How is lung cancer patient double lower limb weakness to return a responsibility? Four reasons need attention, how to prevent?

Uncle Li, 76 years old, is adenocarcinoma of the apex of the lung. He has received radiotherapy and chemotherapy. Every review of chest CT shows that the lesion is well controlled. But Grandpa Li had a new affliction. He said that he ate a lot every day, but he always felt weak. His lower limbs were weak, and he sometimes stumbled when walking. What could possibly be causing this?

There may be several reasons for lower limb weakness in lung cancer patients:

Lumbar spinal metastasis

When cancer cells metastasize to the lumbar spine, destroying the bone tissue of the vertebral body, it can cause spinal instability, after all, the lumbar spine is loaded. When the tumor presses on the spinal cord, it may even progress to paraplegia, complete loss of motor and sensory function in the lower extremities. I have met many patients with thoracic and lumbar metastases from lung cancer, who eventually developed paraplegia, unable to take care of themselves and unable to discharge urine and feces.

Brain metastases

The brain is the center of the human body, directing the movement of the whole body muscles. When a certain functional area of the brain is transferred, it may cause motor dysfunction, but the movement disorder of patients with brain metastasis is usually unilateral. For example, metastases to the left side of the brain can cause motor and sensory impairments to the right side of the limb.

Cancerous weak

Cancer fatigue is also known as cancer related fatigue, or CRF. CRF is considered as the sixth vital sign -- temperature, pulse, respiration, blood pressure, and sixth sign after pain. Cancer fatigue can occur in more than 75% of patients with advanced cancer and in more than 40% of patients after surgery. The causes of cancer fatigue are various, one of which is due to the secretion of some substances by tumor cells themselves, such as interleukin-1, interleukin-6, tumor necrosis factor and so on to induce cancer fatigue.

JiaJian

With the widespread use of immunotherapy in clinical practice, patients with advanced lung cancer are more likely to use immunotherapy, but PD1/PD-L1 inhibitors have a fairly common adverse reaction, namely immune-associated hypothyroidism, or hypothyroidism. The common symptom of hypothyroidism is weakness, inappetence, memory decline, response is slow and so on. Subclinical hypothyroidism is very insidious and may have no specific symptoms other than fatigue. The use of immunotherapy, will be routine blood test thyroid function, hypothyroidism needs to supplement thyroxine replacement therapy in time.

When lung cancer patients present with unexplained weakness of both lower limbs, relevant examinations should be conducted in time, including thoracolumbar magnetic resonance imaging (MRI) and cranial magnetic resonance imaging (MRI) to exclude the presence of relevant metastases. Local radiotherapy may be considered for brain metastases or bone metastases with mannitol and hormonal dehydration.

For advanced patients without brain metastases and vertebral metastases, cancer fatigue is more likely. The treatment of cancer fatigue includes: 1. Strengthen nutrition and supplement high quality protein; 2. 2. Get some exercise; 3. Keep a good attitude and get enough sleep; 4. Drug therapy: patients with severe fatigue can consider the use of central stimulant methylphenidate or short-term use of corticosteroids. Traditional Chinese medicine and traditional Chinese medicine, such as Zhengyuan capsule and Fuzheng capsule, can be added to improve fatigue.