Small cell carcinoma of the lung (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). About 10% to15% of all lung cancers are the small cell type. This kind of cancer often starts in the bronchi near the center of the chest, and multiplies quickly to form large tumors, even metastasizes throughout the body. Small cell carcinoma of the lung is almost caused by smoking. Frequent symptoms include cough, chest pain, hoarseness and shortness of breath. Treatments include radiation, chemotherapy or surgery.

What are the symptoms of Small cell carcinoma of the lung?
Early small cell carcinoma of the lung does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:


 * Cough that does not go away


 * Chest pain


 * Hoarseness


 * Weight loss and loss of appetite


 * Bloody sputum


 * Shortness of breath


 * Iterative infections such as bronchitis or pneumonia


 * New onset of wheezing

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

What causes Small cell carcinoma of the lung?
About 15% of all lung cancer cases are small cell lung cancer. Small cell lung cancer is slightly more common in men than women.

Almost all cases of SCLC are due to cigarette smoking. SCLC is rare in those who have never smoked.

SCLC is the most aggressive form of lung cancer. It usually starts in the breathing tubes (bronchi) in the center of the chest. Although the cancer cells are small, they grow very quickly and create large tumors. These tumors often spread rapidly (metastasize) to other parts of the body, including the brain, liver, and bone.

Who is at highest risk?
Clinical data has suggested that the development of small cell carcinoma of the lung is related to several factors.


 * Smoking: Clinical data show that smoking is by far the leading risk factor for lung cancer, especially for small cell carcinoma of the lung. Women and children are victimization of Secondhand smoke.


 * Radon: As a radioactive gas, radon increases the risk of small cell carcinoma of the lung.


 * Asbestos: Epidemiological survey suggests people who work with asbestos have a higher risk of developing lung cancer, especially for small cell carcinoma of the lung.

When to seek urgent medical care?
Lung cancer is a tumor that cannot be found early. If symptoms of lung cancer develop, go to see your doctor as soon as possible:


 * Severe cough that does not go away


 * Severe chest pain


 * A large amount of bloody sputum


 * Severe shortness of breath

Diagnosis

 * Chest X-ray: This is the basic test for lung cell.


 * Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose lung cancer. It can confirm the location of the cancer and show the organs near the lung, as well as lymph nodes and distant organs where the cancer might have spread. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.


 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.


 * Whole Bone Scan: The goal of a whole body bone scan is to show if a cancer has metastasized to your bones.


 * Sputum test: Cancer cell may be detected, if the doctor checks your sputum for many times.

Treatment options
Patients with small cell carcinoma of the lung have many treatment options. The selection depends on the stage of the tumor. The options are radiation therapy, chemotherapy, surgery, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.


 * Surgery: Surgery is rarely used in small cell lung cancer because this kind of cancer cell tends to metastasize early.

Diseases with similar symptoms

 * Chronic obstructive pulmonary disease


 * Pulmonary tuberculosis


 * Acute upper respiratory infection

Where to find medical care for Small cell carcinoma of the lung?
Directions to Hospitals Treating lung cancer

What to expect (Outlook/Prognosis)?
For most patients with small cell lung cancer, current treatments do not cure the cancer. The prognosis of small cell carcinoma of the lung depend on the following:


 * The stage of the cancer


 * The blood level of lactate dehydrogenase (LDH)


 * The patient’s gender and general health

Prevention
The most important measure of preventing small cell carcinoma of the lung is quitting smoking, including avoidance of secondhand smoke. Other measure includes to be away from radioactive source.