What Is Small Cell Lung Cancer?
The two major types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLC accounts for 10 to 15 percent of all lung cancers. It’s less common than NSCLC.
However, SCLC is the more aggressive form of lung cancer. With SCLC, the cancer cells tend to grow quickly and travel to other parts of the body, or metastasize, more easily. As a result, the condition is usually only diagnosed after the cancer has spread throughout the body, making recovery less likely. If SCLC is detected early, however, it may be treated effectively before the cancer advances.
SCLC may also be referred to as oat cell cancer, oat cell carcinoma, and small cell undifferentiated carcinoma.
What Are the Symptoms of Small Cell Lung Cancer?
SCLC is usually asymptomatic, which means it doesn’t cause symptoms. Once symptoms do appear, it often indicates that the cancer has invaded other parts of the body. The severity of symptoms usually increases with increased cancer growth and spread. The symptoms may include:
- bloody mucus from the lungs
- shortness of breath
- chest pain or discomfort
- a persistent cough or hoarseness
- a loss of appetite
- weight loss
- facial swelling
Call your doctor immediately if you’re experiencing any of these symptoms. It may not be SCLC, but it’s best to find it early if it is.
What Causes Small Cell Lung Cancer?
The exact cause of lung cancer isn’t known. However, it’s believed that precancerous changes in the lungs can lead to cancer. These changes affect the DNA of cells inside the lungs, causing lung cells to grow faster. Too many changes can cause the cells to become cancerous. Blood vessels feed the cancer cells, allowing them to grow into tumors. Over time, cancer cells may break away from the primary tumor and spread to other parts of the body.
Who Is at Risk for Small Cell Lung Cancer?
People who smoke are at the highest risk for SCLC. Nearly all people who are diagnosed with SCLC are smokers. The condition is rarely found in nonsmokers. The risk of developing SCLC directly corresponds with the number of cigarettes you smoke each day and the number of years you have been a smoker. This means that long-term smokers who smoke large quantities of cigarettes every day are at the greatest risk of developing SCLC.
Contrary to popular belief, smoking low-tar or “light” cigarettes doesn’t lower your risk of developing lung cancer. Menthol cigarettes may increase your risk of lung cancer even more, as menthol might allow for deeper inhalations of cigarette smoke. Smoking cigars and pipes is also dangerous, putting you at the same risk for lung cancer as cigarettes.
You may also be at an increased risk for lung cancer if you’re frequently exposed to secondhand smoke. According to the American Lung Association, secondhand smoke can increase your risk of developing lung cancer by almost 30 percent. Secondhand smoke causes more than 7,000 deaths from lung cancer each year.
Contact with certain substances in your environment can also put you at risk for lung cancer. These cancer-causing substances, known as carcinogens, include:
- radon, which is a radioactive gas found in the basements of some homes
- asbestos, which is a material that may be found in older buildings and homes
- uranium and other radioactive metal ores
- inhaled chemicals, such as arsenic, silica, and coal products
- diesel exhaust and outdoor air pollution
- drinking water contaminated with arsenic
- certain dietary supplements, such as beta carotene
Researchers are currently conducting studies to assess whether the use of marijuana, talc, and talcum powder increase the risk of developing lung cancer.
How Is Small Cell Lung Cancer Diagnosed and Staged?
The diagnosis of SCLC begins with a thorough physical examination and medical history. Make sure to tell your doctor if you smoke. If SCLC is suspected, your doctor will use various tests to help diagnose SCLC accurately. Once a diagnosis of SCLC is confirmed, your doctor will stage the cancer. Staging describes the severity or extent of the cancer. It can help your doctor determine your treatment options and your outlook.
Diagnosing the Cancer
The symptoms of SCLC usually don’t surface until the cancer has already progressed to a more advanced stage. However, SCLC is sometimes found early during diagnostic testing for a different medical condition. SCLC can be detected by several common tests, such as:
- a chest X-ray, which produces clear, detailed images of your lungs
- a CT scan, which creates a series of cross-sectional X-ray images of your lungs
- an MRI which uses magnetic-field technology to detect and identify tumors
- a bronchoscopy, which involves the use of a tube with an attached camera and light to view your lungs and other structures
- a sputum culture, which is used to analyze the liquid substance produced by your lungs when you cough
SCLC may also be discovered during a screening test for lung cancer. Your doctor may recommend a screening test if you’re at an increased risk for lung cancer and you:
- are between 55 and 75 years old
- are in fairly good health
- smoke more than 30 packs of cigarettes each year
- are currently smoking or have quit smoking in the past 15 years
If SCLC is suspected, your doctor will perform numerous tests before making a diagnosis. These may include:
- a complete blood count (CBC) test to evaluate overall health
- a lung needle biopsy to remove a small sample of lung tissue for analysis
- a chest X-ray to check for tumors in the lungs
- a microscopic examination of sputum to check for abnormal lung cells
- a CT or MRI scan to check for tumors in other parts of the body
- a bone scan to check for bone cancer
Staging the Cancer
If there’s a definite SCLC diagnosis, your doctor will determine the stage of the cancer. SCLC is usually broken down into two stages.
In the limited stage, the cancer is confined to one side of your chest. Your lymph nodes might also be affected.
In the extensive stage, the cancer has spread to the other side of your chest, affecting your other lung. The cancer has also invaded your lymph nodes as well as other parts of your body.
If cancer cells are found in the fluid surrounding the lungs, the cancer will also be considered to be in the extensive stage. At this stage, the cancer isn’t curable. According to the American Cancer Society, two out of three people have extensive stage SCLC at the time of their diagnosis.
How Is Small Cell Lung Cancer Treated?
Receiving prompt treatment is critical for increasing the likelihood of a favorable outcome. However, once the cancer has become more advanced, treatment will no longer be effective. When SCLC reaches the extensive stage, treatment is aimed at relieving symptoms, not at eradicating the disease.
Surgery is only done when there’s just one tumor present and cancer cells haven’t spread to distant parts of the body. However, this is rarely the case when SCLC is diagnosed. As a result, surgery typically isn’t helpful.
If surgery is an option for you, your doctor may perform one of the following surgeries:
- a pneumonectomy, which involves the removal of an entire lung
- a lobectomy, which involves the removal of an entire section, or lobe, of a lung
- a segmentectomy, which involves the removal of a segment of a lung lobe
- a sleeve resection, which involves the removal of a section of the airway and reattachment of the lung
All of these surgeries are done under general anesthesia, which means you’ll be asleep throughout the procedure. Lobectomy is the ideal surgery for people with SCLC if it can be done. This operation is often more effective at removing all of the cancer than the other types of surgery.
Though surgery can be effective in treating SCLC, the outcome largely depends on the state of your overall health before the procedure. Surgery also carries some risks, such as heavy bleeding, infection, and pneumonia.
If surgery is successful, the recovery period can take several weeks to several months. You can expect your activity to be limited for at least one month.
Chemotherapy is an aggressive form of drug therapy that’s meant to attack cancer cells. The medications may be taken orally or administered through a vein. They travel through the bloodstream to kill cancer cells in distant organs.
While chemotherapy has proven to be effective in destroying cancer cells, it can cause serious side effects that may impact the quality of your life. These include:
- major hair loss
- a loss of appetite
- dry mouth
- mouth sores
- pain from nerve damage
You should weigh these side effects against other options when deciding whether chemotherapy is right for you. Consult your doctor if you need more guidance.
Radiation therapy uses concentrated radiation beams to kill cancer cells. The most common type of radiation therapy is external beam radiation. This involves the use of a machine that directs high-energy beams of radiation at cancer cells. The machine allows radiation to be targeted at specific sites.
Radiation therapy may be combined with chemotherapy to ease pain and other symptoms. Though there are some side effects associated with radiation therapy, most of them go away within two months of treatment.
What Is the Long-Term Outlook for People
with Small Cell Lung Cancer?
SCLC is a very aggressive form of cancer that often goes undiagnosed until it’s more advanced, so the survival rate tends to be low. However, if the cancer is detected in its early stages, the chances of making a recovery are much higher.
Talk with your doctor and treatment team about the details of your cancer and the treatment options that are best for you. Each person is different, and your treatment will be tailored to fit your needs.
Living with Small Cell Lung Cancer
Coping with a cancer diagnosis can be difficult. Aside from experiencing grief and anxiety, people with SCLC must undergo a long period of treatment and recovery that can be physically challenging.
People who’ve been diagnosed with SCLC can cope with their condition in many different ways. The key to moving forward and to living a full, happy life is to be adaptable and optimistic. Here are some steps you can take that you may find helpful:
- Learn more about your condition and possible treatments by talking to your doctor. You can also use online resources to increase your understanding and to gain a sense of control over your situation.
- Find a healthy way to express your emotions, whether it’s seeing a therapist, going to art or music therapy, or keeping a journal of your thoughts. Many people also join cancer support groups so they can talk about their experiences with other people who can relate to what they’re going through. Ask your doctor about support groups in your area or visit the American Cancer Society and CancerCare websites.
- Make sure to nurture your mind and body by doing activities you enjoy, eating well, and exercising. Spending time with family and friends can also boost your mood and energy during treatment.