医学汉语(一)癌症治疗

                   Medical Chinese(I) Cancer Treatment

           

 

今天,杨老师想和大家聊一聊医疗问题,特别是癌症的治疗问题。这是我们第一次接触医学汉语。

 

Today, JYang wish to talk with you about medical problems, especially the treatment of cancer. This is the first time for us to touch Medicin Chinese.


我们先学习几个重点词语 First let's learn some key words:

 

1. 治zhì疗liáo treatment

2. 治zhì愈yù cure

3. 化huà疗liáo chemotherapy

4. 手shǒu术shù surgery operation

5. 放fànɡ疗liáo radiotherapy

6. 免miǎn疫yì系xì统tǒnɡ immune system

7. 基jī因yīn检jiǎn测cè DNA testing

8. 靶bǎ向xiànɡ治zhì疗liáo targeted therapy

9. 高ɡāo血xuè压yā hypertension

10. 糖tánɡ尿niào病bìnɡ diabetes

11. 白bái血xuè病bìnɡ leukemia

12. 淋lín巴bā瘤liú lymphoma

13. 肺fèi癌ái lung cancer

14. 胃wèi癌ái gastric cancer

15. 基jī因yīn突tū变biàn gene mutation

16. 精jīnɡ准zhǔn诊zhěn疗liáo precise diagnosis and treatment

17. 细xì胞bāo免miǎn疫yì疗liáo法fǎ cellular immunotheratpy

18. 疫yì苗miáo vaccine

 

众所周知,信息在现代社会中的重要性不言而喻。在一定意义上可以说,信息决定着成败。


As is known to all, the importance of information in modern society is self-evident. In a certain sense, information can determine our success or failure.

 

可怕的癌症是人类的一大杀手,被称为不治之症。随着科学技术的发展,癌症现在已经可以得到控制和缓解,甚至不乏完全治愈的病例,患者有了生的希望。然而杨老师根据自己的经验认为,癌症患者是否可以获得生的希望,关键仍在于对于信息的掌握。下面我们一起来学习关于癌症治疗的最新信息。


Terrible cancer is a major killer of human beings and so is called incurable disease. With the development of science and technology, cancer can now be controlled and alleviated, and even there are many cases of complete cure, thus patients gain hopes for life. However, JYang maintains ideas from the past experience that the key to cancer patients' hopes for life lies in mastering the information. Now let's learn the latest information on cancer treatment.

 

传统的癌症治疗方法有三剑客,即化疗、手术和放疗。虽然现在出现了紫杉醇和卡铂、顺铂等强大的药物,可以很快控制某些癌症,然而化疗毕竟属于“杀敌一千、自损八百”的办法,对于自身的伤害也是非常大的,特别是降低了免疫系统抵抗癌症的能力。据统计,化疗后即使药物对症出现效果,80%的患者仍会发生耐药或再次复发。传统手术和放疗也无法根治癌症,与化疗同样,患者还要遭受很大痛苦。


The three ways, like three swordsmen, of traditional cancer treatment include chemotherapy, surgery operation and radiotherapy. Although there are now powerful drugs such as paclitaxel, carboplatin and cisplatin, which can quickly control certain cancers, after all, chemotherapy is a way of “killing one thousand and losing eight hundred”, also very harmful to the patient himself. In particular, it reduces the function of the immune system to fight cancer. According to statistics, even the medicine has effect after chemotherapy, 80% of patients will still develop drug resistance or relapse. Traditional surgery and radiotherapy can't cure cancer thoroughly. Like chemotherapy, patients suffer a lot from them.


近年来,新一代抗肿瘤药物的研发使得癌症的药物治疗进入基于基因组测序(即基因检测)的精准靶向治疗新时代。大量临床证明,分子靶向治疗不仅精准地“杀灭”癌细胞,而且有效阻止肿瘤的发展,以达到所谓“带瘤生存”的使得癌症成为类似高血压、糖尿病的“慢性病”的目标。


In recent years, the study and development of a new generation of anti-tumor drugs has led to the entry of cancer drug therapy into a new era of precise targeted therapy based on genome sequencing test (ie, genetic testing). A large number of clinical cases have proven that molecular targeted therapy not only accurately "kills" cancer cells, but also effectively prevents the development of tumors, so as to achieve the so-called "survival with tumor", making cancer a "chronic disease" similar to hypertension and diabetes.

 

有些癌症可以直接接受靶向治疗,比如白血病,因为这类患者大多数都有BCR-ABL的基因突变,有名的“神药”格列卫可以直接救命。


Some cancers can be directly targeted to treatments, such as leukemia, because most of such patients have mutations in the BCR-ABL gene, and the famous "medicine" Gleevec can directly save their lives.

 

然而更多癌症治疗是必须做基因检测的,因为不同的靶向药针对不同的靶标,进行基因检测确定是否存在合适的靶点。为了提高效果或防止耐药,还可以联合使用靶向药物或与化疗药物组合使用。

 

However, more cancers treatment need badly genetical test because different targeted drugs target different target points, so genetic test aiming at determining if a suitable target point exists. In order to promote the effect or prevent drug resistance, it is also possible to use a combination of targeted drugs, use targeted drugs with chemotherapy drugs.

 

目前美国食品药品管理局(FDA)批准的靶向药主要用于:胃癌、膀胱癌、脑癌、乳腺癌、宫颈癌、结直肠癌、皮肤肉瘤、头颈癌、神经内分泌肿瘤、胃肠道间质瘤、骨巨细胞瘤、肾癌、白血病、肝癌、肺癌、淋巴癌、多发性骨髓瘤、神经母细胞瘤、上皮卵巢癌、原发性腹膜癌、胰腺癌、前列腺癌、软组织肉瘤、甲状腺癌,以及具有NTRK或微卫星缺陷的实体瘤等。


At present, targeted drugs approved by the US Food and Drug Administration (FDA) are mainly used for: gastric cancer, bladder cancer, brain cancer, breast cancer, cervical cancer, colorectal cancer, cutaneous sarcoma, head and neck cancer, neuroendocrine tumor, gastrointestinal stromal tumor, giant cell tumor of bone, kidney cancer, leukemia, liver cancer, lung cancer, lymphoma, multiple myeloma, neuroblastoma, epithelial ovarian cancer, primary peritoneal cancer, pancreatic cancer, prostate cancer , soft tissue sarcoma, thyroid cancer, and solid tumors with NTRK or microsatellite defects.

 

另外,有大约14种小分子靶向药物是不需要做基因检测的,如贝伐珠单抗、依维莫斯、乐伐替尼、帕唑帕尼,等等。


In addition, about 14 targeted drugs of small molecules do not require genetic testing, such as bevacizumab, everolimus, levabinib, pazopanib, and so on.

 

顺便说一说基因检测。癌症基本上属于基因疾病,因此最近两年基因检测已经成为癌症诊断治疗的标准程序,在研究型医院,每个患者都有自己的病理检测和基因检测报告,实现一个患者一个方案的个体化精准诊疗。基因检测就是发现发生变异的基因,有的是缺失了,有的是重复了,有的是歪斜了,等等。这就是癌细胞与正常细胞的不同。


By the way, genetic testing. Cancer is basically a genetic disease, so genetic testing has become the standard procedure for cancer diagnosis and treatment in the last two years. In research hospitals, each patient has his own pathological and genetic test reports to achieve individualized precise diagnosis and treatment plan for each patient. Genetic testing is to discove genes that are mutated, some missing, some repetitive, and some skewed, and so on. This is just the difference between cancer cells and normal cells.

 

下面我们继续聊一聊被认为是可以最后攻克癌症的细胞免疫疗法。不久前,美国和日本相继正式批准了两款CAR-T疗法,使得白血病和淋巴瘤的治疗进入新的时代,免疫治疗也逐渐引起医学研究机构和研究型医院的最大重视,目前世界各国都在加紧免疫治疗技术的研究,包括DC细胞(即树突细胞,德国及日本为代表。2011年诺贝尔医学奖特地颁发给对DC细胞对肿瘤治疗的突破性研究做出突出贡献的三位科学家)、NK细胞、TIL细胞等,而且进展巨大、令人乐观。


Next let's continue our talk about cellular immunotherapy that is considered to be able to overcome cancer completely. Not long ago, the United States and Japan officially approved two CAR-T therapies, which have brought leukemia and lymphoma treatment into a new era. Immunotherapy has gradually attracted the biggest attention of medical research institutions and research hospitals. Recently all the countries have intensive research on intensifying immunotherapy techniques, including DC cells (dendritic cells, represented by Germany and Japan. The 2011 Nobel Prize in Medicine was specially awarded to three scientists who made outstanding contributions to the breakthrough research of DC cells on cancer therapy) , NK cells, TIL cells, etc., and the progress is huge and optimistic.

 

癌症发生的根本原因就是患者本身的免疫系统无法控制癌细胞的发生和发展,或是由于免疫能力降低或无法识别癌细胞的出现。因此免疫治疗便成为彻底治愈癌症的关键。


The underlying cause of cancer is that the patient's own immune system is unable to control the development and progression of cancer cells, or is owing to reduced immunity or the inability to recognize cancer cells. Therefore, immunotherapy has become the key to completely cure cancer.

 

根据不同的癌症情况,可以选择以下免疫疗法:细胞免疫治疗(培养体内免疫细胞然后通过血液回输去清除癌细胞)、树突细胞疫苗、CAR-T疗法以及其他T细胞疗法。


Depending on the cancer situation, the following immunotherapies can be chosen: cellular immunotherapy (cultivating immune cells in vivo and then removing cancer cells by blood transfusion), dendritic cell vaccine, CAR-T therapy, and other T cell therapies.

 

顺便说一说治疗性癌症疫苗。世界上研发成功的第一款抗癌疫苗是古巴的历经25年研制成功的CIMAvax肺癌疫苗。疫苗疗法可以说是癌症治疗的一项突破。疫苗治疗非常简单,只是在胳膊上打一针,但是通过激活人体免疫细胞特别是T细胞(包括调节T细胞和杀手T细胞)和NK细胞去杀灭癌细胞,所以疫苗治疗非常受欢迎。目前古巴、美国、中国、德国、日本等都研制成功了各自的疫苗,用于早期、晚期的非小细胞肺癌、结直肠癌、前列腺癌、头颈癌、胰腺癌、食管癌、胃癌以及转移癌症等。


By the way, the therapeutic cancer vaccine. The first anti-cancer vaccine successfully developed in the world is Cuba's successful CIMAvax lung cancer vaccine after 25 years of research. Vaccine therapy can be said to be a breakthrough in cancer treatment. Vaccine treatment is very simple, just a shot on the arm, but vaccine therapy functions by activating human immune cells, especially T cells (including regulatory T cells and killer T cells) and NK cells, which then kill cancer cells. At present, Cuba, the United States, China, Germany, Japan have successful developed their respective vaccines for early and advanced non-small cell lung cancer, colorectal cancer, prostate cancer, head and neck cancer, pancreatic cancer, esophageal cancer, gastric cancer and metastatic cancers, etc.

 

此外,近年来还出现很多癌症治疗的黑科技,例如速锋刀、质子或重离子治疗、电场治疗、热灌治疗、病毒治疗,使得很多癌症患者有了治愈的希望。

 

Additionally, in recent years, there have been many black technologies for cancer treatment, such EDGE, proton or heavy ion therapy, electric field therapy, and hot irrigation therapy, viral therapy, which have brought many cancer patients hopes for cure.

 

好,我们今天暂时聊到这里。如果大家喜欢,我们今后对癌症的治疗还会进行更深入的学习,共同分享学习的体会,了解更多医疗知识和医药汉语。

 

Ok, so much for today’s talk. If you like it, in the future we will conduct more in-depth studies on cancer treatment, share the experience of learning, and learn more medical knowledge and medical Chinese.

 


未完待续 To be continued

 

学习汉语的课堂;了解中国的窗口

A Classroom for Chinese Learning;

A Window for Knowing China