How to deal with suspected lung cancer when a lung nodule is found? How to treat bone metastasis of lung cancer?

How to deal with suspected lung cancer when a lung nodule is found

Some patients are found to have small nodules in their lungs during CT scans. If they want to rule out the possibility of lung cancer, they should undergo a multidisciplinary evaluation and receive smoking cessation counseling.

Lung cancer risk assessment

Medical history: At this point, the doctor needs to specifically analyze the patient's age, smoking history, cancer history, family history, occupation, and other lung diseases (such as chronic obstructive pulmonary disease and pulmonary fibrosis), exposure to infectious pathogens (such as fungal infections, areas where tuberculosis is endemic), or risk factors or medical history that suggest a previous infection (such as immunosuppression, aspiration, symptoms of respiratory tract infection).

Imaging factors: After a detailed understanding of the patient's medical history, imaging examinations should also be performed to determine the size, shape, and density of lung nodules, associated lung parenchymal changes (e.g., scarring or suspected inflammatory changes), and pET imaging showing enhanced metabolism (increased affinity for fluorodeoxyglucose (FDG)).

After the above evaluation, the doctor will treat the nodule according to its size and characteristics:

1) For lung nodules smaller than 8 mm, regular radiological examination and follow-up (such as CT) are required;

2) For solid non-calcified nodules larger than 8 mm, consider PET-CT scanning; if lung cancer is suspected, a biopsy or surgical resection is required. If cancer is ruled out, regular health check-ups and lung cancer screening can be performed. If cancer is confirmed, it will be treated as lung cancer.

3) For non-solid or partially solid nodules larger than 10 mm, it is recommended to have an LDCT examination every 3 to 6 months. If the condition is stable, an LDCT examination should be performed every 6 to 12 months, or a biopsy or surgical resection should be performed. If the nodule continues to grow, surgical resection is required. If the nodule is pathologically confirmed to be lung cancer, the treatment and follow-up should be carried out according to the treatment principles of lung cancer.

How to treat bone metastasis after it is discovered

Lung cancer is a common malignant tumor of the respiratory system. Lung cancer is prone to bone metastasis, especially small cell lung cancer and adenocarcinoma. The incidence of bone metastasis is 20% to 40%, of which 86% is osteolytic destruction, 6.9% is osteoblastic destruction, and 6.9% is mixed destruction. There are no symptoms in the early stage of bone metastasis, but in the late stage, it manifests as local intractable pain, causing serious pain to the patient. How to treat after bone metastasis is discovered

1. The three-step analgesia system can select appropriate analgesic drugs according to the patient's pain severity, improve the patient's symptoms, promote sleep, and improve the quality of life.

2. After bone metastasis occurs due to intravenous administration of phosphate drugs, the patient's bones are attacked by the tumor for a long time and become brittle. Intravenous administration of phosphate drugs can effectively inhibit bone destruction, promote ossification, and reduce adverse events such as pathological fractures.

3. Radiotherapy can be selected according to the patient's different conditions and targeted at bone metastases in important areas to reduce the possibility of fractures or paraplegia.

4. Chemotherapy Chemotherapy not only treats bone metastases, but also has a therapeutic effect on other potential metastases, thus reducing unnecessary harm.

5. Surgery Cancer can metastasize to the spine, and long-term adverse damage can cause paraplegia. For single spinal metastasis, surgical resection and filling with bone cement can be used to restore the integrity of the spine.

6. Traditional Chinese Medicine Treatment Traditional Chinese Medicine, as a systemic treatment, also plays a positive role in the treatment of bone metastasis of lung cancer. Combined with radiotherapy and chemotherapy, it can alleviate symptoms, reduce the toxicity of radiotherapy and chemotherapy, improve treatment effects, and enhance the body's immune function. The effect is better than radiotherapy and chemotherapy alone and can increase the patient's survival.