Pancoast syndrome

　　1. Etiology

　　Common causes include lung cancer, pleural mesothelioma, breast cancer, thyroid cancer, esophageal cancer, etc., with lung cancer being the most common, especially lung apex cancer or superior sulcus cancer, sometimes metastatic cancer in the lung apex.

　　2. Pathogenesis

　　Tumors can cause symptoms by invading bones and neural plexuses through the thoracic inlet, if the first and second ribs are destroyed, there may be local pain; when the brachial plexus is involved, there may be sensory or motor disorders in the upper limb; when the sympathetic chain is involved, Horner syndrome can be caused.

　　Tumors can cause Horner syndrome by invading bones and neural plexuses through the thoracic inlet, causing symptoms. If the first and second ribs are destroyed, there may be local pain; when the brachial plexus is involved, there may be sensory or motor disorders in the upper limb; when the sympathetic chain is involved, Horner syndrome can be caused. Due to any compression and destruction on the pathway from the sympathetic nerve center to the eye, a syndrome of pupil constriction, enophthalmos, ptosis of the upper eyelid, and anhidrosis on the affected side of the face may occur.

　　Lung cancer or mediastinal tumor patients may experience persistent severe shoulder pain, axillary pain, and upper limb pain, and may also have ptosis of the eyelid on the affected side, enophthalmos, pupil constriction, anhidrosis on the affected side of the face, and sensory abnormalities, etc., which are the symptoms of Horner syndrome.

　　This syndrome is mainly caused by lung cancer or other tumors. Any compression and destruction on the pathway from the sympathetic nerve center to the eye can cause this syndrome, the causes include inflammation, tumor, trauma, surgery, etc., the treatment and prognosis depend on the cause. Therefore, when patients show symptoms such as pupil constriction, enophthalmos, ptosis of the upper eyelid, and anhidrosis on the affected side of the face, they should go to the hospital for examination and treatment as soon as possible. If it is caused by a tumor, there is generally no opportunity for radical surgery, and the primary disease should be actively treated while strengthening supportive therapy.

　　Chest X-ray examination: In the early stage, there may be no abnormalities, or only a blurred shadow at the apex of the lung, as the mass gradually increases, there may be a convex mass shadow in the lung, erosion and ulceration of 1-3 ribs often occur, and the adjacent vertebral bones may also be destroyed.

　　One, dietary principles

　　1. Avoid or eat less spicy foods, including fried foods; avoid eating foods that are likely to cause allergies, such as shrimps and crabs; do not smoke or drink alcohol.

　　2. It is important to consume foods rich in vitamin C, such as fresh vegetables and fruits like green, yellow, red vegetables, black fungus,杏仁露, water chestnuts, asparagus, lemon, jujube, garlic, etc., which are anti-cancer substances and can block the formation of cancer cells.

　　3. According to different symptoms, select foods with cough-relieving, antipyretic, hemostatic, Qi-regulating, chest-expanding, and pain-relieving effects to alleviate pain and enhance the confidence in treatment.

　　4. Foods that can enhance the body's immunity and help inhibit cancer cells by drugs, such as turtle, sweet shrimp, sweet almonds, walnuts, jujube, mushrooms, etc.

　　Second,食疗方 (Food therapy formulas)

　　Breakfast: Milk (250g fresh milk, 10g sugar), boiled egg 1 (50g egg), steamed bun (50g flour), mixed vegetables (70g celery, 10g dried bean curd sticks).

　　Snack: Fruit (250g pear).

　　Lunch: Rice (100g rice), minced meat tofu (100g minced meat, 100g tofu), green pepper radish shreds (200g green peppers, 50g radish shreds).

　　Snack: Fresh fruit juice (200g fresh orange juice).

　　Dinner: Millet porridge (25g millet), Steamed cake (75g flour), fried sprouts (200g mung bean sprouts), steamed fish (75g crucian carp).

　　First, traditional Chinese medicine divides the clinical syndrome of pulmonary tumor into the following types

　　1. Lung heat and phlegm stasis type:The treatment is to clear the lung and regulate Qi, remove phlegm and consolidate, with the main formula being Wei Jing Decoction with modifications.

　　2. Spleen deficiency and phlegm dampness type:The treatment is to strengthen the spleen and transform dampness, ventilate the lung and resolve phlegm, with the main formula being Sijunzi Decoction with modifications.

　　3. Yin deficiency and phlegm heat type:The treatment is to nourish the kidney and clear the lung, resolve phlegm and consolidate, with the main formula being Sha Shen Mai Dong Decoction with modifications.

　　4. Qi and Yin deficiency type:The treatment method is to tonify Qi and nourish Yin, resolve phlegm and consolidate, with the main formula being Shengmai Powder with modifications.

　　Second, Western medical treatment methods for syndrome

　　1. Treatment:Painkillers such as morphine and pethidine (Dolantin) can be used when the pain is severe, or nerve block therapy can be adopted. At the same time, nutritional support therapy should be strengthened.

　　2. Treatment of the primary tumor:Radiotherapy or chemotherapy should be administered according to the primary tumor. Most patients have missed the opportunity for surgery, but for those with severe pain, although the focus cannot be removed, a neurotumor stripping operation or a first or second thoracic nerve resection can be performed to alleviate pain symptoms.

　　3. Prognosis:Generally poor prognosis.