Lung cancer - small cell Health Article

Definition

Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It tends to spread much more quickly than non-small cell lung cancer.

There are three different types of small cell lung cancer:

• Small cell carcinoma (oat cell cancer)
• Mixed small cell/large cell carcinoma
• Combined small cell carcinoma

Most small cell lung cancers are the oat cell type.

Alternative Names

Cancer - lung - small cell; Small cell lung cancer; SCLC

Causes, incidence, and risk factors

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

Smoking almost always causes small cell lung cancer. This type of lung cancer is rare in those who have never smoked.

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

Symptoms

• Bloody sputum
• Chest pain
• Cough
• Loss of appetite
• Shortness of breath
• Weight loss
• Wheezing

Other symptoms that may occur with this disease:

• Facial swelling
• Fever
• Hoarseness or changing voice
• Nail abnormalities
• Swallowing difficulty
• Weakness

Signs and tests

The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.

When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs. This could (but does not always) suggest cancer.

Small cell lung cancer has usually spread by the time it is diagnosed.

Tests that may be performed include:

• Bone scan
• Chest x-ray
• Complete blood count (CBC)
• CT scan
• MRI
• Positron emission tomography (PET) scan
• Sputum test
• Thoracentesis

In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

• Bronchoscopy combined with biopsy
• CT scan-directed needle biopsy
• Endoscopic esophageal ultrasound (EUS) with biopsy
• Mediastinoscopy with biopsy
• Open lung biopsy
• Pleural biopsy

Usually, if a biopsy reveals cancer, more imaging tests are done to find out the stage of the cancer. (Stage means how big the tumor is and how far it has spread.) However, the traditional staging system, which uses numbers to tell how bad the cancer is, is usually not used for patients with SCLC. Instead, SCLC is grouped as either:

• Limited (cancer is only in the chest and can be treated with radiation therapy)
• Extensive (cancer has spread outside the chest)

Most cases are extensive.