سرطان ریه؛ از تشخیص زودهنگام تا درمان جراحی دکتر فرحناز صادق‌بیگی، جراح توراکس و جراح قفسه سینه

Lung cancer in its early stages may not have any obvious symptoms, but early detection can increase the chances of effective surgery and treatment. Who should be screened? Is every lung nodule cancer, and which patients can undergo surgery? In this program from the Erfan Niayesh Hospital Medical Talk Series, Dr. Farahnaz Sadeghbeigi, a thoracic surgeon and chest surgeon, explains the symptoms, diagnosis, staging, and surgical treatment of lung cancer. What is lung cancer? Lung cancer occurs when abnormal cells in the lung tissue grow uncontrollably. This cancer is divided into two main groups: Non-small cell lung cancer, or NSCLC, which is more common and more curable in the early stages. Small cell lung cancer, or SCLC, which usually grows and spreads faster and is treated more with medication and radiation therapy. Important symptoms of lung cancer Persistent cough or change in chronic cough Blood in sputum New shortness of breath or wheezing Persistent chest pain Hoarseness Recurrent lung infections Weight loss, loss of appetite, and unusual fatigue These symptoms do not always mean cancer, but they should be checked, especially in people who smoke or have a history of smoking. Does early lung cancer have symptoms? Sometimes early lung cancer is asymptomatic and is found during a CT scan for another reason or during a screening program. For this reason, people at high risk may benefit from a low-dose CT scan of the lungs. Who is screening for? Lung cancer screening is not done with a simple chest X-ray. The appropriate method is a low-dose CT scan, or LDCT. According to many authoritative guidelines, annual screening is recommended for people ages 50 to 80 who have smoked at least 20 pack-years and who are still smoking or have quit within the past 15 years. A pack-year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years smoked. For example, one pack per day for 20 years equals 20 pack-years. People who have a persistent cough, bloody sputum, or weight loss are considered symptomatic and should not wait to be screened. Are all lung nodules cancer? No. Many lung nodules and spots are caused by previous infection, inflammation, or benign lesions. The size, shape, location, and growth of the nodule, the patient’s age, and smoking history are important in assessing risk. Depending on the level of risk, periodic CT scans, PET scans, or biopsy may be recommended. How is a definitive diagnosis made? Imaging suggests cancer, but definitive diagnosis is usually made with biopsy and pathology. Biopsy may be done by bronchoscopy, EBUS, CT-guided needle aspiration, or thoracoscopy. Staging of lung cancer Stage determines how large the tumor is, whether lymph nodes are involved, and whether the disease has spread to other organs. This may include CT scans, PET scans, MRIs of the brain, and lymph node biopsy. Accurate staging is essential before deciding whether to have surgery. Who is a candidate for surgery? Surgery is most often considered for early-stage non-small cell lung cancer, when the tumor is removable and there is no distant spread. Lung function, heart condition, exercise capacity, and comorbidities are evaluated before surgery. The tumor may be removable, but the patient cannot tolerate extensive surgery. How is surgery performed? Depending on the size and location of the tumor, part of the lung, a segment, a lobe, or in rare cases, an entire lung may be removed. A lobectomy is a common lung cancer surgery. Lymph nodes are also examined for accurate staging. In many patients, surgery can be performed using a minimally invasive thoracoscopy or VATS procedure. Is surgery alone enough? In some early cancers, surgery is the main treatment. However, chemotherapy, radiation therapy, targeted therapy, or immunotherapy may be recommended before or after surgery, depending on the stage of the disease and the pathology results. The chances of cure depend on the stage of the cancer, the type of tumor, lymph node involvement, the ability to completely remove the tumor, the patient's general condition, and the response to treatment. Is it beneficial to quit smoking after diagnosis? Yes. Quitting smoking, even after diagnosis, can improve lung function, reduce complications from surgery and treatment, and reduce the chance of developing new cancers. This video answers the following questions: What are the early signs of lung cancer? Who should get a low-dose CT scan? Are all lung nodules cancerous? How is a lung biopsy performed? Which stages of lung cancer are surgically treated? Is chemotherapy needed after surgery? If you have a persistent cough, bloody sputum, shortness of breath, chest pain, or unexplained weight loss, don't delay seeking medical attention. Early diagnosis can open up more treatment options. This content is provided for general education purposes and is not a substitute for examination, biopsy, sta...