After 40 years of being an "old smoker", his lungs have become like this
According to the Global Cancer Report 2020, lung cancer ranks second among the cancers with the highest incidence in the world, accounting for about 18% of the total deaths from cancer; chronic respiratory diseases, mainly COPD and bronchial asthma, are also the global burden of disease One of the four most serious chronic diseases, COPD alone causes more than 3 million deaths worldwide each year.
How important are our lungs?
What about the lungs that have undergone the test of "smoke"?
The story told by Feng Qixiao, director of the Department of Respiratory Medicine/Department of Thoracic Oncology, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, shows the lungs of a 40-year-old smoker.
Text/Guangzhou Daily All-Media Reporter Zhou Jieying Correspondents Zhang Chengbin, Ren Xi, Zhu Qinwen, Peng Fengmei
Three packs of cigarettes a day for 40 years
Coughing up phlegm and wheezing pain and treating lung cancer as coronary heart disease
The 68-year-old Gao (a pseudonym) smokes two or three packs of cigarettes a day. He has a history of smoking for nearly 40 years. His smoking index is as high as 1600 cigarettes (smoking index = number of cigarettes smoked per day × number of years of smoking).
Uncle Gao developed severe symptoms of cough, phlegm, wheezing, and chest pain. He thought he had coronary heart disease. CT examination showed irregular nodules in the upper right lung, and multiple bullae and emphysema in both lungs.
Considering Uncle Gao's heavy smoking history, the consultation doctor judged that he was likely to have lung cancer.
But Uncle Gao felt that it was a chronic bronchitis and refused to accept further examination and treatment.
After more than half a year, Uncle Gao came to review again. The result of the examination made Feng Qi school sweat for him.
Uncle Gao's lung tumor doubled in 7 months, the nodule shadow enlarged by 3.4cm×2.3cm, and the index of various lung cancer tumor markers soared.
After a careful examination, Feng Qi school judged that Gao's lung function was very poor and he did not have the conditions for a total surgical resection. He decided to perform CT-guided percutaneous lung biopsy and microwave ablation of the right lung tumor.
Considering that Mr. Gao has multiple bullae, CT-guided percutaneous puncture biopsy of the right lung mass will definitely cause pneumothorax. Director Feng made a pretreatment plan for pneumothorax complications in advance.
Uncle Gao’s right lung malignant tumor belongs to the early and mid-term. The implementation of microwave ablation can minimize the tumor burden, relieve the symptoms caused by the tumor and even achieve complete ablation, with fewer complications and less surgical trauma.
After the operation, Uncle Gao's tumor was ablated, and with the treatment of Anlotinib and other drugs, the tumor gradually stabilized and was no longer life threatening.
The tumor is treated and he smokes again
The doctor had no choice but to continue his life
In addition to lung cancer, Mr. Gao also suffers from lung diseases such as chronic obstructive pulmonary disease and bullae, and he still needs treatment.
However, Uncle Gao didn't take this seriously, he smoked again, did not take the medicine properly, and did not conduct monthly review.
After another six months, Uncle Gao's lungs really couldn't stand it anymore, and he had repeated coughing, yellow sputum, and asthma.
The examination revealed that Uncle Gao had a new infection in his upper left lung, but every time he went to the hospital to get an anti-inflammatory shot and left, he thought that the sputum turned from yellow to white as a recovery, and he never stopped smoking.
Until later, Uncle Gao’s lungs issued a final warning to him: there was blood sputum, shortness of breath, and low-grade fever.
Feng Qi checked his examination and found that the acid-fast bacillus was positive, and later diagnosed as a non-tuberculous pulmonary abscess mycobacterium infection in the upper left lung.
"This type of infection itself is not serious, but Gao's infection occurred on the basis of a variety of lung diseases caused by a history of heavy smoking, which adds a lot of difficulty to the treatment." Feng Qixiao said.
Non-tuberculous pulmonary abscess mycobacterial infections require a long treatment time, but Mr. Gao’s lungs are already full of holes. During the treatment, he suddenly developed symptoms of breathing difficulties and chest tightness, ruptured bullae and pneumothorax.
Feng Qixiao successively performed right thoracic closed drainage, argon knife therapy, bronchoscope alveolar lavage and right upper lobe apical balloon closure for him, and accurately found him through bronchoscopy and thoracoscopy The bronchopleural fistula of the anterior segment of the right upper lobe of the lung was finally successfully sealed by the bronchoscope intracavitary flap technique, saving the life of Uncle Gao.
Entering 50 years old should receive early screening for lung cancer
Feng Qixiao pointed out that the early symptoms of lung cancer are not obvious, and 70% of patients are found to be in the middle and late stages. It is recommended that people over 50 years of age with a history of smoking should undergo early screening for lung cancer every year.
The screening method is simple, just do a low-dose chest CT.
However, COPD requires regular pulmonary function tests by monitoring blood pressure and blood sugar.
In addition, the prevalence of COPD has increased significantly in recent years, and smoking is the most important environmental pathogenic factor for lung diseases. Both smoking and passive smoking may cause respiratory symptoms, lung cancer and COPD.
Therefore, Feng Qi school recommends that everyone quit smoking as soon as possible or minimize smoking to reduce the risk of lung disease. At the same time, it is necessary to supplement nutrition, eat more fruits and vegetables, strengthen exercise, and participate in exercises such as Baduanjin, aerobics and jogging to enhance physical fitness and maintain Positive and optimistic attitude.