Small cell lung cancer is a disease in which cancer (malignant)
cells are found in the tissues of the lungs. The lungs are a pair
of cone-shaped organs that take up much of the room inside the
chest. The lungs bring oxygen into the body and take out carbon
dioxide, which is a waste product of the body's cells. Tubes called
bronchi make up the inside of the lungs. There are two kinds of
lung cancer based on how the cells look under a microscope: small
cell and non-small cell. Small cell lung cancer is usually found in
people who smoke or who used to smoke cigarettes.
- a cough or chest pain that doesn't go away
- a wheezing sound when breathing
- shortness of breath
- coughing up blood
- hoarseness, or swelling in the face and neck.
If there are symptoms, a doctor may want to look into the
bronchi through a special instrument, called a bronchoscope, that
slides down the throat and into the bronchi. This test, called
bronchoscopy, is usually done in the hospital. Before the test, the
patient will be given a local anesthetic (a drug that causes a loss
of feeling for a short period of time) in the back of the throat.
Some pressure may be felt, usually with no pain. The doctor can
take cells from the walls of the bronchi tubes or cut small pieces
of tissue to look at under the microscope to see if there are any
cancer cells. This is called a biopsy.
The doctor may also use a needle to remove tissue from a place
in the lung that may be hard to reach with the bronchoscope. A cut
will be made in the skin and the needle will be put in between the
ribs. This is called a
needle aspiration biopsy.
will look at the tissue under the microscope to see if there are
any cancer cells. Before the test, a local anesthetic will be given
to keep the patient from feeling pain. The chance of recovery
(prognosis) and choice of treatment depend on the stage of the
cancer (whether it is just in the lung or has spread to other
places), and the patient's gender and general state of health.
Once small cell lung cancer has been found, more tests will be
done to find out if cancer cells have spread from one or both lungs
to other parts of the body (staging). A doctor needs to know the
stage of the disease to plan treatment. The following stages are
used for small cell lung cancer:
- Limited stage:
Cancer is found only in one lung and in
nearby lymph nodes. (Lymph nodes are small, bean-shaped structures
that are found throughout the body. They produce and store
- Extensive stage:
Cancer has spread outside of the lung
where it began to other tissues in the chest or to other parts of
- Recurrent stage:
Recurrent disease means that the cancer
has come back (recurred) after it has been treated. It may come
back in the lungs or in another part of the body.
There are treatments for all patients with small cell lung
cancer. Three kinds of treatment are used:
- surgery (taking out the cancer)
- radiation therapy (using high-dose x-rays or other high-energy
rays to kill cancer cells)
- chemotherapy (using drugs to kill cancer cells)
Additionally, clinical trials are testing the effect of new
therapies on the treatment of small cell lung cancer. Surgery may
be used if the cancer is found only in one lung and in nearby lymph
nodes. Because this type of lung cancer is usually not found in
only one lung, surgery alone is not often used. Occasionally,
surgery may be used to help determine exactly which type of lung
cancer the patient has. If a patient does have surgery, the doctor
may take out the cancer in one of the following operations:
- Wedge resection:
removes only a small part of the
removes an entire section (lobe) of the
removes the entire lung.
During surgery, the doctor will also take out lymph nodes to see
if they contain cancer.
Radiation therapy uses x-rays or other high-energy rays to kill
cancer cells and shrink tumors. Radiation therapy for small cell
lung cancer usually comes from a machine outside the body (external
beam radiation therapy). It may be used to kill cancer cells in the
lungs or in other parts of the body where the cancer has spread.
Radiation therapy may also be used to prevent the cancer from
growing in the brain. This is called
). Because PCI may affect brain
function, the doctor will help the patient decide whether to have
this kind of radiation therapy. Radiation therapy can be used alone
or in addition to surgery and/or chemotherapy.
Chemotherapy is the most common treatment of all stages of small
cell lung cancer. Chemotherapy may be taken by pill, or it may be
put into the body by a needle in the vein or muscle. Chemotherapy
is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells
outside the lungs, including cancer cells that have spread to the
Treatment of small cell lung cancer depends on the stage of the
disease, and the patient's age and overall condition. Standard
treatment may be considered because of its effectiveness in
patients in past studies, or participation in a clinical trial may
be considered. Most patients are not cured with standard therapy
and some standard treatments may have more side effects than are
desired. For these reasons, clinical trials are designed to find
better ways to treat cancer patients and are based on the most
up-to-date information. Clinical trials are ongoing in most parts
of the country for most stages of small cell lung cancer.
Limited stage small cell lung cancer
Treatment may be one of the following: 1. Chemotherapy and
radiation therapy to the chest with or without radiation therapy to
the brain to prevent spread of the cancer (prophylactic cranial
irradiation). 2. Chemotherapy with or without prophylactic cranial
irradiation. 3. Surgery followed by chemotherapy with or without
prophylactic cranial irradiation. Clinical trials are testing new
drugs and new ways of giving all of the above treatments.
Extensive stage small cell lung cancer
Treatment may be one of the following: 1. Chemotherapy with or
without radiation therapy to the brain to prevent spread of the
cancer (prophylactic cranial irradiation). 2. Radiation therapy to
places in the body where the cancer has spread, such as the brain,
bone, or spine to relieve symptoms. Clinical trials are testing new
drugs and new ways of giving all of the above treatments.
Recurrent small cell lung cancer
Treatment may be one of the following: 1. Radiation therapy to
reduce discomfort. 2. Chemotherapy to reduce discomfort. 3. Laser
therapy, radiation therapy, and/or surgical implantation of devices
to keep the airways open to relieve discomfort. 4. A clinical trial
testing new drugs.
National Cancer Institute,
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
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