Earlier detection and new treatments are bringing hope to thousands at risk of suffering from lung cancer. Here's how one surprising new treatment is amazing doctors around the world.
较早发现和各种新疗法正为数千面临肺癌风险的人带来希望。本文介绍一种让全世界的医生都大吃一惊的新疗法。
When Ann Long, from Liverpool, started smoking at about 17, she never imagined that she was putting herself in danger.
利物浦的Ann Long17岁开始抽烟时，根本没想到她在将自己置于险境。
In the years after cigarettes first became popular, tobacco companies campaigned furiously to cast doubt on findings about a lung cancer-smoking link. And it worked. By the time the evidence was so overwhelming that all doubt was gone, the seeds of cancer had been planted in millions of lungs—dormant, sometimes, for decades, but almost always deadly.
香烟开始流行的多年里，烟草公司进行声势浩大的活动来让公众怀疑肺癌与吸烟的关联，这确实奏效。当吸烟可能导致肺癌的证据无可置疑而怀疑的声音消失时，癌症的种子已经埋在了数百万人的肺中——肺癌有时会潜伏数十年，但几乎都是致命的。

In 1976 Ann, by then a mother of six mostly school-aged children, lost her husband George, a heavy smoker, to lung cancer. And although she smoked far less and gave up entirely before 1993, Ann herself got the terrifying diagnosis late in 2003.
1976年，Ann的烟瘾很大的丈夫死于肺癌，那时她是六个即将到学龄期的孩子的母亲。另外，虽然她抽的烟比丈夫少很多，而且在1993年之前就彻底戒掉了，但2003年末她被诊断出令人恐惧的肺癌。
Today, dread haunts the minds of many women, smokers as well as ex-smokers: Will I get it too?
现在，很多吸烟和曾经吸过烟的女性经常面临这样的担忧：我也会得肺癌吗？
Early detection is crucial早发现非常关键
Lung cancer accounts for about 20 per cent of all cancer deaths in Europe. In the UK and Poland, where women started smoking earlier than in most other EU countries, it might soon overtake breast cancer as the leading cause of cancer mortality in women.
在欧洲，肺癌导致的死亡数占全部癌症的20%。英国和波兰的女性开始吸烟的年龄较欧洲多数国家的女性早，肺癌可能很快超过乳腺癌成为女性癌症死亡的罪魁祸首。
Although smoking is behind the vast majority of lung malignancies—90 per cent in men and 80 per cent in women—exposure to certain substances, including asbestos, radon and diesel fumes, can also increase risk, as can genetic mutations. Genes are often to blame when the illness strikes younger people, says Dr Rafael Rosell of the Catalan Institute of Oncology, Barcelona. And genes help determine which treatments work best for each individual.
尽管吸烟是绝大多数肺部恶性肿瘤的幕后凶手（男性中有90%，女性中有80%），但接触石棉、氡和柴油机烟气等物质及基因突变也能增加患肺部恶性肿瘤的风险。巴塞罗那加泰罗尼亚肿瘤研究所的Rafael Rosell博士说，是年轻人患病的原因常常能归咎于基因。另外，基因有助于确定每个人的最佳治疗方法。

About a week before Christmas, she got the bad news. And she thought back to how devastating losing her husband George had been for her family. She remembers, “How was I going to tell my kids?”
大概在圣诞节前一周，她得到了坏消息。她回想到失去丈夫George曾对她的家庭是个多么大的打击。她回忆说：“我要怎么告诉孩子们呢？”
On January 3, 2004, Ann had half her left lung removed and has been cancer-free since. Surgery is often a good option for people whose cancers are detected early, as Ann’s was. And a newer, less-invasive type of operation, video-assisted thoracic surgery, lets surgeons remove diseased tissue with a much smaller incision, reducing trauma and recovery time.
2004年1月3日，Ann的左肺被切除，从此她摆脱了癌症。对于像Ann这样的被发现患有早期癌症的人，手术是良好的治疗手段。一种更新的低创型手术——电视胸腔镜手术使外科医生能通过小得多的切口切除病变组织，从而减少创伤并缩短康复时间。
However, if the cancer is metastatic, meaning it’s spread to other parts of the body, surgery might not always be the best therapy. But there are numerous treatments today that can prolong life even in people with more advanced cancers.
然而，如果癌症转移了，即癌症扩散到了身体其他部位，外科手术可能不总是最佳疗法。但现在有很多能延长更严重癌症病人生命的疗法。

The new approach
新疗法
“We’ve changed quite a lot in how we think about lung cancer,” says Dr Mina Gaga, medical director of the Athens Chest Hospital, Greece.
“我们对肺癌的看法已有了很大的改变。”希腊雅典胸科医院医疗总监Mina Gaga博士说。
“When people have a good health status then it’s worth trying all types of therapies because people may respond quite strikingly.”
“如果患者健康状况良好，那么所有的疗法都值得尝试，因为患者的反应可能十分显著。”
Standard chemotherapy drugs and radiation can slow a tumour’s growth, shrink tumours and kill cancer cells. These therapies are often used after surgery to mop up any malignancy that might have been missed and are also typically the first-line treatments used for more advanced tumours when surgery isn’t feasible.
标准化疗药物和放射疗法能减缓肿瘤的生长，使肿瘤缩小并杀死癌细胞。通常在手术后使用这些疗法来清除手术未能切除的残余瘤体；无法进行手术时，这些疗法一般也是更严重癌症的一线疗法。
It’s been found that precision or personalised chemotherapy can help. Just like normal cells, cancer cells need “growth factors”—hormones, proteins and other substances that occur naturally in all of our bodies—in order to thrive.
研究发现，精确的化疗和个人化的化疗有助于癌症的治疗。和正常细胞一样，癌细胞也需要“生长因子”才能增殖，“生长因子”包括激素、蛋白质及其他在我们体内自然产生的物质。
“We do a genetic analysis of tumour tissues,” says Dr Eric Haura, a physician-scientist at the Moffitt Cancer Centre, Florida. “If this shows that a cancer is being fuelled by particular growth factors, targeted drugs can block the cancer cell from accessing its ‘fuel’ source.”, says Dr Haura.
“我们对肿瘤组织进行基因分析。”弗罗里达莫菲特肿瘤中心的临床科学家Eric Haura博士说。“如果基因分析发现肿瘤由某种生长因子提供养料，靶向药物能阻止肿瘤从其‘养料’源获取养料。” Haura博士说。

He points out though that these drugs aren’t cures, as cancers eventually develop resistance to these and other drugs.
但是，他指出这些药无法治愈癌症，因为癌症最终会对这些及其他药物产生抗性。
New drugs, tailored to the mutating cancer, can in some cases replace the ones it’s developed resistance to. These are designed to behave like a super-charged version of your body’s own immune defences. The two most used are bevacizumab or cetuximab. Each blocks cancer cells from growing by denying access to the growth factors they need.
在某些情况下，为突变的癌症定制的新药能替代那些癌症对其有抗性的药物。这些新药的作用犹如你身体自己的免疫防御的强化版，其中最常用的两种药是贝伐单抗（bevacizumab）和西妥昔单抗（cetuximab），它们都能阻止癌细胞获得所需的生长因子从而使癌无法生长。
Current immune therapies only benefit about 20 to 30 per cent of lung-cancer patients. But when they do work, the results can be amazing. “In some cases, most of the tumour goes away,” says Dr Haura. And the effects can sometimes last for years.
当前的免疫疗法只能让20%-30%的肺癌患者受益。但当这些疗法确实起作用时，治疗结果会很惊人。“在某些情况下，大部分癌都消失了。” Haura博士说。另外，这种效果能持续多年。

Put down the cigarettes
远离香烟
You can improve your odds of not getting lung cancer right now. If you smoke, stop. Within ten years of giving up smoking the risk of dying from lung cancer drops by half. But it won’t drop to the levels of someone who’s never smoked.
你可以马上就降低自己患肺癌的几率，如果你吸烟，请别吸了。戒烟十年内，死于肺癌的可能性下降50%，但不会降到与不吸烟者相同的水平。
Dr Haura says: “We think that cancer is a process that began many decades before, where cells and their DNA were damaged.” As we age, our immune systems, which might protect us against the consequences of such damage for all those decades, eventually become less robust.
Haura博士说：“我们认为，癌症这一过程在几十年前细胞及其DNA损伤时就开始了。”我们衰老时，这几十年间可能保护我们免于遭受损伤后果的免疫系统最终变得不那么强大。
Nonetheless, people with lung cancer who stop smoking live about 50 per cent longer than those who continue to smoke. And the sooner you get diagnosed and treated, the better your odds.
然而，不再吸烟的肺癌患者的存活时间比继续吸烟的肺癌患者长50%。另外，你确诊和接受治疗的时间越早，存活时间延长的几率就越大。
Ann Long is a testament to all of the above. Now aged 80, more than 20 years after she stopped smoking and more than ten after the surgery to remove half her lung, she leads an active life, travels widely, exercises more than some people half her age and has a positive attitude.
Ann Long的经历证明上述内容所言不虚。她现在80岁，戒烟已有20多年，半个肺切除已有10多年，她过着活跃的生活，去过很多地方旅行，锻炼量比只有她一半岁数的人还多，并且有着积极的态度。
But what saved her might have been her willingness to face her worst fears and go straight to the doctor. “I know from talking to people, they’re so terrified they might have cancer, they don’t go.”
但是，挽救她生命的，或许是她愿意面对自己最大的恐惧并勇敢就医。“在与人交谈中我知道，他们对自己可能得了癌症感到太恐惧了，他们不去就医。”
When Ann thinks back to losing her husband in 1976 to the same disease, she remembers that doctors could offer him nothing other than painkillers. Medicine has progressed exponentially since then.
回忆1976年她丈夫死于肺癌时，她记得当时医生除了给他开止痛药外束手无策。自那时开始，医学有了长足的发展。
“I just realise how fortunate I am,” says Ann, “to be living at the time that I am.”
“能活在这个世界上，” Ann说道，“我发现我简直太幸运了。”

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