Small Cell Carcinoma

The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013

Question

I am trying to find information on small cell carcinoma. I was diagnosed recently with small cell carcinoma and am being treated with chemotherapy. I am a 44 yo male, non-smoker with no history of cancer in my family. CT's and a PET/CT did not find where the tumor came from before spreading to my lymph nodes. I was diagnosed with this cancer from a biopsy of a swollen lymph node in my neck. Doctors seem to be baffled by this and tell me that mine is an unusual case. Any help or information you may have would be appreciated.

Answer

Charles B Simone II, MD, Radiation Oncologist at Penn Medicine, responds:
Small cell carcinoma most commonly arises in the lung, but can occur as a primary cancer in other body sites, including the prostate, cervix, and head and neck. This type of cancer is almost always initially responsive to chemotherapy and radiation therapy. Small cell cancer of the lung, for example, has a response rate to chemotherapy of approximately 60-90% depending on the stage of the cancer, and 20-75% of patients have a complete response (complete disappearance of their tumors on imaging obtained after treatment is completed). Unfortunately, the cancer most often comes back, either in the place where it originated, or in a new location such as a distant metastasis to the brain, liver, or bone. Your case is very unusual because the primary site has not been discovered. It is also unusual since almost all cases of small cell carcinoma, and particularly small cell lung cancer, occur in patients who have a heavy smoking history. However, chemotherapy, as you are receiving, is the standard treatment for your condition. Chemotherapy goes throughout the body and can treat the lymph nodes that were identified on your CT and PET/CT scans, as well as any other potential site where the cancer originated or is likely to spread to in the future.

For more on small cell lung cancer please see OncoLink's lung cancer site.