After being diagnosed with lung cancer, many elderly patients and their families often feel overwhelmed by a barrage of questions: Can treatment be administered if the patient also has hypertension? Can treatment be given if the patient's lung function is poor? Is lung cancer treatment difficult or easy? If these questions are not professionally answered, they can easily turn into unnecessary panic and anxiety.
To this end, Professor Yang Nong, a lung cancer diagnosis and treatment expert and a specially-appointed expert at Hainan Cancer Hospital, provided a detailed analysis of the core issues that patients and their families are most concerned about, helping everyone to calmly deal with every key aspect of lung cancer treatment.
Q1: Will lung cancer complicated with hypertension affect the treatment?
Professor Yang Nong: It is quite common for lung cancer patients over 60 years old to have comorbid hypertension. Hypertension can indeed affect lung cancer treatment - when blood pressure is poorly controlled, regardless of whether it is surgery, chemotherapy, targeted therapy, or immunotherapy, the risk of cardiovascular accidents will significantly increase, and there may also be an increased risk of bleeding, accompanied by symptoms such as dizziness and chest tightness.
In addition, anti-tumor drugs such as anti-angiogenic targeted drugs may also lead to increased blood pressure, which requires early attention and continuous monitoring throughout the treatment process.
Hypertension increases the burden on the heart, while lung cancer affects oxygen supply to the lungs. The combination of the two can reduce patients' treatment tolerance and cause symptoms such as fatigue and shortness of breath.
Therefore, both need to be managed synchronously, with emphasis on three points:
First, before treatment, actively inform the doctor about your blood pressure control status, details of antihypertensive medications, and medical history of heart disease, cerebrovascular disease, etc., to facilitate the development of a safe treatment plan;
Secondly, during the treatment period, measure and record blood pressure every morning, afternoon, and evening. If there is a sudden increase in blood pressure, inform the doctor immediately. Do not stop or change antihypertensive medication without authorization;
Thirdly, maintain a daily low-salt and low-fat diet, refrain from smoking and drinking, avoid staying up late, steer clear of sudden movements such as jumping or squatting, and keep emotions calm.
Q2: Can immunotherapy be performed if lung function is poor?
Professor Yang Nong: Poor lung function is not an absolute contraindication for immunotherapy. Unlike chemotherapy, immunotherapy does not directly kill tumor cells, but activates the body's own immune system to attack tumors, causing less direct damage to lung tissue.
Clinically, many elderly patients with chronic obstructive pulmonary disease (COPD), emphysema, or those who have undergone lung surgery and have decreased lung function, can still tolerate immunotherapy.
However, extreme caution is required in two situations:
Firstly, patients with severe underlying lung diseases in acute exacerbation, such as chronic obstructive pulmonary disease (COPD), acute exacerbation of asthma, and severe lung infections, need to control their underlying diseases first. Otherwise, immunotherapy may exacerbate lung inflammation and induce breathing difficulties;
Secondly, if the patient has previously experienced severe immune therapy-related pulmonary adverse reactions, the decision to use it again should be made after a comprehensive evaluation by a multidisciplinary team
Q3: Is lung cancer treatment difficult or not?
Professor Yang Nong: The difficulty of treating lung cancer not only depends on the cancer itself, but also closely relates to the timing of detection and whether the treatment is standardized. Many people mistakenly believe that lung cancer is a "terminal illness" with extremely difficult treatment, which is the biggest misconception.
In fact, early-stage lung cancer is not terrifying - even for the aggressive small cell lung cancer, early detection offers a high chance of achieving clinical cure.
Patients with early-stage lung cancer treated by Yang Nong's team generally have a chance for surgery. Most of them can be discharged from the hospital about a week after surgery, and the vast majority do not require additional chemotherapy or radiotherapy. The 5-year survival rate is 80%-90%. After recovery, they can lead a normal life and work.
The real challenge lies in the treatment of advanced lung cancer, where cancer cells have already spread. Monotherapy proves to be ineffective, necessitating multidisciplinary collaboration and combined intervention using various approaches. Moreover, issues such as drug resistance and metastasis must be addressed.
However, even though it is difficult to treat, it is not impossible to find a solution. Currently, precision treatment methods such as targeted therapy, immunotherapy, ADC, and various clinical trials of new drugs can help many patients with advanced or terminal diseases achieve long-term survival with tumors, and some can even achieve clinical cure.
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, leader of the oncology department, and head 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, complex recurrent and resistant clinical cases, scientific research, and teaching 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 eight 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 for his anti-cancer science popularization videos.
[Medical expertise]
Specialties: Precision treatment of lung cancer, breakthrough in difficult, recurrent, drug-resistant, and brain metastatic cases; individualized and precise treatment for brain metastatic tumors of lung cancer; early diagnosis of pulmonary nodules and lung cancer; personalized comprehensive diagnosis and treatment for various 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 Class 1 national new drugs), and is particularly skilled in treating complex cases such as refractory, recurrent, and drug-resistant conditions, as well as brain metastases.
He is also proficient in the comprehensive diagnosis and treatment of multiple cancer types, individualized, and interdisciplinary, covering a wide range of solid tumors (such as stomach, intestine, brain, etc.).
[Visit Information]
1. Clinic Hours and Location
April 25th, 14:00-17:00
Sixth Consultation Area of Hainan Cancer Hospital
2. [Appointment registration]
Follow the official account of Hainan Cancer Hospital for "appointment registration"
3. Health consultation
18976324546
[Friendly Reminder]
To facilitate the expert 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 ever done in chronological order
4. Paper medical records of previous visits
5. Surgical case biopsy: paraffin block 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