什么是肺癌？症状，原因，诊断，治疗和预防

肺癌是一种癌症的一种形式 - 异常细胞的控制外生长 - 通常从支气管内的细胞（将空气移入肺部和其他部位）或肺部其他部位开始。美国癌症协会。（（1)

根据国家癌症研究所的数据，肺癌是迄今为止男性和女性死于癌症的主要原因，该研究所估计该疾病约占与癌症相关的死亡人数的25％。（（2)

肺癌类型

肺癌有两种主要类型：

• Non-small-cell lUNGcancer
• Small-cell lung cancer

Types of Non-Small-Cell Lung Cancer

From 80 to 85 percent of people with lung cancer have non-small-cell lung cancer (NSCLC), according to the American Cancer Society. (1)

根据美国国立卫生研究院的说法，NSCLC有三种主要形式：（（3)

• 腺癌sThe most common form of NSCLC, often found in an outer area of a lung
• Squamous-Cell Carcinomas通常在支气管旁边的肺中心发现
• Large-Cell CarcinomasCan be located anywhere in the lung

Types of Small-Cell Lung Cancer

Small-cell lung cancer (SCLC) accounts for around 10 to 15 percent of all lung cancers in the United States, according to the American Cancer Society. (1)

lungcancer.org称，小细胞肺癌往往比非小细胞肺癌更具侵略性。（（4)

了解有关肺癌类型的更多信息

了解有关非小细胞肺癌的更多信息

After doctors have diagnosed lung cancer and identified the type, the next step is舞台- 确定肿瘤的大小和程度，并确定癌症是否已扩散，如果是的话，则需要多远。

分期是确定治疗的重要组成部分。不同类型的肺癌分期不同。

Main Stages of Non-Small-Cell Lung Cancer (NSCLC)

NSCLC可以从阶段0到stage 4 lung cancer, with many substages. In general, the higher the number, the more advanced the disease.

The breakdown here simplifies the criteria: (5,6)

• Stage 0The cancer is very small and hasn’t spread beyond the inner lining of the lungs. It’s sometimes known as “carcinoma in situ.”
• Stage 1The cancer is only located in the lungs and hasn’t spread to any lymph nodes. The tumor is usually smaller than 4 centimeters (cm) across — about 1.5 inches.
• Stage 2癌症大于4 cm或已扩散到附近的淋巴结，胸壁，肺部或隔膜。
• Stage 3The cancer is larger than 7 cm (about 3 inches) or it has grown large and spread to nearby tissues or further into the lymph nodes in the middle of the chest.
• Stage 4癌症已扩散到两个肺，周围肺或心脏的液体，或者体内较远的部位，例如大脑，骨骼和肝脏。

Main Stages of Small-Cell Lung Cancer (SCLC)

根据美国癌症协会的数据，小细胞肺癌通常分为两个阶段: (7)

• 有限阶段癌症仅在胸部的一侧。如果淋巴结受到影响，它们通常也位于胸部的那一侧。
• Extensive StageThe cancer has spread widely throughout the lung, to the other lung, to lymph nodes on both sides of the chest, or to other parts of the body. The majority of people with SCLC have extensive disease when diagnosed.

了解有关肺癌阶段的更多信息

Signs of lUNGcancer don’t typically appear until the disease is advanced. Lung癌症症状根据Mayo诊所包括：

• 一个新cough那不会消失
• Coughing up blood, even a small amount
• 呼吸急促
• 胸痛
• 嘶哑
• Losing weight without trying
• 骨痛
• Headache (8)

Is Back Pain a Symptom of Lung Cancer?

有背痛的许多原因including, rarely, cancer. Around 1 in 4 people with lung cancer say they have experienced背疼at some point.

The pain may come from a tumor pressing on the spine or affecting nerves around the chest wall and spine. Lung cancer that has metastasized to the spine may also cause back pain, notes the Dana-Farber Cancer Institute. (9)

Read More About Lung Cancer Symptoms

吸烟是肺癌的第一危险因素。国家癌症研究所说，烟草吸烟会导致男性10例肺癌中约9例，女性10例肺癌中约有8例。（（10)

根据美国癌症协会的说法，吸烟和吸烟几乎与吸烟一样可能与吸烟一样。（（11)

根据疾病控制与预防中心（CDC）的说法，增加肺癌风险的其他因素包括：（（12)

• 环境风险因素，例如exposure to the gas radon
• Secondhand cigarette smoke or other tobacco smoke
• Family history of lung cancer
• 胸部的辐射作为其他癌症的治疗
• Exposure to substances in the workplace such as asbestos

Learn More About Causes and Risk Factors for Lung Cancer

肺Cancer and Smoking

据CDC称，cigarette smoking is linked to anywhere from 80 to 90 percent of lung cancer deaths.

吸烟的人患肺癌或死亡的可能性是people who have never smoked。

Quitting smoking at any agecan lower the risk of developing lung cancer. (12)

二手烟和肺癌

二手烟是来自燃烧的香烟或其他烟草产品的烟雾，还是吸烟的人呼出。两者都可以导致肺癌。

据CDC称，二手烟每年美国非吸烟者中有7300多人死亡。

The CDC also states that there is no risk-free level of exposure to secondhand smoke. (13)

Marijuana and Lung Cancer

没有证据表明吸烟marijuanaraises lung-cancer risk, but there’s reason to believe it may. Marijuana smoke contains tar and several other cancer-causing substances that are found in tobacco smoke.

Since marijuana is illegal in many places in the United States, researchers face challenges in studying its health effects.

And since studies of lung cancer and marijuana have often found that many marijuana smokers also smoke cigarettes, it's hard to know how much each contributes to lung cancer risk. (11)

A Swedish study that followed nearly 50,000 men over a 40-year period found a link between marijuana use and lung cancer. Heavy marijuana smokers — those who reported smoking more than 50 times in their life — were twice as likely to get lung cancer as those who didn't smoke marijuana. (14)

E-Cigarettes and Lung Cancer

E-cigarettes，一种电子尼古丁交付系统仍然是相当新的，需要更多的研究才能知道它们是否长期使用（称为vaping）构成肺癌风险。（11）

可以使用多种测试来确定您是否患有肺癌。美国癌症学会指出：（15)

• Chest X-Ray这可能是第一个测试你收到having symptoms affecting your lungs. If theX-rayreveals a suspicious mass, your doctor might recommend a more sensitive test, such as a computerized tomography (CT) scan.
• CT Scan这些扫描可以检测到肺部的小肿瘤和斑点，并检测可能含有扩散的癌症的淋巴结肿大。
• 支气管镜检查A tube with a video camera attached to the end is inserted into your nose or mouth and threaded into your lungs so that the doctors are able to view suspicious masses and take a tissue sample forbiopsy。
• Needle BiopsyA hollow needle may be inserted through the skin and into the lung to collect tissue or fluid for testing.

Learn More About Lung Cancer Diagnosis and Tests

肺癌的存活率通常揭示出诊断后五年还活着的癌症类型和阶段的人所占的百分比。

A five-year survival rate of 61 percent, for instance, means that 61 percent of people with a particular type and stage of lung cancer are still alive five years after diagnosis.

These numbers are estimates that don’t account for many other factors influencing the course of the disease, and they can’t predict how long any one person with lung cancer can expect to live.

美国国家癌症研究所（National Cancer Institutelung cancer treatment自2015年以来一直很重要。

而不是雇用the most widely used type of staging, which ranges from stage 0 to stage 4, the SEER data relies on the following terms:

• 本地化The cancer has not spread outside the lung.

• Regional癌症已在肺部外扩散到附近的结构或淋巴结。

• 遥远The cancer has spreadto more distant parts of the body, such as the bones, the liver, or the other lung.

根据美国癌症学会的数据，这些类别的生存率是：（16)

Non-Small-Cell Lung Cancer

• 本地化Five-year relative survival rate is 61 percent.

• RegionalFive-year relative survival rate is 35 percent.

• 遥远五年的相对存活率为6％。

小细胞肺癌

• 本地化Five-year relative survival rate is 27 percent.

• RegionalFive-year relative survival rate is 16 percent.

• 遥远五年的相对存活率为3％。

肺癌症治疗has changed dramatically in recent years, particularly with the availability oftherapies targeted to genetic mutationsandimmunotherapy drugs known as checkpoint inhibitors。

Among the treatment options your doctor may discuss with you are:

• 手术A variety of surgical techniques可用于清除肿瘤。
• 化学疗法Chemo是杀死癌细胞的药物方案。
• Radiation Therapy高能射线或颗粒靶向并破坏癌细胞。
• 有针对性的疗法在靶向疗法, drugs home in onspecific mutations (gene changes)on cancer cells or block new blood vessel growth in tumors.
• ImmunotherapyA class of immunotherapy drugs known as checkpoint inhibitors stimulate the body’s own immune system to attack cancer cells, according to the American Cancer Society. (17,18)

Learn More About Lung Cancer Treatment

Who Treats Lung Cancer: Your Team of Doctors

治疗肺癌需要许多不同类型的医生和其他医疗保健提供者一起工作。

The teammay include the following:

• 医疗的肿瘤学家
• 辐射肿瘤学家
• 胸外科医生
• 在terventional pulmonologist
• Pathologist
• Radiologist
• Palliative care doctor

医学肿瘤学家

A doctor who uses chemotherapy, targeted drugs, or immunotherapy.

Radiation Oncologist

使用放射疗法杀死癌细胞的医生。

Thoracic Surgeon

A doctor who uses surgical techniques for lung cancer treatment.

在terventional Pulmonologist

诊断和分期肺癌并使用医疗技术来缓解某些症状的医生。

Pathologist

A doctor who examines tissues, fluid, or blood to help with diagnosis and treatment.

Radiologist

进行成像研究的医生，例如胸部X射线，CT，正电子发射断层扫描（PET）和磁共振成像（MRI）。

姑息治疗医生

根据美国肺部协会，一名致力于最大程度地减少疼痛和副作用并改善生活质量的医生。（（19)

Home remedies and homeopathic medicine will not cure lung cancer, but according to the Mayo Clinic, certain alternative and complementary therapies may make it easier to cope with symptoms of the disease or side effects of treatment, including: (20)

• Acupuncture
• 芳香疗法
• Massage
• 音乐疗法
• 瑜伽
  

Palliative carecan also make life with cancer better. Some examples include:

• Emotional support and counseling
• 营养补充剂
• Medication to treat pain, per the American Lung Association (21)
• 医疗的procedures to make breathing easier, per the American Cancer Society (22)

了解有关肺癌替代和补充疗法以及姑息治疗的更多信息

Prevention of Lung Cancer

无法完全消除肺癌风险，但是您可以降低几率。您可以做一些事情：

• Don’t smoke, or如果您吸烟，请停止
• 避免二手烟
• 测试您的房屋中的ra
• Avoid carcinogens at work, like asbestos
• 吃装满水果和蔬菜的饮食
• Exercise most days of the week (8)

Learn More About Lung Cancer Prevention

肺癌会导致多种并发症，包括：

• 疼痛You may feelpain if cancer spreads (metastasizes) to the lung lining, the bone, or another area of the body.
• 呼吸急促This can occur if the cancer grows to block the major airways or if fluid builds up around the lungs, making it harder to take a full breath.
• 咳血肿瘤会导致气道出血。（8）

了解有关肺癌并发症的更多信息

Approximately 6.3 percent of people in the United States will be diagnosed with lung cancer at some point in their lives, based on data from 2014 to 2016, according to the National Cancer Institute. (2)

The National Cancer Institute also offers these estimates:

• 2019年，有228,000多人被诊断出患有肺癌，预计将死于这种疾病。
• About 13 percent of all new cancer cases — and 23.5 percent of all cancer deaths — are caused by lung cancer.
• 在过去的十年中，新的肺癌诊断平均每年下降约2.3％，部分原因是人们是quitting smoking。
• Death rates are also falling平均而言，每年平均几乎3％，部分原因是吸烟和治疗和早期发现的进展减少。

美国癌症协会说，在65至74岁的人群中，肺癌最常被诊断出。（（23)

As many as 20 percent of people who die from lung cancer in the United Stateshave never smokedor used any form of tobacco. (24)

A number of other diseases and chronic health conditions appear to increase the risk of developing lung cancer.

这些包括：

• Previous Lung DiseaseAccording to the Mayo Clinic, researchers have found an association between lung cancer and a history of other lung diseases, such aschronic obstructive pulmonary disease (COPD)。（（25)
• HIV感染的人人类免疫缺陷病毒（HIV）are twice as likely to develop lung cancer as the general population, per the National Cancer Institute. (26)

If you or someone close to you receives a肺癌诊断, there are many resources for information and support, including:

• American Cancer SocietyTheAmerican Cancer Societyoperates a NationalCancer InformationCenter where trained specialists are available 24 hours a day, 365 days a year, via phone or live chat.
• 国家癌症研究所The国家癌症研究所is a go-to source for reliable information about cancer topics, research, and clinical trials.
• 取消取消是一家非营利组织，为肺癌，治疗信息和肺癌支持小组提供的免费专业支持服务提供由肿瘤学社会工作者领导的小组。

Additional reporting byPamela Kaufman。