What Is the Connection Between a Cough and Lung Cancer?

Bronchial lung cancer is a malignant tumor that originates from the bronchial mucosa or glands. Its morbidity and mortality rank first among all malignant tumors. Smoking is the most important causative factor of lung cancer. Cough, hemoptysis, weight loss and other symptoms are common in patients with lung cancer, and timely examination of chest imaging and fiberbronchoscopy can make most patients diagnosed. In terms of treatment options, according to different tumor pathological types, stages and molecular biological characteristics, combined with the actual situation of the patient, the corresponding surgical treatment methods such as surgery, chemotherapy, radiotherapy, targeting, immunotherapy, and traditional Chinese medicine were selected. Although the therapeutic effect of lung cancer has improved greatly in recent years, the prognosis of advanced lung cancer is still poor. Therefore, reducing the incidence of lung cancer through tobacco control and protecting the environment, and screening for lung cancer in high-risk populations are important to improve the prognosis. .

Basic Information

English name: bronchogenic carcinoma
Visiting department: Oncology
Common locations: Lung bronchus
Common causes: Smoking, occupational and environmental exposure, ionizing radiation, previous chronic lung infections, genetic factors, air pollution

Common symptoms: Local, systemic, infiltration and metastatic symptoms, and extrapulmonary symptoms
Contagious: no

Causes of bronchial lung cancer

Smoking

At present, smoking is considered to be the most important high-risk factor for this disease. There are more than 3,000 chemicals in tobacco, among which multi-chain aromatic hydrocarbon compounds (such as benzopyrene) and nitrosamines have strong carcinogenic activity. Multi-chain aromatic hydrocarbons and nitrosamines can cause DNA damage in bronchial epithelial cells through various mechanisms, causing activation of oncogenes (such as Ras gene) and inactivation of tumor suppressor genes (such as p53, FHIT gene, etc.), and then cause Transformation, eventually cancerous.

2. Occupational and environmental exposure

Bronchial lung cancer is the most important type of occupational cancer. Occupational environmental carcinogens such as by-products of aluminum products, arsenic, asbestos, chromium compounds, coke ovens, mustard gas, nickel-containing impurities, and vinyl chloride can increase the incidence of this disease. Long-term exposure to beryllium, cadmium, silicon, formalin and other substances will also increase the incidence of the disease.

3. Ionizing radiation

The lungs are organs that are sensitive to radiation. Radon and radon gas, ionizing radiation, and microwave radiation generated when radioactive materials such as uranium and radium decay, can increase the risk of lung cancer by 3 to 30 times.

4. Previous chronic lung infections

Such as patients with tuberculosis, bronchiectasis, etc., bronchial epithelium may metamorphose into squamous epithelium during chronic infection, causing cancer, but it is rare.

5. Genetic factors

Familial aggregation, genetic susceptibility, decreased immune function, metabolism, and endocrine dysfunction may also play important roles in the occurrence of bronchial lung cancer. Many studies have demonstrated that genetic factors may play an important role in people and / or individuals who are susceptible to environmental carcinogens.

6. Air pollution

The main reason is that the morbidity of benzopyrene carcinogenic hydrocarbons and other harmful substances generated by the combustion of petroleum, coal and internal combustion engines and the dust of asphalt roads after the combustion of petroleum, coal and internal combustion engines and the pollution of the atmosphere lead to increased incidence. Air pollution and smoking may contribute to the incidence of the disease and play a synergistic role.

Clinical manifestations of bronchial lung cancer

The clinical manifestations of lung cancer are more complicated. The presence, severity, and appearance of symptoms and signs depend on the tumor site, pathological type, metastasis, and complications. The early symptoms of lung cancer are usually mild, without any discomfort. Symptoms of central lung cancer appear early and severe, and symptoms of peripheral lung cancer appear late and mild, or even asymptomatic. They are often found during physical examination.

The symptoms of lung cancer are broadly divided into local symptoms, systemic symptoms, infiltration and metastasis symptoms, and extrapulmonary symptoms. Local symptoms are symptoms caused by tumors irritating, blocking, infiltrating and compressing tissues during local growth. Cough, bloody or hemoptysis in sputum, chest pain, chest tightness, shortness of breath, and hoarseness are common. Systemic symptoms can appear fever, weight loss and cachexia. The common metastatic sites of lung cancer include lymph nodes, pleura, brain, liver, adrenal glands, bones, etc. When tumors infiltrate and metastasize, corresponding symptoms and signs can appear.

In addition, due to some special active substances (including hormones, antigens, enzymes, etc.) produced by lung cancer, patients may develop one or more extrapulmonary symptoms, clinically with pulmonary osteoarthrosis and ectopic hormone secretion syndrome More common.

Bronchial lung cancer diagnosis

The diagnosis of primary bronchial lung cancer includes symptoms, signs, imaging findings, tumor markers, and pathological examinations, which are often distinguished from tuberculosis, lung abscess, lung infection, and other benign tumors of the lung. A complete diagnosis of primary bronchial lung cancer should include pathological diagnosis, TNM stage diagnosis, and molecular genetic diagnosis.

The diagnosis of primary bronchial lung cancer mainly depends on tissue and cytopathological examination. The cytology specimens mainly come from sputum, serous fluid, brush bronchoscopy and fine needle aspiration specimens from various parts. Histological specimens can be derived from biopsies such as bronchoscopy, thoracoscopy, mediastinoscopy, and percutaneous mass puncture. The pathology of lung cancer is divided into two categories: non-small cell lung cancer and small cell lung cancer. The two are significantly different in treatment and prognosis.

After making a histological diagnosis of lung cancer, a staged diagnosis is needed, that is, the location and size of the tumor, the presence or absence of local lymph node metastasis, and distant organ metastasis are determined through various imaging studies in order to choose the appropriate treatment method and judgment Prognosis. Currently, the TNM stage is divided into stages I, II, III, and IV. The higher the stage, the worse the prognosis.

In lung adenocarcinoma, the detection of genes such as EGFR and ALK is also essential and plays a decisive role in guiding the treatment of targeted drugs.

Bronchial Lung Cancer Treatment

A good treatment plan for primary bronchial lung cancer often requires multidisciplinary experts and doctors, such as thoracic surgery, radiotherapy, oncology, imaging, and pathology.

Small cell lung cancer is mainly a comprehensive treatment based on radiotherapy and chemotherapy. A small number of very early patients can choose surgery.

Surgical treatment is preferred for patients with stage I-IIB non-small cell lung cancer. Neoadjuvant chemotherapy after surgery for stage II patients can help improve patient survival. Stage III patients (locally advanced) are mainly treated with radiotherapy and chemotherapy. Stage IV patients (advanced) are mainly comprehensive treatment based on chemotherapy and / or targeted therapy, but radiotherapy still plays an important role in bone metastasis, brain metastasis, and local symptom control in advanced patients. Chemotherapy is suitable for general conditions. In patients, EGFR-TKI and ALK inhibitors are effective in treating EGFR mutations and ALK-positive non-small cell lung cancer.

Bronchial lung cancer prevention

Lung cancer is controllable and preventable. Primary prevention of lung cancer is etiological intervention, which is mainly achieved through tobacco control and environmental protection; secondary prevention is early diagnosis and early treatment, and low-dose spiral CT screening in high-risk groups can help early diagnosis of lung cancer and reduce lung cancer mortality; Tertiary prevention is rehabilitation prevention.