According to the International Agency for Research on Cancer of the World Health Organization, in 2020, China had approximately 4.57 million new cancer cases, with lung cancer accounting for around 820,000 cases. According to the Chinese National Cancer Center’s “Guidelines for Lung Cancer Screening and Early Diagnosis and Treatment in China,” the incidence and mortality rates of lung cancer in China account for 37% and 39.8% of the global statistics, respectively. These figures far exceed the proportion of China’s population, which is approximately 18% of the global population.
Definition and Sub-types of Lung Cancer
Definition: Primary bronchogenic lung cancer, commonly known as lung cancer, is the most common primary malignant tumor originating from the trachea, bronchial mucosa, small bronchi, or glands in the lungs.
Based on histopathological characteristics, lung cancer can be classified into non-small cell lung cancer (80%-85%) and small cell lung cancer (15%-20%), which has a higher degree of malignancy. Non-small cell lung cancer includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Based on the location of occurrence, lung cancer can further be categorized as central lung cancer and peripheral lung cancer.
Pathological Diagnosis of Lung Cancer
Central Lung Cancer: Refers to lung cancer originating from the bronchi above the segmental level, primarily consisting of squamous cell carcinoma and small cell lung cancer. Pathological diagnosis can typically be obtained through fiber bronchoscopy. Surgical resection of central lung cancer is challenging, and often limited to complete resection of the entire affected lung. Patients may have difficulty tolerating the procedure, and due to the advanced stage, local invasion, mediastinal lymph node metastasis, and other factors, surgical outcomes may not be ideal, with a higher risk of bone metastasis.
Peripheral Lung Cancer: Refers to lung cancer occurring below the segmental bronchi, primarily including adenocarcinoma. Pathological diagnosis is commonly obtained through percutaneous transthoracic needle biopsy guided by CT. In clinical practice, peripheral lung cancer is often asymptomatic in the early stages and is frequently detected incidentally during physical examination. If detected early, surgery is the primary treatment option, followed by adjuvant chemotherapy or targeted therapy.
For lung cancer patients who are not eligible for surgery, have a confirmed pathological diagnosis requiring subsequent treatment, or require regular follow-up or treatment after surgery, standardized and appropriate treatment is particularly crucial. We would like to introduce you to Dr. An Tongtong, a renowned specialist in thoracic oncology with over 20 years of experience in medical oncology at the Department of Thoracic Oncology, Beijing University Cancer Hospital.
Renowned Expert: Dr. An Tongtong
Chief Physician, Doctor of Medicine. With research experience at MD Anderson Cancer Center in the United States, and a youth committee member of the Chinese Anti-Cancer Association Lung Cancer Professional Committee.
Areas of Expertise: Chemotherapy and molecular targeted therapy for lung cancer, thymoma, mesothelioma, and diagnostic and therapeutic procedures such as bronchoscopy and video-assisted thoracic surgery in internal medicine.
Dr. An has conducted in-depth research on the standardization and multidisciplinary comprehensive treatment of advanced-stage lung cancer, particularly in the context of individualized comprehensive treatment for non-small cell lung cancer. Dr. An is proficient in the latest international diagnostic and therapeutic guidelines for thoracic tumors. During consultations, Dr. An fully understands the patient’s medical history and closely monitors the changes in the disease over time. He also carefully inquiries about previous diagnostic and treatment plans to ensure timely adjustment of the most optimized individualized treatment plan for the patient. For newly diagnosed patients, the related reports and examinations are often incomplete. After obtaining a clear understanding of the medical history, Dr. An will clearly explain the treatment strategy for the current condition to the patient and their family members. He will also provide guidance on which additional examinations are needed to help confirm the diagnosis, ensuring that the family members fully understand before allowing them and the patient to leave the consultation room with peace of mind.
Recent Cases
Mr. Wang, a 59-year-old lung adenocarcinoma patient with multiple systemic metastases, sought medical treatment in Beijing during the epidemic in late 2022. Due to travel restrictions at the time, he had to receive his first round of chemotherapy at a nearby hospital after the pathological diagnosis was confirmed. However, Mr. Wang experienced significant chemotherapy toxicity and poor physical condition due to concomitant hypoalbuminemia.
Approaching his second round of chemotherapy, his family, concerned about his condition, inquired about Dr. An’s expertise and eventually succeeded in making an appointment at the VIP Outpatient service of our Hospital. After a detailed medical history review, Dr. An provided treatment recommendations. In light of Mr. Wang’s low albumin levels and chemotherapy reactions, Dr. An adjusted the chemotherapy regimen by replacing paclitaxel with pemetrexed while incorporating bisphosphonates to inhibit bone destruction.
Upon receiving the genetic test results, Dr. An further matched Mr. Wang with an appropriate targeted therapy, Osimertinib. Two months later, during a follow-up visit, Mr. Wang’s family reported that his condition had improved, with reduced symptoms and the ability to engage in activities such as walking, watering plants, and sweeping the floor at home. Based on the results of the follow-up examination, Dr. An advised Mr. Wang to continue the current treatment plan and undergo regular check-ups.
Post time: Aug-31-2023