On May 20, Zuo Hui, the founder and chairman of Shell, died at the age of 50 due to an unexpected deterioration in his condition.

According to sources, Zuo Hui was diagnosed with lung cancer in September 2013, after a long period of treatment abroad.

As a common cancer, lung cancer is a serious threat to human life. According to statistics, in 2020, 18 out of every 100 new cancer cases in China will be lung cancer; 23 out of every 100 nationals who lose their lives to cancer will be due to lung cancer.

A number of studies have proven that smoking significantly increases the risk of lung cancer, and more than 80% of lung cancer patients have a history of smoking. However, it is puzzling that Zuo Hui does not have the habit of smoking.

Why do non-smokers get lung cancer? Where does lung cancer come from?

In order to find out the truth about lung cancer, we interviewed Prof. Liang Weifeng, President of Kang Dafu International Hospital, winner of the National Science and Technology Grand Prize, and doctoral supervisor of Zhejiang University.

It is well known that smoking is a clear risk factor for lung cancer, and the more a smoker smokes, the higher the risk of lung cancer. However, it is important to note that smoking is not the only risk factor for lung cancer.

That is to say, even if a person does not smoke, it is possible to develop lung cancer, such as the life of people often do 3 things, there may be "triggered" lung cancer.

1. Passive smoking

Even though you don't smoke, if you are exposed to secondhand smoke or thirdhand smoke for a long time, the risk of lung cancer will increase. One study showed that the risk of lung cancer in people exposed to secondhand smoke was 1.33 times higher than in people not exposed to secondhand smoke.

2. Long-term exposure to kitchen fumes

Cooking oil produces fumes at high temperatures, which contain more than 200 kinds of harmful substances. Studies have shown that cooking fumes increase the risk of lung cancer by 3.79 times in female non-smokers.

3. Long-term exposure to radon released from building materials

Research shows that radon exposure can increase the risk of lung cancer by 48%. And radon mainly comes from building foundations (soil and rock), building materials, domestic water, natural gas and coal combustion.

In addition, if there is a history of asbestos, silica exposure people, as well as people with chronic obstructive pulmonary disease, family history of lung cancer, the risk of lung cancer will also increase.

In summary, lung cancer occurs as a result of multiple factors **** together. Multiple factors include smoking, disease history, genetics, and more.

As one of the cancers with the highest mortality rate in China, early diagnosis of lung cancer is seriously inadequate, and most lung cancer patients are found to be in advanced stages. According to 2012-2014 statistics, the percentage of stage IIIA~IV lung cancer in China is as high as 64.6%.

The later the diagnosis, the worse the prognosis. 5-year survival rate decreases with increasing diagnostic stage.

In China, the survival rate of stage I lung cancer is 70% to 90%, by stage III, the 5-year survival rate is 10% to 40%, and once it reaches stage IV, the survival rate is less than 10%. There are also studies showing that the 5 survival rate of stage IV lung cancer patients is only 5.3%.

Evidently, early diagnosis and treatment of lung cancer is very critical. Early detection is the basis for early treatment.

Currently, for the early detection of lung cancer, China's guidelines recommend the use of low-dose spiral CT of the chest to screen high-risk groups.

According to the American Lung Cancer Screening Trial, the high-risk group for lung cancer is defined as people aged 50-74 years old with one of the following conditions:

For the above high-risk group, it is recommended to undergo a low-dose spiral CT examination once a year, and consult with a specialist if any abnormality is found.

Most people who find out about lung nodules will have a knot in their stomach, which is normal, after all, lung cancer has a high incidence and high mortality rate. However, the detection of lung nodules is not equivalent to having lung cancer, and excessive worry is not necessary.

Sensible view and correct response is the best strategy. We only need to remember 4 sentences:

Don't worry about benign, remove malignant early,

It is difficult to distinguish benign and malignant, and follow-up is the key.

We have sorted out 3 questions that people are most concerned about according to the "Lung Nodule Diagnosis and Treatment by Chinese Experts*** Knowledge (2018 Edition):

1.

Clinically, a focal, round-like, increased-density solid or subsolid lung shadow of 3 centimeters in diameter on imaging is defined as a lung nodule, but not directly linked to lung cancer, as it can be inflammation, tuberculosis... ...

In other words, any disease related to the lungs can cause nodules.

2. What to do if you find lung nodules?

First, look at the size, second, look at the shape, and third, compare.

First, look at the size.

The second is the shape.

Generally speaking, lung nodules with the following signs are more likely to be malignant:

Lobular sign, burr sign (or spiny protrusion), pleural depression sign, and vascular cluster sign, etc.

Lobular sign, burr sign (or spiny protrusion), pleural depression sign, and vascular cluster sign.

Three for comparison.

Regular follow-up to compare the external structure and internal features of lung nodules is important for the differential diagnosis of benign and malignant lung nodules. Any of the following changes during follow-up should be considered malignant:

3. What kind of lung nodule requires surgery?

There is no strict clinical definition of whether a lung nodule requires surgery, and it depends on the doctor's judgment. Generally speaking, for nodules as small as 8 millimeters, regular observation is the mainstay. If changes occur during follow-up, especially if there are high risk factors or signs of malignancy, timely surgery is recommended.

In short, if you find a lung nodule, don't worry about it blindly, consult a specialist first to determine the benign or malignant nature of the nodule is the key point. Even if you are diagnosed with lung cancer, don't give up lightly, but actively treat it. In recent years, new technologies and means of cancer treatment have emerged, and these can improve the quality of survival and prolong the lives of cancer patients.

References:

1. China Lung Cancer Screening and Early Diagnosis and Treatment Guidelines (2021, Beijing)

2. Lung Cancer Low-Dose Spiral CT Screening Guidelines (2018 Edition)

3. "Lung Nodule Diagnosis and Treatment by Chinese Experts*** Knowledge (2018 Edition)

4. Life Times, "At the Age of 50! Famous entrepreneur dies of lung cancer: doctor lists 'screening priorities for high-risk groups'"