　9, Pleural metastasis:It is more common in undifferentiated cancer and adenocarcinoma, with squamous cell carcinoma being less common. It is the result of direct invasion or implantation of lung cancer, and the diagnostic measures are needle aspiration and fluid cytology. Clinically, it often manifests as rapid growth of pleural effusion, which increases again within 2-3 days after aspiration, and cancer cells can often be found in bloody pleural effusion. Non-bloody pleural effusion cannot be ruled out as cancer, which may be due to a few cancer foci in the pleura.

　　10, Bloodborne metastasis:Bloodborne metastasis commonly occurs in bones, liver, and brain, followed by kidneys, adrenal glands, and subcutaneous tissues.

　　(1) Bone metastasis:Commonly affected bones include ribs, vertebrae, skull, iliac bones, sacral bones, etc., among which rib metastasis is the most common, with local pain appearing earliest, often 1-2 months before bone destruction, and turning into severe and stubborn local pain. Spinal metastasis can compress or invade the spinal cord, causing paraplegia.

　　(2) Liver metastasis:Manifested as decreased appetite, nausea, weight loss, pain in the liver area, and sometimes jaundice. The main characteristics of diagnosis are the progressive enlargement of the liver within a short period of time, the disappearance of the normal contour, inconsistent flexibility, nodules upon palpation, and metastatic foci larger than 2cm. Ultrasound and CT can be used to detect it, and serum alkaline phosphatase may show progressive increase, often exceeding 20 units of gold A, gamma-glutamyl transpeptidase (γ-GT) may be positive, alanine aminotransferase and other liver function changes are not obvious, and most patients die within a short period of time.

　　(3) Brain metastasis:The prognosis is extremely poor, with increased intracranial pressure being more common, often accompanied by severe headache, projectile vomiting, or vertigo. After metastasis to the posterior cerebellum, ataxia may occur, with positive finger-nose and eye tests, patellar reflex tests, and sometimes hemiplegia, delirium, nystagmus, diplopia, and other symptoms. In a few cases, symptoms such as hallucinations, delusions, and personality changes may occur, and sometimes the first symptom may be convulsions and sudden fainting. CT and MRI are helpful for diagnosis.

　　(4) Renal, adrenal, and subcutaneous metastasis:Adrenal转移 may cause Addison's syndrome, and subcutaneous转移 may cause subcutaneous nodules.

　　Symptoms outside the lung

　　Abnormal hormones and substances secreted by lung cancer have been discovered, including adrenocorticotropic hormone (ACTH), antidiuretic hormone (ADH), gonadotropin (GTH), calcitonin (CT), serotonin (γ-HT), insulin-like substances, renin-like substances, and others, which can cause corresponding clinical manifestations.

　　1, Carcinoid syndrome: It is caused by serotonin (5-hydroxytryptamine) and manifests as symptoms such as flushing of the skin, diarrhea, edema, wheezing, and paroxysmal tachycardia, as well as acanthosis nigricans and dermatomyositis, hyperkeratosis of the palmoplantar skin, scleroderma, and extrapulmonary manifestations such as thrombophlebitis, nonbacterial thrombotic endocarditis, thrombocytopenic purpura, and capillary hemolytic anemia.

　　2, Cushing's syndrome: It is the result of undifferentiated cell carcinoma secreting adrenocorticotropic hormone, with clinical manifestations of central obesity, striae, polycythemia, and osteoporosis, etc., with a few cases showing sufficient manifestations, as the activity of the large molecular weight ACTH secreted by the cancer cells is only 1/10 of that of the pituitary ACTH. To differentiate, attention must be paid to other abnormal metabolic manifestations, such as hypokalemia with hypochloremic alkalosis, elevated blood glucose levels, and diabetes, etc.

　　3, Undifferentiated cell carcinoma: Particularly oat cell carcinoma can secrete antidiuretic hormone (ADH), causing inappropriate 'antidiuretic hormone secretion syndrome', which is characterized by hyponatremia with low osmolality, clinical manifestations of hyponatremia and water intoxication, severe cases with cerebral edema, persistent sodium excretion in urine without renal or adrenal insufficiency, and treatment must include limiting water intake and the use of diuretics.

　　4, Some lung cancers produce ectopic prostaglandins, which may cause hypercalcemia, common in squamous cell carcinoma, with symptoms such as drowsiness, anorexia, nausea, vomiting, weight loss, and changes in mental state.

　　5, Ectopic gonadotropin syndrome: The main manifestation is male breast development and precocious puberty, menstrual disorders in women, and multiple ovarian cysts, with increased levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in plasma.

　　6, Ectopic growth hormone syndrome: The main manifestation is primary pulmonary hypertrophic osteoarthropathy, swelling and pain in the limbs, periosteal hyperplasia, acropachy (acropodium) and acromegaly, etc., with plasma growth hormone up to 20mg/ml, while the normal range is (5～9)μg/ml.

　　7, In addition, there are some special manifestations, such as the nervous and muscular system: cerebellar cortical atrophy, ataxia, encephalopathy, dementia, nystagmus, myasthenia gravis, and polyneuritis, etc.

　　Three, Signs

　　Early lung cancer chest examination may show partial airway obstruction and signs of lung infection, such as localized or unilateral wheezing and dry or moist rales, weakened or absent lung breath sounds, and dull or resonant percussion sounds, indicating partial or complete atelectasis and involvement of the pleura. When the tumor infiltrates and grows into extrapulmonary tissues and organs, palpable enlargement of axillary or supraclavicular lymph nodes may be found. When mediastinal lymph nodes enlarge and compress the superior vena cava, symptoms such as facial and upper extremity edema, neck swelling, and dilated jugular veins may occur. Lung apex lung cancer, which compresses the cervical sympathetic nerve, can cause symptoms such as miosis, ptosis of the upper eyelid, and hypohidrosis on the forehead. In the late stage of lung cancer, the formation of intracranial, bone, and abdominal organ metastases can lead to symptoms such as neck stiffness, hemiparesis, cerebellar orientation and dysfunction, neuromuscular lesions, disturbance of consciousness, fractures, jaundice, ascites, and systemic symptoms. Chronic consumption can lead to anemia, peripheral edema, and cachexia.

　　Be vigilant about the possibility of lung cancer when the following symptoms appear.

　　1. Irritating cough lasting for 2 to 3 weeks without treatment; or if there is a chronic cough with a change in cough character.

　　2. Persistent blood-streaked sputum that cannot be explained by other reasons.

　　3. Local wheezing, no change after coughing.

　　4. Recurrent pneumonia in the same location.

　　5. Unexplained lung abscess, with poor anti-inflammatory effect, no foreign body aspiration trigger, no toxic symptoms, and a large amount of sputum.

　　6. Unexplained joint pain in the limbs and clubbing (toes).

　　7. Local emphysema on X-ray, segmental and lobar atelectasis, solitary round lesions, and unilateral hilum shadow thickening and enlargement.

　　8. The original stable pulmonary tuberculosis lesions, in which the shadow expands instead during treatment, or eccentric cavities form, or new lesions appear, and sputum examination is negative.

　　9. Migratory, embolic lower limb phlebitis of unknown cause.

　　The elderly with lung cancer should take three-level preventive measures for early detection, early diagnosis, and early treatment. The specific preventive measures are as follows.

　　First, the third level of prevention

　　1. Primary prevention:Also known as etiology prevention. It is a set of preventive measures taken against the etiology and risk factors. The research on the prevention and treatment of lung cancer holds an extremely important position in epidemiology, etiology, and early diagnosis and treatment. Establishing research institutions for the prevention and treatment of lung cancer, vigorously carrying out publicity and education on the prevention and treatment of lung cancer, adopting various forms of publicity, and popularizing knowledge about the prevention and treatment of lung cancer. Strengthening the control of known carcinogenic factors: formulating environmental protection regulations, establishing monitoring institutions for air pollution, strictly controlling industrial three wastes pollution in order to achieve the goal of reducing air pollution. The issue of radiation pollution should also be strictly controlled. Controlling smoking, vigorously publicizing the danger of smoking causing lung cancer. Prohibiting minors from smoking, prohibiting smoking in public places or poorly ventilated enclosed rooms, conducting regular checks on heavy smokers with a smoking index (the product of the number of cigarettes smoked daily and the number of smoking years) above 400, establishing follow-up cards for the three preventions (prevention of cancer, tuberculosis, and pneumoconiosis); adopting various forms of publicity to explain that quitting smoking can reduce the incidence of lung cancer, encouraging people to quit smoking, especially among workers exposed to occupational lung cancer factors, making them realize that smoking and occupational carcinogenic factors have additive or even multiplicative effects. Conducting epidemiological surveys on occupational lung cancer, reforming technological processes, doing a good job in smoke, dust, and pollution prevention, and to the maximum extent limiting and avoiding the exposure of workers and engineering and technical personnel to known occupational carcinogenic substances. In terms of diet, it is recommended to frequently consume vegetables rich in vitamin A and vitamin C, such as carrots and spinach, as well as pumpkins and fresh chili peppers, which also have a certain effect on preventing the occurrence of lung cancer.

　　2. Second-level prevention:Due to the long preclinical period of lung cancer, with atypical symptoms and signs, it is very necessary to carry out a general survey of lung cancer among people over 40 years old who have smoked for a long time, and those who are exposed to carcinogenic substances in their occupation. The methods of general survey can be divided into three types: imaging examination, that is, chest X-ray examination, aiming to check once a year; cytological examination, that is, sputum cytology examination, a series of sputum specimens with 3 or more times can increase the diagnostic rate of central lung cancer to 80%; serological examination, such as the levels of hormones, enzymes, antigens, and carcinoembryonic antigen (CEA). The positive rate of CEA in lung adenocarcinoma is 60% to 80%, and it can be considered as a serum marker for small cell lung cancer.

　　3. Third-level prevention:Chronic inflammation of the respiratory tract and other chronic respiratory diseases can all cause squamous metaplasia of the tracheal epithelium. Therefore, actively preventing and treating precancerous conditions and precancerous lesions is of certain significance in preventing lung cancer.

　　Second, risk factors and intervention measures

　　1. Through a large amount of research work on the epidemiology and etiology of lung cancer, it is fully reflected that the occurrence of lung cancer is closely related to environmental factors. Therefore, controlling and eliminating known carcinogenic factors in the internal and external environment of the human body may reduce the incidence and mortality rate of lung cancer. Vigorously cultivate and train professionals in the prevention and treatment of lung cancer, and establish a network for the prevention and treatment of lung cancer. Manage the factors causing lung cancer in high-risk areas and populations. Conduct regular comprehensive examinations for high-risk populations.

　　2. Strengthen the legal system, formulate environmental protection regulations. For newly built industrial and mining enterprises, unified planning, reasonable layout, strict review of design plans, and complete measures for the elimination of three wastes pollution are required before they can be permitted to be constructed. Maximum efforts should be made to reduce pollution. Technological transformation should be carried out for existing enterprises, and comprehensive management of the three wastes should be implemented to transform harm into benefit. Standards should be established to strictly control the concentration of harmful substances in the production environment.

　　3. Vigorously promote the hazards of smoking, encourage smoking cessation, strengthen labor protection against carcinogens in occupational contact, and reduce the risk of lung cancer.

　　3. Community Intervention

　　1. Use various forms of publicity, such as bulletin boards, to publicize the danger of smoking causing lung cancer, encourage citizens to quit smoking or give up smoking, publicize the harm of smoking to the fetus, and strongly advocate that pregnant women quit smoking; in terms of diet, consume more fresh fruits and vegetables rich in vitamin A, C, β-carotene, etc., which can have a certain effect on preventing lung cancer.

　　2. Enhance the awareness of the public on environmental protection, plant flowers and trees, beautify and improve the environment. Reduce air pollution, develop electric vehicles, electrify civil fuel, develop solar energy, and apply harmless energy.

　　The examination of elderly lung cancer includes sputum cytology examination, bronchoscopy, biopsy, and serological examination, etc. The specific examination methods in the early stage are described as follows.

　　1. Sputum Cytology Examination

　　It is generally believed that the positive rate of sputum examination in central-type lung cancer is higher than that in peripheral-type lung cancer. If the sputum samples are collected properly, taking a series of sputum samples 3 times or more can increase the diagnostic rate of central-type lung cancer by 80%. The coincidence rate between cytological diagnosis of small cell lung cancer and pathological tissue diagnosis is the highest, followed by squamous cell carcinoma. The coincidence rate of adenocarcinoma is the lowest, mainly because certain poorly differentiated adenocarcinomas, squamous cell carcinomas, and large cell undifferentiated carcinomas have certain difficulties in differentiation, and it is sometimes difficult to classify. The positive rate also depends on the quality of the specimen and the number of inspections. It is generally believed that 4 to 6 inspections are appropriate.

　　2. Bronchoscopy

　　Fiberoptic bronchoscopy has developed rapidly and has become one of the indispensable examination methods for many visceral diseases. Fiberoptic bronchoscopy can be performed under local anesthesia, with convenient operation, less patient suffering, and a wide visual range. Lesions in the main bronchus, lobar bronchus, segmental bronchus, and subsegmental bronchus can all be seen, and biopsies, brushings, and photographs can be taken. Not only can lung cancer be diagnosed, but the nature and extent of precancerous lesions can also be determined. It has become one of the routine methods in the diagnosis and treatment of lung cancer. Tumors in the trachea can be diagnosed by cytological examination obtained through biopsy, brushing, or rinsing. Peripherally located tumors can also be diagnosed by aspirating cells through the bronchus guided by fluorescence. In recent years, it has also developed the ability to inject drugs or guide laser treatment under the microscope. The main complications of bronchoscopy biopsy are bleeding, laryngospasm, hypoxemia, pneumothorax, and worsening infection.

　　3. Needle Biopsy

　　Fine needle aspiration biopsy through the pleura is more reliable for diagnosing suspicious peripheral lesions than bronchoscopy.

　　4. Thoracotomy Biopsy

　　Thoracotomy biopsy is the most invasive examination method. However, when other methods cannot make a definitive diagnosis, thoracotomy biopsy is sometimes necessary.

　　5. Serological Examination

　　Serum and resected tumor tissue of some lung cancer patients contain one or more bioactive substances, such as hormones, enzymes, antigens, and carcinoembryonic antigens, etc. Among them, the positive rate of neuron-specific enolase (NEC) in small cell lung cancer can reach 100%, with a sensitivity of 70%, which is closely related to the stage of the disease and the tumor burden, and can be considered as a serum marker for small cell lung cancer. Carcinoembryonic antigen (CEA) has a positive rate of 60% to 80% in lung adenocarcinoma, reflecting the changes in the condition. However, all the above examinations lack specificity and only have reference significance.

　　6. Imaging Examination

　　In the imaging diagnosis of lung cancer, the most basic is chest X-ray, tomography is a supplementary examination method for chest X-ray, and CT, MRI have greatly improved the diagnosis of lung cancer in terms of定性, positioning, and staging on the basis of traditional chest X-ray diagnosis.

　　Elderly lung cancer patients should eat foods rich in high-quality protein and selenium; eat anti-inflammatory foods. Avoid spicy and greasy foods. The specific dietary precautions are described as follows.

　　1. Diet recommendations for elderly lung cancer patients

　　1. Eat more foods that can enhance the body's immune system and have anti-lung cancer effects, such as Job's tears, sweet almonds, water chestnuts, oysters, jellyfish, yellowfish, sea turtles, crabs, horseshoe crabs, clams, sea cucumber, Fuling, yam, jujube, Trimeresurus, soybeans, mushrooms, walnuts, turtles.

　　2. Patients with cough and sputum should eat whitebark, radishes, rapeseed, almonds, orange peel, loquat, olives, loquat cake, jellyfish, water chestnuts, kelp, seaweed, winter melon, loofah, sesame, figs, pine nuts, walnuts, sea asparagus, Fuling, yam, jujube, Trimeresurus, soybeans, mushrooms, walnuts, turtles.

　　3. Patients with fever should eat cucumbers, winter melon, bitter melon, lettuce, eggplant, kelp, lilies, amaranth, shepherd's purse, water spinach, stone flower, portulaca, plums, watermelons, pineapples, pears, persimmons, oranges, lemons, olives, mulberries, water chestnuts, ducks, cyprinids.

　　4. Patients with hemoptysis should eat plums, lotus root, sugarcane, pears, cotton, jellyfish, sea cucumber, lotus seeds, water chestnuts, kelp, wheat grass, black beans, tofu, shepherd's purse, eggplant, milk, crucian carp, turtles, grass carp, cuttlefish, yellowfish, turtles, oysters, sea asparagus.

　　5. Eat foods that can reduce the side effects of radiotherapy and chemotherapy, such as goose blood, mushrooms, sharks, longans, eels, walnuts, turtles, kiwi fruit, water spinach, chrysanthemum, jujube, sunflower seeds, apples, crucian carp, mung beans, soybeans, adzuki beans, shrimps, crabs, silverside, mud eel, grass carp, mackerel, green tea,螺蛳.

　　2. Diet taboos for elderly lung cancer patients

　　1. Avoid spicy and刺激性 foods, such as scallion, garlic, chive, ginger, Sichuan pepper, chili, cassia bark, etc.

　　2. Avoid fried, roasted, and other hot foods.

　　3. Avoid greasy, sticky foods that produce phlegm.

　　The treatment of elderly lung cancer includes medication, surgery, and radiotherapy, and the specific treatment methods are described as follows.

　　1. Comprehensive treatment plan

　　For most early non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) cases, the cure rate and quality of life of patients can be improved through comprehensive treatment; for middle and advanced patients, a considerable proportion can also achieve remission, and the survival period and quality of life can be prolonged and improved. It is not difficult to understand that the treatment of lung cancer should first consider the pathological type, followed by clarifying the scope of invasion, and also paying attention to the balance between the body's immune system and the disease. In fact, it is a treatment based on dialectical treatment.

　　1. Comprehensive treatment plan for SCLC:The comprehensive treatment of SCLC is widely recognized by the academic community as superior to single treatment. The recent efficacy of radiotherapy and chemotherapy is relatively good, with an efficacy rate of about 80%, and 20% to 80% of patients can achieve complete remission after treatment, but the long-term results are poor.

　　2. Comprehensive treatment for NSCLC:Although people have tried for many years to improve the cure rate of NSCLC through comprehensive treatment, there are not many successful experiences.

　　Two. Surgical treatment

　　1. NSCLC:Surgical treatment for stage II NSCLC has good outcomes, as long as the patient's general condition allows and the cardiopulmonary function can withstand it, good results can be achieved.

　　2. SCLC: Early reports on rare solitary small cell lung cancer showed good surgical treatment outcomes.

　　Three. Radiotherapy

　　1. Radiotherapy for NSCLC:Radiotherapy can achieve a significant cure rate in a considerable proportion of early-stage patients.

　　2. Radiotherapy for SCLC:SCLC is a systemic disease, and treatment is mainly systemic chemotherapy. Radiotherapy has been confirmed to have good efficacy for limited-stage small cell lung cancer by many researchers.

　　Four. Drug treatment

　　Since two-thirds of lung cancer patients have already exceeded the scope of surgical resection at the time of diagnosis, and half have clinical or potential metastasis, chemotherapy plays a relatively important role in clinical practice. The drug treatment of lung cancer includes chemotherapy, biological therapy, traditional Chinese medicine treatment, gene therapy, etc.

　　1. Effective antitumor drugs for lung cancer:Vinca alkaloids, podophyllotoxin derivatives, platinum drugs, cyclophosphamide (CTX), taxol, docetaxel, gemcitabine, vinorelbine (nornoranthracene), camptothecin derivatives.

　　2. Intralesional injection therapy for cancerous pleural effusion:Malignant pleural effusion in lung cancer often occurs in the middle and late stages of lung cancer, and the current treatment is only at the palliative treatment stage, usually with local treatment in the pleural cavity. Repeated and repeated fluid aspiration can lead to the loss of a large amount of protein.

　　3. Immunotherapy:With the discovery of animal tumor-specific transplantation antigens, a series of specific and non-specific tumor immunotherapy research has been carried out.

　　4. Traditional Chinese medicine treatment:Clinical and experimental studies have shown that traditional Chinese medicine has certain immune regulatory effects and antitumor effects with very few adverse reactions.

　　5. Gene therapy:Cancer is known as a genetic disease, as the occurrence and development of cancer are closely related to genetic abnormalities.