New Book Recommendation by Dr. Li Yu Chung, Jacky
Written by Dr. Li Yu Chung, Jacky, Specialist in Clinical Oncology, Hong Kong
Synopsis: Lung cancer is not only one of the top ten most common cancers in Hong Kong, but it has also been the leading cause of cancer death in the city over the past few decades. The vast amount of information available online can be overwhelming for patients and their families, and may not even be applicable to the local healthcare environment.
As a seasoned clinical oncologist based in Hong Kong, Dr. Li Yu Chung, Jacky, observed that most medical information on lung cancer available to the public lacks practicality and targeted relevance. He thus wrote this book, carefully curating topics and compiling practical knowledge to equip patients with a clear understanding of their condition during their cancer fight, with the aim of helping them access the most suitable and personalized treatment plans.
Each chapter of the new book 50 Advanced Practical Strategies for Lung Cancer Treatment is crafted by Dr. Li Yu Chung, Jacky, a Hong Kong-based oncologist, based on specific or special scenarios encountered in lung cancer management. Dr. Li skillfully adopts a real-world perspective to focus on researching the most common and up-to-date clinical issues related to lung cancer diagnosis and treatment. These 50 invaluable clinical tips will provide practical knowledge and serve as a guiding resource for the general public, especially lung cancer patients and their family members.
Types of lung cancer, symptoms, diagnosis, survival rate, and treatment methods
Lung cancer is the second most common cancer in Hong Kong, second only to colorectal cancer in incidence, and has been the leading cause of death for many years. According to data from 2018, there were 5,252 new cases of lung cancer in Hong Kong, with nearly 4,000 deaths.
It is important to note that non-smokers can also develop lung cancer. Therefore, we should understand the classification and symptoms of lung cancer, methods of examining lung cancer such as tissue biopsies, and various treatment methods for lung cancer in order to facilitate early detection and treatment.
Introduction to Lung Cancer
Lung cancer can be mainly divided into two categories: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), with the former accounting for about 85% of all lung cancer cases. Because the symptoms of early-stage lung cancer are not obvious, more than half of the patients are already in the late stage when diagnosed, resulting in a low survival rate. Therefore, early detection and treatment are very important.
Fortunately, significant progress has been made in lung cancer treatment over the past decade. Various techniques for lung cancer tissue aspiration and treatment (including post-operative care) have rapidly advanced, including chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Many patients with advanced lung cancer can now improve their survival rates through these treatments.
I. Types of Lung Cancer
Lung cancer is mainly divided into non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), which previously accounted for about 85% of all lung cancers and are also the most common types of lung cancer in Hong Kong.
Non-small cell lung cancer (NSCLC) is further subdivided into the following three types based on the tumor's growth structure and morphology:
Lung adenocarcinoma
Lung cancer can be mainly divided into two categories: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), with the former accounting for about 85% of all lung cancer cases. Because the symptoms of early-stage lung cancer are not obvious, more than half of the patients are already in the late stage when diagnosed, resulting in a low survival rate. Therefore, early detection and treatment are very important.
Squamous cell carcinoma
Squamous cell carcinoma accounts for approximately 25% to 30% of all non-small cell lung cancer (NSCLC) cases, and most patients have a history of smoking. It typically originates in the central lung near the bronchi and spreads relatively slowly.
Large cell carcinoma
It accounts for about 10% to 15% of all non-small cell lung cancer (NSCLC) cases. It can grow in any location in the lungs, spreads rapidly, and is difficult to treat.
Non-small cell lung cancer staging and symptoms
Issue 0
Also known as "carcinoma in situ", cancer cells are confined to the space between the epithelial tissue and the basement membrane and have not yet invaded the basement membrane, so they rarely spread.
Issue 1
The cancer cells were confined to the lungs, were less than 3 centimeters in size, and the adjacent lymph nodes had not yet been affected.
Issue 2
The tumor is approximately 3 to 7 centimeters in size and may have spread to the lymphatic tissue near the lungs or the chest wall.
Issue 3
The tumor was over 7 centimeters in size and had spread to the entire lung, lymph nodes, mediastinum, etc., but had not yet spread to other parts of the body outside the chest cavity.
Issue 4
In addition to the primary lung tumor, the cancer cells have also spread to other organs of the body, such as the liver, brain, and bones.
Small cell lung cancer (SCLC)staging and symptoms
Small cell lung cancer accounts for about 15% of all lung cancer cases, and the majority are caused by smoking. This type of lung cancer generally grows faster than non-small cell lung cancer, and about 70% of patients have already experienced metastasis at the time of diagnosis.
Limited period
Limited stage: The tumor is confined to one side of the lung, but it may have already spread to the lymphatic tissue of that side. Approximately one-third of all small cell lung cancer patients are in the limited stage at the time of diagnosis.
Diffusion period
Extensive stage: The tumor has spread to the other lung and/or lymph nodes, surrounding fluids, or other organs. Approximately two-thirds of small cell lung cancer patients are diagnosed at this stage.
II. Symptoms of Lung Cancer
Early-stage lung cancer often presents with subtle symptoms, and patients typically do not notice any abnormalities in the initial stages. However, when patients experience obvious symptoms such as persistent cough, excessive phlegm, shortness of breath, or coughing up blood, it indicates advanced-stage lung cancer. Furthermore, the hormones secreted by lung cancer cells can easily cause bone hyperplasia, potentially leading to clubbing of the fingers. Simultaneously, frequent oxygen deficiency can also easily cause bone hyperplasia and swelling in the extremities.
Early symptoms of lung cancer may include coughing or shortness of breath, but the following symptoms may also occur:
- Physical pain: The patient may feel chest pain or pain in other parts of the body
- Persistent cough: Even after taking the medicine, the cough has not improved, or the cough lasts for more than three weeks, especially if it is accompanied by blood or hoarseness in the sputum.
- Dyspnea: The tumor blocks the respiratory tract or the fluid around the lungs increases, which may cause dyspnea.
These symptoms often lack specific characteristics and may be very similar to the symptoms of other diseases. Therefore, if the above symptoms occur, you should consult a doctor in time and undergo relevant examinations to determine the cause and confirm whether it is a symptom of lung cancer.
Early detection of lung cancer is crucial for improving treatment success rates. Here are some common methodsfor lung cancer screening:Lung cancer screeningway：
III. Lung Cancer Examination and Diagnostic Methods
Radiological diagnosis (or imaging examination)
Chest X-ray examination
CT scan
Positron emission tomography (PET) scan
Isotope bone scan
Biopsy examination
If the radiological examination reveals abnormalities, the doctor will recommend a biopsy for further diagnosis. In addition to determining whether a tumor is benign or malignant, a biopsy for lung cancer screening can also detect the presence of specific gene mutations. A biopsy for lung cancer screening can be performed using the following methods:
Imaging Guided Lung Biopsy
Guided by images from CT or ultrasound scans, doctors insert a small scalpel into the lung to extract tissue from abnormal cells for lung cancer testing, checking for cancerous cells. The procedure requires local anesthesia and takes only a few minutes, causing minimal discomfort.
Bronchoscopy
An endoscope is used to examine the lungs and the lining of the trachea, taking pictures of the inside of the lungs for detailed analysis. Lung tissue can also be extracted for lung cancer screening. The endoscope is inserted into the lungs through the nostrils and mouth. Patients can take sedatives and anesthetics beforehand to help relax their throats and reduce discomfort during the insertion of the endoscope.
Mediastinoscopy
This method of drawing tissue for lung cancer requires general anesthesia and aims to examine the mediastinum, located between the lungs and the heart, as well as the lymph nodes and thymus. The procedure involves making an incision at the base of the neck and above the sternum, then inserting an endoscope. If swollen lymph nodes are found, the doctor can remove them for further testing.
Genetic testing
The examination for specific gene mutations in tumors includes biopsies for laboratory testing and liquid biopsies. If the results reveal specific gene mutations in the tumor, such as EGFR, ALK, ROS1, BRAF, etc., targeted drugs can be used.
IV. Treatment methods and postoperative care for lung cancer
Doctors will recommend the most suitable treatment plan based on the patient's age, physical condition, type of lung cancer, location, and growth rate. The following are common lung cancer treatments; depending on the patient's situation, doctors may use these treatments alone or in combination:
Surgery
Lung cancer resection surgery is primarily suitable for patients with early-stage lung cancer, meaning the tumor is confined to the lung. Lung cancer resection surgery offers a high chance of curing non-small cell lung cancer. However, surgery is not suitable for patients whose cancer cells have spread or who have poor lung function.
Lung cancer surgery generally falls into the following categories:
Wedge resection of the lung: removal of lung tissue containing cancer cells.
Pulmonary septal resection:removal of larger lung tissues
Lobectomy:removal of one or two lobes of the lung
Lung resection:removal of one lung
Radiotherapy
Radiation therapy (also known as electrotherapy) uses high-energy radiation to destroy the chromosomes within cancer cells, thus killing them. Radiation therapy can be used at various stages of cancer treatment, offering benefits such as radical tumor removal, adjuvant therapy, and relieving discomfort. When necessary, radiation therapy can be used for post-operative treatment of lung cancer: cancer patients can undergo radiation therapy after surgery to eliminate cancer cells that were not completely removed and reduce the chance of recurrence; or, before tumor resection surgery, radiation therapy can be used to shrink the tumor, increasing the success rate of the surgery.
However, electrotherapy still has certain limitations. For example, the irradiated skin may become red, dry, and lose hair. Patients may also experience loss of appetite, swelling of the lungs and esophagus, and fatigue.
Chemotherapy
Chemotherapy kills cancer cells in a patient's body using anti-cancer drugs. These drugs can be injected intravenously or taken orally. Chemotherapy drugs can be used alone or in combination, and can also be used in combination with radiation therapy and surgery. They can also be used to relieve discomfort associated with advanced cancer.
Many patients have heard about the side effects of chemotherapy, such as vomiting, diarrhea, hair loss, and fatigue, and are reluctant to undergo chemotherapy. However, various treatment options can cause different side effects, and the severity of the side effects varies from person to person. Before undergoing chemotherapy, patients can consult their doctors to understand the possible side effects and how to deal with them.
Chemotherapy is commonly used for small cell lung cancer that spreads rapidly. Doctors will develop one or more chemotherapy cycles based on the patient's condition, age, health status, and stage of cancer. Each cycle involves several days of chemotherapy, while the rest of the days are for the body to recover.
Common chemotherapy drugs for lung cancer can be categorized into platinum-based compounds, antimetabolites, vinca alkaloids, and paclitaxel. Platinum-based drugs are more likely to cause side effects in lung cancer patients, such as numbness and tingling in the hands and feet, which can potentially affect their daily lives. Although the side effects of chemotherapy may be more pronounced, most of them will gradually disappear after the chemotherapy course is completed.
In recent years, chemotherapy drugs have been continuously developed, and many new chemotherapy drugs can greatly reduce the side effects of treatment. Furthermore, chemotherapy's effectiveness in treating lung cancer is clearly evident. Lung cancer patients can consult their doctors before undergoing chemotherapy to understand how to reduce treatment side effects.
Targeted therapy
Targeted therapy utilizes targeted drugs to target gene mutations in tumors. By blocking growth signals or nutrient supply to cancer cells, it prevents cancer cells from multiplying and gradually induces apoptosis. Currently, there is also an anti-angiogenesis targeted therapy regimen, which targets the endothelial cells within cancer cells, using drugs to inhibit endothelial cell proliferation, preventing blood vessel formation and thus suppressing cancer cell growth. Targeted therapy causes fewer side effects than chemotherapy and has a lower impact on bone marrow hematopoietic cells or the immune system.
Before undergoing targeted therapy, lung cancer patients need to undergo genetic testing to identify mutated genes or abnormal cells and then receive appropriate treatment. In recent years, the medical community has successively discovered targets such as EGFR, ALK, ROS1, HER2, and BRAF, and developed corresponding targeted drugs with significant efficacy.
Immunotherapy
The principle of immunotherapy is to reboot the body's immune system, enabling it to re-identify and kill cancer cells. Immunotherapy mainly uses PD-1 inhibitors and PD-L1 inhibitors, allowing the immune system to kill cancer cells again or preventing cancer cells from disrupting white blood cells in the immune system.
Cancer cells appear because PD-L1 in tumors binds to PD-1 in T-cell receptors, thereby suppressing the body's immune system and preventing it from killing cancer cells. Immunotherapy can be broadly divided into two main approaches:
PD-L1 therapy:
It binds to PD-L1 in cancer cells, preventing them from binding to PD-1 in T cell receptors.
PD-1 therapy:
Directly prevents PD-L1 in cancer cells from binding to PD-1 in the immune system.
Before undergoing immunotherapy, patients can first undergo a PD-L1 protein test to assess their body's response to immunotherapy.
Common side effects of immunotherapy include cough, rash, loss of appetite, and joint pain. In more severe cases, it can lead to autoimmune reactions such as pneumonia, hepatitis, enteritis, or hormonal imbalances that attack healthy cells.
FAQ
1. What are the main types of lung cancer?
Lung cancer is mainly dividedinto non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).The former accounts for about 85% of cases and includes lung adenocarcinoma, squamous cell carcinoma, and large cell carcinoma; the latter is highly associated with smoking and grows and spreads more rapidly.
2. If lung cancer is suspected, what are some common diagnostic methods?
Clinical diagnosis includes radiological imaging examinations ( such as CT scans and PET-CT scans), biopsy examinations (such as bronchoscopy and mediastinoscopy),Genetic testingand crucial genetic testing to determine the presence of mutations such as EGFR and ALK, and to decide whether targeted therapy is appropriate.
3. What are the early signs or symptoms of lung cancer?
Early-stage lung cancer often presents with subtle symptoms, easily mistaken for a common cold. Be alert if youexperience a persistent cough (lasting more than three weeks), blood in your sputum, chest pain,or difficulty breathing. Some patients may also experience hoarseness or unexplained weight loss.
4. What are the current treatment options for lung cancer?
Doctors will develop personalized treatment plans based on the stage of lung cancer, includingsurgical resection, radiation therapy (electrotherapy), and chemotherapy.For advanced-stage patients,targeted therapy and immunotherapycan significantly improve survival rates and reduce side effects.
5. Is there any hope for stage IV (advanced) lung cancer? What are the latest treatment trends?
Even stage IV lung cancer is no longer a terminal illness thanks to medical advancements. The latest treatment trend emphasizes "personalized precision medicine," using genetic testing to screen forsuitable targeted drugs, such asAnother situation，ImmunotherapyMany advanced-stage patients can effectively control their tumors, prolong survival, and maintain a good quality of life through combination therapies (such as chemotherapy combined with immunotherapy).
6. Why do non-smokers also get lung cancer?
In Hong Kong, many lung adenocarcinoma patients are non-smokers, especially women. This may be related tosecondhand smoke, kitchen fumes, ambient air pollution (such as PM2.5), or family genetic predisposition.Therefore, even non-smokers are advised to undergo low-dose computed tomography (LDCT) screening if they experience persistent respiratory symptoms.
Lung cancer related information
Durvalumab consolidates treatment breakthroughs: Significantly prolongs the survival of confined small cell lung cancer
The third phase of the ADRIATIC study showed that Durvalumab consolidation therapy significantly extended the survival of patients with limited-stage small cell lung cancer (SCLC), with a median total survival of 56 months, which was significantly improved compared to 33 months in the placebo group. This article introduces the research data, clinical significance and treatment prospects in detail to help you understand the latest advances in immunotherapy for lung cancer.
The U.S. FDA accelerated the approval of Tarlatamab-dlle for the treatment of broad-stage small cell lung cancer
The U.S. FDA accelerated the approval of Tarlatamab-dlle (trade name Imdelltra) for the treatment of extensive small cell lung cancer on May 16, 2024, bringing new hope to patients who have progressed after platinum chemotherapy. This innovative bispecific T-cell adapter showed excellent efficacy in the DeLLphi-301 clinical trial, with an objective remission rate of 40% and a median remission duration of 9.7 months. The drug effectively activates the patient's own immune system to attack cancer cells by targeting DLL3 and CD3. It is worth noting that the Hong Kong Department of Health has also recently approved the registration of related new drugs for the treatment of diffuse small cell lung cancer, indicating Hong Kong's positive progress in integrating the field of cancer treatment with international standards. For patients and their families in need, the professional team of the Hong Kong United Cancer Centre (HKUOC) can provide detailed medical consultations to help formulate the most suitable personalized treatment plan and grasp the golden opportunity for treatment.
A new choice for the treatment of EGFR mutant lung cancer! The combined regimen of first-line Amivantamab and Lazertinib increases the survival period!
On August 19, 2024, the U.S. Food and Drug Administration (FDA) approved the combination therapy of lazertinib (Lazcluze) and amivantamab-vmjw (Rybrevant) for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC), and the FDA-approved test with EGFR exon 19 deletion or deletion. Mutation in the exon 21 L858R gene.
Repotrectinib, a new lung cancer drug in the United States, was approved, and 79% of patients' tumors shrank significantly!
On November 15, 2023, the U.S. FDA approved oral tyrosine kinase
New efficacy data of CAR-M cell therapy CT-0508 in the treatment of solid tumors released
November 19, 2023, "OncLive" Medicine Online
Patients with lung cancer resistant to oxytinib: amivantamab expands new indications
In May 2021, avantumab (amivantamab)
Doctor Updates
Stage 4 Lung Cancer Recovery Miracle | A Successful Treatment Case of HER2 Gene Mutation
Ms. Zhong Xiying was diagnosed with multiple metastases of stage 4 lung cancer in the brain, liver and bone, and once wanted to give up treatment. Dr. Li Yu Chung, Jacky insisted on genetic testing to find rare HER2 mutations, and quickly formulated a personalized targeted treatment plan to successfully control the condition. Real cases share how genetic testing has changed destiny, and now Ms. Zhong can travel with her family and enjoy happiness. The United Cancer Centre of Hong Kong provides comprehensive genetic testing and personalized treatment services.
Manulife Health Seminar, September 18, 2025: New Trends in the Treatment of Lung Cancer, Breast Cancer, and Prostate Cancer – Dr. Li Yu-chung of the Hong Kong United Oncology Centre shares his insights.
On September 18, 2025, Dr. Li Yu Chung, Jacky of the Department of Clinical Oncology at the Hong Kong United Oncology Centre (HKUOC) will share the latest treatment trends in lung cancer, breast cancer, and prostate cancer at the Manulife Health Seminar. The seminar will be held at Manulife Tower in Kwun Tong from 10:30 a.m. to 11:30 a.m. All are welcome to attend and learn about the cutting-edge treatment technologies and personalized plans!
Sing Tao Front Page Exclusive Interview: 55% of New Lung Cancer Cases Are at Advanced Stages, Personalized Therapy Helps Reduce Recurrence Risk
Sing Tao Headline invited Dr. Li Yu Chung, Jacky to analyze the trend of lung cancer treatment. In 2022, 55% of new lung cancer diseases have reached stage 4, with a survival rate of 72.4% in stage 1 vs. 24.6% in stage 3. The United Cancer Centre of Hong Kong provides personalized lung cancer treatment options guided by genetic testing to help reduce the risk of recurrence, improve treatment effectiveness and early screening success rate.
Diagnosis and treatment of early-stage lung cancer｜Cancer Lecture series (2025/06/06｜Invited by HKHCA)
On June 6, 2025, Dr. Li Yu Chung, Jacky, a specialist in the Department of Clinical Oncology at the Hong Kong United Oncology Centre (HKUOC), was invited by the Hong Kong Healthcare Alliance (HKHCA) to deliver a lecture titled Early Lung Cancer: Diagnosis and Treatment. He shared the latest information on lung cancer screening, symptoms of early-stage lung cancer, diagnostic procedures, and treatment options such as immunotherapy and targeted therapy regimens. The content is for health education purposes only and does not constitute medical advice. Treatment decisions should be made by a physician based on individual case assessments.
【240711 Team Medicine Sharing Seminar】 New Trends in the treatment of lung cancer, breast cancer and prostate cancer
With advancements in medicine, cancer treatment has entered an era of precision and personalized care. Taking lung cancer, Hong Kong's leading cancer killer, as an example, next-generation sequencing technology can detect over 300 cancer genes at once, helping doctors screen and find the most appropriate treatment plan or clinical trial program. This not only avoids delaying treatment but also makes better use of limited resources to maximize benefits for patients.
【Medipartner * Medical Seminar】 New Trends in Lung Cancer Treatment and Nutritional Support
With advancements in medicine, cancer treatment has entered an era of precision and personalized care. Taking lung cancer, Hong Kong's leading cancer killer, as an example, next-generation sequencing technology can detect over 300 cancer genes at once, helping doctors screen and find the most appropriate treatment plan or clinical trial program. This not only avoids delaying treatment but also makes better use of limited resources to maximize benefits for patients.