What you need to know about small cell lung cancer
Smoking is the main risk factor for SCLC, though it can also affect people who have never smoked.
However, the number of new cases of lung cancer is falling. Between 2005 and 2014, the numbers fell by 2.5% for men and 1.2% for women.
A persistent cough is one symptom of SCLC.
The symptoms of SCLC often do not appear until after the tumor has started to spread. Also, the symptoms, such as a cough, can occur with other conditions.
Both of these factors can delay diagnosis.
Symptoms of SCLC include:
- a hoarse voice
- a persistent cough
- coughing up blood, or blood in the sputum
- wheezing and difficulty breathing
- frequent or persistent infections, such as bronchitis or pneumonia
- chest pain or pain when breathing, coughing, or laughing
- loss of appetite and weight loss
- pain or difficulty swallowing
- swelling in the face or neck veins
If any of these symptoms become long term or troublesome, it is important to see a doctor.
When is a cough is a sign of cancer? Find out here.
Cancer occurs when genetic changes cause cells to divide and grow uncontrollably. As they do so, they form a tumor.
According to Genetics Home Reference, most lung cancers result from changes that occur during a person's lifetime. Only rarely is lung cancer due to an inherited genetic feature.
The main factors that can give rise to lung cancer, including SCLC, are:
- smoking, which accounts for around 80% of cases
- exposure to secondhand smoke
- exposure to radiation, asbestos, and other substances
- exposure to high levels of air pollution
- a personal or family history of lung cancer
- age, as the average age at diagnosis is 70 years
Imaging tests can help to identify damage to the lungs.
To diagnose SCLC, a doctor will usually:
- ask the person about their symptoms
- conduct a physical examination
- review the person's medical history
They may also take blood, urine, or sputum samples.
Imaging tests, such as an X-ray or a CT scan, can show if there is damage to the lungs or other parts of the body.
If the doctor believes that cancer may be present, they will recommend a biopsy.
A lung biopsy usually involves using a special needle to take a sample of cells from the lungs for examination under a microscope.
After this, a health professional will work out the stage of the cancer to determine how far it has spread. They may also need to conduct further scans to see if cancer has affected the liver, the brain, or other areas of the body.
What is the difference between small and non-small cell lung cancer? Find out here.
When describing SCLC, health professionals may talk about limited or extensive cancer. We discuss these in more detail below.
In limited stage SCLC, tumors are present in one lung. If the cancer has reached any lymph nodes, they will be on the same side as the affected lung.
Around 1 in 3 cases of SCLC are in this stage at diagnosis.
At this stage, cancer affects both lungs, other parts of the chest, and possibly the rest of the body. A doctor may say that SCLC is extensive when the cancer has spread to the fluid surrounding the lungs.
About 2 in 3 cases of SCLC are in this stage at diagnosis.
Diagnosis of SCLC often occurs in the later stages. For this reason, a doctor may prescribe an aggressive treatment plan.
This may involve a combination of:
Chemotherapy: This can extend a person's life, but it is unlikely to cure the cancer.
Radiation therapy: This can improve the chances of survival at both the limited and extensive stages. It may also help relieve symptoms in the later stages.
Surgery: This may help if the tumor is small and limited. The person will normally undergo chemotherapy, radiation therapy, or both after surgery.
Some people might consider asking their doctor about clinical trials, as these can give people access to new drugs before they become more widely available.
Researchers will only enroll people in trials when there is plenty of evidence that a new drug or technique will be safe.
If it is not possible to cure a cancer, a person may need palliative care. This involves keeping them as comfortable as possible.
A doctor may prescribe pain relief medication, for example.
In the later stages, metastatic cancer may develop. Learn more here about what to expect at this stage.
Yoga may help improve the quality of life of a person with SCLC.
People use complementary therapies alongside conventional medical therapies. They may help manage symptoms and improve a person's quality of life.
Options that may help relieve pain, discomfort, and anxiety include:
Other tips that may help include:
- getting plenty of rest
- avoiding nonessential tasks, when possible, to conserve energy
- staying in touch with friends and family
- joining an online or community support group
- getting exercise when possible
- choosing fresh, regular meals over processed snacks
- attending all medical appointments and following the doctor's advice
Experts calculate how likely a person is to survive for 5 years or longer after a diagnosis by analyzing past statistics.
- Localized cancer: People with one tumor in one lung have a 29% chance of surviving for at least 5 more years.
- Regional cancer: If the cancer has spread to nearby tissues, the person has a 15% chance.
- Distant cancer: When SCLC has spread throughout the body, the 5 year survival rate is 3%.
The overall chance of surviving for 5 years or longer with SCLC is around 6%.
Other factors can also affect a person's chances of survival, such as their age and overall health status.
As experts make new discoveries regarding diagnosis and treatment options, people can expect the outlook of various cancers to increase in time.
My friend has just heard that she has late stage SCLC. She is trying to decide whether to have chemotherapy, radiation therapy, or both. However, with the high cost and the chance of side effects, she is not sure what to do. How can she decide?
I am sorry to hear about your friend. I wish her well in this process.
To help them decide on a treatment option, people can talk to their oncologist about the best options for their specific cancer.
They may recommend chemotherapy, radiation therapy, or both. Also, the oncologist will work with the insurance company to get these treatments covered.
If a person does not have insurance, many hospitals have programs to help people pay for their treatments and medications.Alana Biggers, MD, MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.