Small cell lung cancer

Synonyms

1

Overview

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.

There are two types of small cell lung cancer.

These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:

• Small cell carcinoma (oat cell cancer).

• Combined small cell carcinoma.

Source: National Cancer Institute (US)

Symptoms

These and other symptoms may be caused by small cell lung cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A cough that doesn’t go away.

• Shortness of breath.

• Chest pain that doesn’t go away.

• Wheezing.

• Coughing up blood.

• Hoarseness.

• Swelling of the face and neck.

• Loss of appetite.

• Weight loss for no known reason.

• Unusual tiredness.

Source: National Cancer Institute (US)

Causes

Most experts agree that lung cancer is attributable to inhalation of carcinogenic pollutants by a susceptible host. Who's most susceptible? Any smoker older than age 40, especially if he began to smoke before age 15, has smoked a whole pack or more per day for 20 years, or works with or near asbestos.

Pollutants in tobacco smoke cause progressive lung cell degeneration. Lung cancer is 10 times more common in smokers than in nonsmokers; 80% of patients with lung cancer are smokers. Cancer risk is determined by the number of cigarettes smoked daily, the depth of inhalation, how early in life smoking began, and the nicotine content of cigarettes. Two other factors also increase susceptibility: exposure to carcinogenic industrial and air pollutants (asbestos, uranium, arsenic, nickel, iron oxides, chromium, radioactive dust, and coal dust) and familial susceptibility.

Source: wd (wrong diagnosis)

Prevention

Smoking Avoidance: based on solid evidence, cigarette smoking causes lung cancer and therefore, smoking avoidance would result in decreased mortality from primary lung cancers.

Smoking Cessation: based on solid evidence, long-term sustained smoking cessation results in decreased incidence of lung cancer and of second primary lung tumors.

Beta Carotene: based on solid evidence, high-intensity smokers who take pharmacological doses of beta carotene have an increased lung cancer incidence and mortality that is associated with taking the supplement.

Radon Exposure: based on solid evidence, exposure to radon increases lung cancer incidence and mortality.

Source: National Cancer Institute (US)

 

Diagnosis

The following tests and procedures may be used:

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

• CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

• Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).

• Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.

• Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.

• Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

Source: National Cancer Institute (US)

Prognosis

An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. Median survival for limited disease is 18–24 months, with up to 25% of patients alive after five years. For patients with extensive disease, median survival is 12 months, with about 10% of patients surviving two years.

Source : Cancer Council Australia

Treatment

Your doctors will plan your treatment by taking into account a number of things, including your general health, the size and position of the tumour, and whether it has spread beyond the lung.

Chemotherapy is the main treatment for people with small cell lung cancer.

In many people, chemotherapy will enable them to live for longer, with better control of symptoms. Chemotherapy may be given on its own, or before radiotherapy . Sometimes chemotherapy and radiotherapy are given at the same time; this is known as chemoradiation.

Surgery is not usually used to treat people with small cell lung cancer, except if the cancer is found very early. This is because the cancer has usually spread to other parts of the body before being diagnosed, even if it can’t be seen on a scan.

If an operation is possible, chemotherapy or radiotherapy may be given after surgery to help reduce the risk of the cancer coming back. Giving treatment in this way is known as adjuvant treatment.

The scans and tests you had to diagnose the cancer may be repeated later, to see how well you are responding to treatment.

Radiotherapy is sometimes given to the head (known as prophylactic cranial radiotherapy) to reduce the risk of the cancer spreading to the brain. This may be done for people with small cell lung cancer, if chemotherapy has worked very well or if they have had surgery to remove the tumour.

Radiotherapy may also be used effectively in people with advanced small cell lung cancer, to relieve symptoms such as pain.

If you have any questions about your treatment, don’t be afraid to ask your doctor or the nurse looking after you. It often helps to make a list of questions, and to take a friend or relative with you.

Source: Macmillan Cancer Support

Resources

Don't smoke!