2023-08-23 04:48:56
Illustration-What should be paid attention to after lung cancer surgery? How to avoid relapse? Physician to answer!
[Health Medical Network/Reporter Wu Yiwen]The death rate of lung cancer ranks first among cancers, and it has become Taiwan’s “new national disease”. At present, surgery is still the most important treatment for lung cancer. Most patients with 1A, 1B, 2A, 2B, and 3A early-stage lung cancer can undergo surgery after evaluation by doctors. However, what should be paid attention to after the operation? How about postoperative care?
Dr. Wang Jinzhou, deputy director of the Department of Internal Medicine of Kaohsiung Chang Gung Hospital, said that since the current surgical methods are mainly minimally invasive, compared with the traditional thoracotomy in the past, there are fewer postoperative complications and side effects, and there is no need to worry too much. Physical and mental recuperation, exercise or rehabilitation to restore function and physical fitness, and cancer risks such as smoking and environmental substance exposure must be avoided. In addition, the most important part is to avoid recurrence and follow up regularly.
Don’t Ignore Recurrence After Lung Cancer Surgery How Can You Reduce the Risk of Recurrence?
After lung cancer surgery, there is still a high chance of recurrence. Dr. Wang Jinzhou said that in terms of 5-year survival rate, the survival rate of stage 1 lung cancer is about 65-75%; the survival rate of stage 2 is about 50-70%; the survival rate of stage 3A is only about 30-40%. For the first stage, there is still about 20-30%, and the more serious stage 3A has about 70% recurrence risk, so lung cancer patients who can be operated on actually have a high chance of recurrence.
Dr. Wang Jinzhou pointed out that there is still a risk of recurrence after surgery because sometimes cancer cells may have metastasized to distant places, but they are too small to be detected by imaging during surgery. In this case, it is recommended that patients undergo postoperative surgery. Adjuvant therapy reduces the risk of recurrence.
▲Dr. Wang Jinzhou, deputy director of the Department of Internal Medicine, Kaohsiung Chang Gung Hospital
Understand the 3 adjuvant treatments after surgery and choose the appropriate method according to individual circumstances
Postoperative adjuvant therapy includes chemotherapy, targeted therapy, immunotherapy, etc. Dr. Wang Jinzhou mentioned that the standard adjuvant therapy is chemotherapy, which can only increase the recurrence prevention effect by about 5%, which is not enough, but now there are other new treatment options for adjuvant therapy, such as; targets, immune drugs, etc. Studies have confirmed that the addition of targeted adjuvant therapy or immune adjuvant therapy after surgery is effective in controlling recurrence, which can increase the recurrence prevention effect by about 30%.
Taking the more serious stage 3A as an example, there was about 70% chance of recurrence originally, and about 65% chance of recurrence is still possible if chemical adjuvant therapy is used after surgery, but if targeted or immune drugs are combined, the chance of recurrence will decrease. Drop below 50%, the gap is very large.
However, how to choose the right medicine? Dr. Wang Jinzhou said that patients should discuss more with the attending physician, and through genetic testing or biomarker testing, formulate treatment plans according to individual conditions. For example, if the genetic mutation is found to have a corresponding target drug, then It is recommended to use target adjuvant therapy; if there is no gene mutation, it is more meaningful to choose immune adjuvant therapy.
Adjuvant treatment and regular follow-up reduce the risk of recurrence and death
In addition to adjuvant treatment, regular postoperative follow-up examinations are also very important, because some patients do not have any symptoms after recurrence, and usually when symptoms such as cough, wheezing, and pain appear, it may be a serious recurrence of lung cancer. Dr. Wang Jinzhou said that after surgery, doctors will arrange time ranging from 3 months to 1 year according to different periods to track chest computed tomography, cancer CEA index, etc.
Therefore, attention should be paid to the risk of recurrence after surgery, and regular follow-up should be followed according to the doctor’s advice. If recurrence is found, follow-up treatment can also be discussed with the doctor. However, Dr. Wang Jinzhou mentioned that although immunization and targeted therapy can also be used after relapse, adjuvant therapy is to kill residual cancer cells in the state of no disease after surgical treatment, and relapse is in a state of disease, and its therapeutic effect is bound to be great. At a discount, the relative side effects are also more troublesome.
The mood and course of treatment after relapse are also very different from those in the period of postoperative adjuvant treatment. Dr. Wang Jinzhou said that 2 of the patients in his hands have completed immunotherapy after surgery, and 1 has been using targeted therapy for more than half a year. The current follow-up is in good condition and there is no recurrence. It is recommended that patients with early-stage lung cancer should undergo surgical treatment as soon as possible. Choose appropriate adjuvant therapy according to individual circumstances after surgery to reduce the risk of recurrence and death.
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