Small Cell Lung Cancer

Symptoms of small cell lung cancer, especially in early stages, can mimic other common respiratory illnesses and ailments. If you are having any of the symptoms below, you should talk to your doctor to address your concern. The earlier small cell lung cancer is caught, the more likely it is that treatment will be effective.

Some small cell lung cancer symptoms include:

• Shortness of breath

• Hoarseness in the voice

• Chest pain that often worsens with coughing, laughing, or deep breaths

• Coughing up blood

• A chronic cough that doesn’t go away, or gets worse

• Feelings of fatigue or weakness

• Unexplained weight loss/loss of appetite

• Sudden wheezing

In advanced stages of small cell lung cancer, symptoms can manifest as:

• Lumps near the surface of the body in the neck or collarbone

• Yellowing of the eyes and skin (jaundice)

• Bone pain

• Changes in the nervous system

It’s Important to Note that many cancer symptoms can be a sign of something else. If you’re concerned about your symptoms, call your doctor for a full health screening.

Diagnosing small cell lung cancer early is a key factor in greater treatment success rates. If you are exhibiting symptoms of small cell lung cancer and are concerned, request an appointment with your physician for a full screening. During your screening for small cell lung cancer, your physician will:

• Collect your medical history

• Perform a physical exam

If your medical history and exam suggest you’re at risk for small cell lung cancer or may have small cell lung cancer, your doctor may perform tests. Imaging tests include:

• Chest x-ray

• CT scan

• CT guided biopsy

• MRI

• PET scan

• Bone scan

If the results of imaging tests suggest small cell lung cancer may be present, further testing will likely be performed. These tests include:

• Sputum cytology: this is where a sputum (mucus you cough up from your lungs) sample is examined under a microscope to look for cancer cells.

• Thoracentesis: during this procedure, skin is numbed and a hollow needle is inserted between the ribs to drain fluid that may have collected around the lungs. The fluid is then examined for cancer cells under a microscope.

• Needle biopsy: during a fine needle aspiration biopsy, your physician will use a syringe with a thin, hollow needle to remove cells and small tissue samples. In a core biopsy, a larger needle is used to remove small cores of tissue.

• Bronchoscopy: a bronchoscopy helps your physician find tumors or blockages in the larger lung airways. 

If small cell lung cancer is found, it’s important to see whether or not it has spread to the lymph nodes, as this can often affect what types of treatment(s) is/are pursued. Tests to detect small cell lung cancer spread include: 

• Endobronchial ultrasound: this test uses sound waves to create images of the inside of your body.

• Endoscopic esophageal ultrasound: this test passes an endoscope (a lighted, flexible scope) down your throat and into the esophagus.

• Mediastinoscopy: during this procedure, a small cut is made in the front of the neck. A thin and hollow tube is then inserted behind the sternum to examine the area. Your physician can pass instruments through the hollow tube to take tissue samples from lymph nodes for examination.

• Mediastinotomy: during this procedure, a slightly larger incision is made between the second and third ribs—this allows your physician to reach lymph nodes that are out of reach from a mediastinoscopy.

• Thoracoscopy: this is used to discover whether or not cancer has spread to the space between the lungs and chest wall or to the linings of these spaces. This procedure is performed under general anesthesia.

• Bone marrow aspiration: the skin and surface of the bone near your hip are numbed with local anesthetic. A thin, hollow needle is inserted into your bone and a syringe is used to aspirate (remove) a small amount of liquid bone marrow.

• Bone marrow biopsy: this is typically performed directly following a bone marrow aspiration. This is when a small piece of bone marrow is extracted with a larger needle.

Small cell lung cancer has two stages. These help physicians decide whether the affected person might benefit from more aggressive treatments, like a combination of chemotherapy and radiation, or whether chemotherapy alone would be a better treatment plan.

• Limited Stage In this stage of SCLC, the cancer is found in only one part of a lung and nearby lymph node. Is also means that it can be treated with a single radiation field. About 1 in 3 people with small cell lung cancer have limited stage cancer when it is found. 

• Extensive Stage In this stage, the cancer has spread to other areas of the chest or body, including the bone marrow. Sometimes, SCLC that has spread to the fluid surrounding the lung is considered extensive stage as well. Approximately 2 out of 3 people with SCLC have extensive stage cancer when their cancer is found.

  • Like with non-small cell lung cancer, the TNM staging system is sometimes used for small-cell lung cancer, though it’s generally not as important for SCLC.

Prognosis

Small cell lung cancer survival rates depend on many factors, including:

• The stage and spread of your cancer

• Age

• Sex (survival rate is higher for women)

• Overall physical health at the time of diagnosis

• Other health conditions

• How you respond to treatment

Generally speaking, the 5-year survival rate for early stage (limited) small cell lung cancer is 18 to 24 months, while the 5-year survival rate for extensive stage small cell lung cancer is 6 to 12 months with treatment.

Treatment options for lung cancer varies depending on the type and stage of cancer, but for small cell lung cancer, chemotherapy with radiation is almost always the chosen treatment option if the cancer is limited to a specific area of the chest. For extensive stage small cell lung cancer, chemotherapy alone is usually given.