Lung cancer, as one of the most common malignant tumors worldwide, ranks first in both incidence rate and mortality rate among malignant tumors in China. With the continuous advancement of medical technology, gene detection technology has opened up new paths for the diagnosis and treatment of lung cancer. However, many patients and their families often become deeply worried when they receive a gene detection report and see the words "gene mutation". In fact, the gene mutation in lung cancer patients cannot be simply judged as "good" or "bad".
In response to the common questions about gene mutations among lung cancer patients, we have specially invited Professor Yang Nong, a distinguished expert from Hainan Cancer Hospital, to provide professional interpretation.
Question: Is the detection of gene mutations in lung cancer considered a high-risk factor?
Answer: Professor Yang Nong: Gene mutation and high-risk factors are two different concepts. Clinically, it is recommended that lung adenocarcinoma patients undergo gene testing. The core purpose is to check whether there are driver gene mutations, so as to find corresponding targeted therapeutic drugs and achieve more precise treatment, rather than using it as a basis for judging high-risk factors.
So, what are the specific high-risk factors for lung cancer?
Professor Yang Nong: There are primarily five high-risk factors for lung cancer: Firstly, smoking and passive exposure to second-hand smoke. Relevant studies indicate that over 80% of squamous cell carcinomas are associated with smoking. Secondly, air pollution. Long-term exposure to industrial exhaust fumes, haze, and other pollutants increases the risk of cancer. Thirdly, chronic lung diseases, such as having previously suffered from chronic obstructive pulmonary disease, pulmonary fibrosis, tuberculosis, and other related conditions. Fourthly, a family history of lung cancer. Lastly, age factors. The incidence rate of lung cancer increases with advancing age.
Question: Which gene mutation is better?
Answer from Professor Yang Nong: Taking patients with advanced lung cancer as an example, those with EGFR-sensitive mutations have a median survival time of approximately 38 to 50 months, while those with ALK fusion mutations can achieve a median survival time of over 70 to 80 months. From this data comparison, it can be seen that different driving mutations are directly related to patient prognosis. Relatively speaking, patients with ALK fusion mutations may have a more ideal survival situation.
Of course, this is only a partial factor affecting the patient's prognosis. The ultimate treatment outcome and survival time of the patient are also closely related to whether they receive standardized comprehensive treatment and whether the appropriate treatment plan is adopted at the right time. Even if there are relatively better types of gene mutations, without scientific and reasonable treatment, it is difficult to achieve ideal prognostic outcomes.
Question: Do lung cancer patients with gene mutations still need immunotherapy and chemotherapy?
Answer from Professor Yang Nong: Having gene mutations does mean that patients have the opportunity to use targeted drugs, but targeted drugs are not the only treatment option for such patients.
From the perspective of the overall principles of malignant tumor treatment, a single treatment approach is difficult to achieve long-term survival for patients. The vast majority of cancer patients who have achieved long-term survival have undergone comprehensive treatment. For example, when a patient responds well to targeted therapy, doctors will consider whether to combine chemotherapy or anti-angiogenic therapy at specific stages based on the specific condition, in order to further improve the efficacy. If the tumor shrinks significantly after treatment, doctors will also assess whether there is an opportunity for surgery or radical radiotherapy. Through the synergistic effects of multiple treatment methods, the disease progression can be controlled to the greatest extent.
Therefore, it is extremely rare to expect complete cure of cancer solely relying on one anti-tumor treatment method. In most cases, comprehensive treatment and multidisciplinary collaboration are the key methods to help cancer patients achieve long-term survival.
Expert Introduction / Visit Information
【 Expert Introduction 】
Yang Nong
Chief Physician, Doctoral Supervisor
Long-term employed experts of Hainan Cancer Hospital and Hainan Chengmei Hospital
He currently serves as Vice President of the Second People's Hospital of Hunan Province, head of the oncology department, and director of the "Yang Nong Famous Doctor Clinic" / "Yang Nong Famous Doctor Expert Team Clinic". He is also a chief expert of the National Major Scientific and Technological Special Project, a member of the Lung Cancer Special Committee of the National Tumor Quality Control Center, the director of the Hunan Provincial Key Laboratory of Precision Diagnosis and Treatment of Lung Cancer, and the director of the Hunan Provincial Respiratory Tumor Clinical Medical Research Center. He has been dedicated to precision targeted therapy for lung cancer and gastrointestinal tumors, as well as to clinical, scientific research, and teaching work related to difficult, recurrent, and drug-resistant cases for nearly 30 years.
He has been honored with the title of "National Famous Doctor - Excellent Style" in the 6th edition, and has been recommended by patients across the country as "Annual Good Doctor" for 8 consecutive years, as well as being awarded the title of "First Brain Doctor - Famous Doctor". He has authored national guidelines, boasts over 500,000 followers across the internet, and has achieved over 120 million views on his anti-cancer science popularization videos.
Medical expertise
Specialties: Precision treatment of lung cancer, breakthrough in refractory, recurrent, and drug-resistant cases with brain metastasis; individualized and precise treatment of brain metastases from lung cancer; early diagnosis of pulmonary nodules and lung cancer; personalized comprehensive diagnosis and treatment of solid tumors; clinical trials of the latest immunotherapy/targeted therapy drugs.
·With nearly 30 years of experience in precision immunotherapy for lung cancer, he has led nearly 400 phase I-III clinical trials of new anticancer drugs (including national Class 1 new drugs), and is particularly skilled in treating complex cases such as refractory, recurrent, and drug-resistant conditions, as well as brain metastases.
·Early diagnosis and treatment of pulmonary nodules and lung cancer, with an annual diagnosis of over 2,000 cases (over 10,000 cases accumulated from 2019 to 2024), and a detection rate of over 90% (retrospective study in 2023).
·Proficient in comprehensive diagnosis and treatment of multiple cancer types, individualized, and interdisciplinary, covering pan-solid tumors (such as stomach/intestine/brain, etc.).
·Professor Yang Nong receives over 14,000 visits annually (2023 data).
·Managing the "Lung Cancer Immunotherapy Patient Group", with long-term follow-up management of over 4,000 lung cancer patients who have achieved long-term survival, accumulating rich clinical experience.
[Visit information]
01 [Visit Time and Location]
October 19th, 14:00-17:00
The sixth consultation area of Hainan Cancer Hospital
02 [Appointment registration]
Follow the official account of Hainan Cancer Hospital for "appointment registration"
03 [Health Consultation]
13876807106
04 [Friendly Reminder]
To facilitate the experts in understanding your condition as soon as possible, please bring:
1. ID card, medical insurance card, mobile phone
2. Accompany immediate family members (with decision-making authority)
3. Arrange the relevant examinations you have undergone in chronological order
4. Paper medical records of previous visits
5. Surgical case biopsy: paraffin blocks or 20-30 white slides
6. Pathological diagnosis report
7. Inpatient medical records and notes
8. Recent relevant examinations
9. The patient's current treatment plan
10. The most pressing questions I want to inquire about