Early adverse symptoms and a later imaging update

CAPTIONS / IMAGE LABELS MYYL Lung cancer PATIENT FOLLOW-UP RECORDS Zhang Liling · 66 · Fuyang, Anhui English translation · Original medical images retained CASE RECORD · Lung cancer · 66 Zhang Liling, from Fuyang, Anhui, had previously received targeted treatment. The May record lists a lung lesion of 31 × 27.5 mm and a left frontal-lobe brain finding considered a metastasis. The July lung measurement was 32 × 28 mm. She sought further care in August. During treatment she continued to report substantial discomfort, including weakness and coughing of blood. The original conversations retain these ongoing symptoms and the staff's replies. The late-August account lists a lung lesion of 32 × 19 mm and says the previous left frontal-lobe finding was no longer identified. The original report wording and other treatment history remain relevant. CHAT PANEL S179-P01 Zhang Liling · Lung cancer 8 Aug PM 3:31 Day 3: patient reports weakness and coughing up blood Voice message: 19 seconds. 19″ Today is my third day taking the Chinese medicine. I feel unwell and weak all over, with less strength than before. I just coughed up blood. I had never done that before; it started after taking this medicine. What color was the blood? For example: bright red, dark red, purplish red or black? Voice message: 13 seconds. 13″ I had never coughed or brought up phlegm before. Today was the first time. I am worried and frightened. Should I go to hospital? Voice message: 19 seconds. 19″ There is no need. You have lung cancer with brain metastases. Chinese medicine aims to deal with the underlying problem, rather than only suppress symptoms. To address it, the body needs to expel the unwanted material inside; there is a process to go through. CHAT PANEL S179-P02 Voice message: 21 seconds. 21″ Since I was diagnosed with lung cancer in May, I have hardly coughed or brought up phlegm. This is the first time. I am very frightened. Are you saying I should not go to hospital for an examination? Voice message: 25 seconds. 25″ There is no need. Think of the toxins in the lungs as phlegm. If they are not expelled, they remain and grow until the lungs cannot hold them, and then coughing starts. The director's medicine is now helping to loosen and gradually expel some of that phlegm. Voice message: 16 seconds. 16″ I did not feel this before. Now, if I sit for a long time, my right leg, foot and ankle go numb. Voice message: 5 seconds. 5″ It is mainly because the circulation of qi and blood is still not smooth. Voice message: 8 seconds. 8″ So I should not worry? Is it okay? Should I go to hospital to be checked? CHAT PANEL S179-P03 Voice message: 24 seconds. 24″ He said the brain metastasis can no longer be seen. There is only a small lipoma at the original site. The metastatic tumor is gone. Shall I send you the examination reports to look at? Patient reports: brain lesion no longer visible; lung tumor smaller Voice message: 8 seconds. 8″ He said the lesion that had spread from the lung cancer to the brain can no longer be seen. Voice message: 17 seconds. 17″ The lung tumor was 32 × 28 mm. It is now 32 × 19 mm. He said it is a little smaller than before.