There is only one 1cm nodule on the lung, why is it judged to be advanced? It turns out to be in the pleural effusion

Lung cancer is a very complex disease. The same manifestations have different results, and the same results have different manifestations. There was a lung cancer patient before, and the lung cancer was found to be accompanied by multiple metastases throughout the body. The gene was checked for EGFR mutation, and she lived for several years after taking the targeted drug. Every time she was hospitalized, her daughter was busy for her. Unfortunately, two years after taking the targeted drug, her daughter checked again. She came out with pleural effusion and was diagnosed with lung cancer. Like her, she also had EGFR mutation, but after taking the targeted drug for only six months, she became resistant to it. She died a year later.

When her daughter was found out, the nodule was actually not big, only about 1cm, but it was such a small nodule that there was no way to operate, why? Because it is already in the late stage, but this late stage of hers is quite special. No metastasis of cancer cells has been detected in all organs except the upper and lower lungs, so a moderate amount of water has grown in the chest cavity. It was bright red, and it was sent for an investigation to find cancer cells. Her mother was similar to her, but she was more powerful than her in that not only cancer cells were found in the pleural effusion, but cancer cells were found in many organs of the body. Instead, her mother outlive her.

In fact, this is not an isolated case of her. There are other patients with advanced stage who also seem to be “wronged”. For example, there was a patient who had a small nodule on the lungs with a diameter of 1.3cm. Left and right, there is no metastasis in other parts of the body, only a 2cm metastatic lesion was found in the brain, both of which are solitary lesions. In this case, surgery can be performed on both ends, and then medical treatment, such as chemotherapy, targeted Treatment, etc., this method can prolong the survival time, but it cannot cure it.

There is also a special case. It is also a nodule in the lung with a diameter of 1.6cm. The performance of the lung is generally considered to be malignant. The organ did not metastasize, but there was a suspected metastases in the calf bone. At that time, the multidisciplinary experts consulted and thought it was metastasized, but the patient insisted on surgery and finally helped her to do it. Unexpectedly, the postoperative effect was very good. After several chemotherapy , the lesions on the bones have also disappeared, and now there is no recurrence, it has been more than three years.

Many people wonder what is metastases and why once metastases cannot be operated, they can only be treated conservatively?

In fact, metastasis is different from the spread that the common people said before. The so-called metastasis is not simply because multiple lesions were found on the body. For example, some people have multiple pulmonary nodules. It is lung cancer, which does not mean that the lung cancer has metastasized. It may be multiple lung cancers that grow at the same time and exist independently of each other. If this situation is compared to the boss, the second, and the third each starting a factory in three places, then The transfer is equivalent to the boss sending his three sons with funds to establish branches in three places. The difference between the two is that the former boss, the second and the third can be removed individually to achieve a radical cure, but the latter case is not, and the removal operation will only speed up the disease. So why is this?

Before this, we need to understand the fundamental difference between the two. The former situation is that the three brothers develop their own careers in three places, and there is no connection between them and neither Sending salesmen to leave their home base to develop in the whole country, that is to say, the tumor does not have cancer cells detached from the parent body and penetrate into the various channels of the human body, such as lymphatic vessels or blood vessels to flow to other places.

The latter situation is different. The boss sent three sons to the road. In the end, the three sons arrived at other places and built their own factories. In fact, the boss may not only send these three sons. One son set out, but sent countless sons, but only these three sons built the factory, it is unknown whether there are other descendants who are building factories, that is to say, cancer cells have entered the blood everywhere. Flowing, those tumors that grow out are only a few cancer cells that are relatively successful. In fact, there are still many cancer cells that are being expelled, or are trying to grow metastases.

As you all understand, only cancer cells are separated from the mother’s body into the blood, and there is a possibility of recurrence. If these cancer cells are not found before surgery, there is a probability of recurrence after surgery. Even early stage lung cancer has the possibility of recurrence and metastasis after surgery. If the metastases have been found, no matter where the metastases grow, the probability of radical surgery is very small, and sometimes even surgery is more life-threatening than no surgery, because surgery is traumatic after all, and it will affect the body’s immunity. Instead, it will cause cancer cells that flow in the blood to grow into metastases.

Of course, surgery is also divided into radical surgery and palliative surgery. The former is for the purpose of radically curing the tumor. Relief of the symptoms caused by the tumor itself is not intended to cure lung cancer. It is worth noting that radical surgery does not mean that it can be cured after surgery, and palliative surgery is basically impossible to cure tumors.

Which cases have been metastasized but still can be operated, mainly include the following.

1. In the case of local lymph node metastasis, in addition to blood vessels, there are lymphatic vessels in various organs of the body. Lymph vessels are responsible for the transport of lymph fluid. If the lung cancer cells are only in the lymph vessels around the lung cancer If the metastases are not transferred to distant places, surgery can also be considered, and there is a certain cure rate after surgery, but the cure rate is not high.

2. As I said above, there are isolated metastases in the lungs, and there is also an isolated metastases in the brain. Surgery on both ends will live longer than no surgery. This does not apply to other organs. Solitary metastases in organs, because of the particularity of brain metastases, the lifespan of patients will be greatly shortened if they are not treated, while isolated metastases in other organs may not have such a significant effect of shortening lifespan, so a small lesion in the lung , A small metastases in the brain can be operated on at both ends.

3. There is a nodule in the upper lung and there is a suspected metastases outside the lungs. If it is uncertain whether the metastases are really metastasized, it is possible to take the risk of surgery and postoperative radiotherapy and chemotherapy. Some can also achieve the purpose of cure.

There are some metastases that many people don’t understand why they can’t do surgery, that is, pleural metastases. Pleural metastases sometimes produce pleural effusion in the pleural cavity. At this time, cancer cells can often be found in the pleural effusion. Once the cancer cells are found in the pleural effusion, it is considered to be an advanced stage, because the tumor in the lungs has metastasized to the pleura through lymphatic vessels or blood vessels. This kind of metastasis is usually not a single metastasis, many of which are covered with metastases on the pleura, and it is meaningless to perform surgery. In some more extreme cases, no metastases were found on the pleura before the operation, and the pleura was found to be full of metastatic nodules after the operation was opened, and they had to be sutured.