Lung cancer is becoming younger and a warning! Headache is cancer brain metastasis? "Double immune" treatment for advanced lung cancer shows promise
Headaches and bone headaches are metastases from lung cancer? Be careful when there are conditions in 5 major locations
Lung cancer has risen to the top of the top ten causes of cancer death in Taiwan in recent years, and is known as the “new national disease”. However, early stage lung cancer is difficult to detect. Prolonged coughing and coughing up blood are not the only signs of lung cancer. Even headaches and bone pain are hidden warning signs? Wang Jinzhou, an attending physician at the Department of Thoracic Medicine at Kaohsiung Chang Gung Memorial Hospital, pointed out that the lungs, brain, liver, bones, and adrenal glands are the five most common metastasis locations of lung cancer. Among them, the treatment prognosis of brain metastasis and liver metastasis of lung cancer is not ideal, while the treatment of bone metastasis is The patient may seek consultation from an orthopedic department due to pain, only to be accidentally discovered to be caused by lung cancer.
Dr. Wang Jinzhou said that in the classification of lung cancer, brain metastasis is more common in lung adenocarcinoma. Many patients with brain metastases first seek medical treatment in neurology or neurosurgery because of headaches. After surgical resection, the disease is further confirmed to be lung adenocarcinoma metastasis. Recently, patients diagnosed with lung adenocarcinoma due to headaches are seen in outpatient clinics almost every week. Among them, 2 of the last 3 patients are female, and two of the three patients have genetic mutations in their lung cancer cells.
Whether cancer cells have genetic mutations has an important impact on the treatment of lung cancer. For patients without genetic mutations, factors such as survival time and side effects of only chemotherapy for advanced lung cancer in the past will affect the patient’s willingness to receive treatment. In recent years, “immunotherapy” has been added to late-stage treatment options, which helps to improve the personalization of lung cancer treatment.
New trend in advanced lung cancer treatment “combination therapy” dual immunity improves survival
“We encourage lung cancer patients to undergo complete genetic testing as much as possible as long as they have the ability, so as to have the opportunity to find the corresponding targeted treatment drugs. As for lung cancer without genetic mutations, immunotherapy is a very important therapeutic weapon, and the future trend will be towards “combination” According to the concept of “different treatment combinations, there will be different patients that are most suitable for you!”
Dr. Wang Jinzhou explained that the combined treatment of lung cancer uses “chemotherapy” + “immunity” as the main structure, and can be combined with neovascular inhibitors or chemotherapy with “double immune” drugs, such as anti-CTLA-4 and anti-PD-L1. The combined use of immune drugs is like the accelerator and brake of a car. On the one hand, it promotes the upstream of T cell maturation (anti-CTLA-4), accelerates the immune system and inhibits cancer cells; on the other hand, it enhances the downstream of T cells’ ability to recognize cancer cells (anti-PD-4). 1) Activate the immune system to fight against cancer cells, making it impossible for cancer cells to escape through upstream and downstream containment.
Dr. Wang Jinzhou pointed out that combination therapy for patients with advanced lung cancer is more effective than immunotherapy alone and chemotherapy alone. For example, research on “double immunity” treatment can increase the 4-year survival rate by 30%, which is 1.5 times higher than chemotherapy. Moreover, immunotherapy works by strengthening the immune system’s ability to recognize cancer cells, so that the previous treatment effects can be maintained even after the drug is stopped. There are more and more treatment options for advanced lung cancer. It is recommended that patients discuss with a pulmonologist or medical oncologist about the most suitable treatment method for them.
The proportion of young people with lung adenocarcinoma is increasing. Screening starts from the “index case” age of onset.
The proportion of lung adenocarcinoma among non-smoking women in Taiwan is high. The Taiwan Health Promotion Administration’s “Lung Cancer Early Detection Program” also raises the screening age for women with a family history to 45 years old. Dr. Wang Jinzhou said that lung adenocarcinoma is more likely to occur in women who do not smoke at a relatively younger age, and it is recommended that early follow-up screening be carried out before the age of 50. In addition, if there is an “index case” of lung cancer in the family that develops around the age of 30-40, the blood relatives of the family should start screening at the age of onset of the disease in order to avoid overlooking the potential for early-stage lung cancer.
Dr. Wang Jinzhou reminded that the proportion of lung adenocarcinoma in young people is gradually increasing. Especially in Taiwanese women, lung cancer occurs about 10 to 15 years earlier than in the West. Special attention should be paid to screening and treatment. As for advanced lung cancer, personalized treatment is now developing, including detection of biomarkers such as PD-L1 expression and TMB (tumor mutation burden), which can help patients find suitable combination treatments to achieve prolonged survival and stable disease. Lung cancer patients are urged to actively discuss treatment options with their doctors so that they can have a better chance of prescribing the right medicine and defeating the disease during early treatment.
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