Small Cell Lung Cancer: The Basics

Author: Christina Bach, MBE, LCSW, OSW-C
Last Reviewed: May 09, 2023

Lung cancer is caused by lung cells growing out of control. As the number of cells grows, they form into a tumor. There are many types of lung cancers. This article will focus on small-cell lung cancer.

Small Cell Lung Cancer (SCLC)

  • 15% of all lung cancers.
  • SCLC is more aggressive than non-small cell lung cancer.
  • Grows more quickly and is more likely to spread to other parts of the body.

Lung cancer that has spread from the lung to another part of the body is called metastatic cancer. Other types of lung cancer include non-small cell lung cancer, mesothelioma, and carcinoid tumors. These cancers are not discussed in this article.


Smoking cigarettes (now or in the past) is the leading cause of lung cancer. Lung cancer in non-smokers has been rising in recent years. Other causes of lung cancer include radon, radiation, asbestos, and pollution.


Smokers or former heavy smokers can have a special test (CT scan) to screen for lung cancer. This test can find lung cancer sooner and may help patients live longer. Talk to your healthcare provider to decide if this test is right for you.

Signs of Lung Cancer

The early stages of lung cancer may not have any signs. As the tumor grows in size, it can cause signs.

  • Cough (one that doesn't go away or gets worse). A cough is the most common sign. Many long-term smokers have a cough that doesn't go away. If there is a change in your cough, see your provider.
  • Chest pain.
  • Hard time breathing or wheezing.
  • Coughing up blood or bloody phlegm.
  • New hoarseness or change in speech.
  • Having pneumonia or bronchitis that keeps coming back.
  • Weight loss and loss of appetite.
  • Feeling tired.

Diagnosis of Small Cell Lung Cancer

When your healthcare providers think you may have lung cancer, they will order tests. Here are some of the tests:

  • Chest x-ray.
  • CT scan ("Cat Scan", a 3-D x-ray).
  • Sputum cytology (looking at your phlegm for cancer cells).
  • A PET scan and an MRI scan of the brain are often done to look at other parts of the body where lung cancer can spread.

These tests are important but a biopsy is the only way to know for sure if you have cancer. A biopsy:

  • Looks at a piece of the lung for cancer cells.
  • Is used to find out the cancer type, how normal it is [grade], and if it has spread.
  • May look at samples from lymph nodes to check for cancer.
  • The biopsy may be done using a bronchoscopy (a small camera passed down your throat into the lungs) or by surgery.

A pathology report sums up these results and is sent to your healthcare provider, usually 5-10 days after the biopsy. This report is an important part of planning your treatment. You can ask for a copy of your report for your records.

Staging Small Cell Lung Cancer

To guide treatment, lung cancer is "staged." This stage is based on:

  • Size and location of the tumor.
  • Whether cancer cells are in the lymph nodes.
  • Whether cancer cells are in other parts of the body.

Small-cell lung cancer is grouped into two stages to help with making decisions about treatment. They are limited stage and extensive stage.


Often, these treatments are used:

  • Surgery is not usually used for small-cell lung cancers unless the cancer is found very early on.
  • A combination of chemotherapy/immunotherapy and radiation therapy is often given.
  • Most people with small cell cancers will also have radiation to the brain to treat metastasis or to prevent the cancer from spreading there.

This article is a basic guide to small-cell lung cancer. You can learn more about your type of lung cancer and treatment by using the links below.

Small Cell Lung Cancer: Staging and Treatment

American Cancer Society. Small Cell Lung Cancer. 2019.

American Lung Association Lung Cancer Screening: Coverage in Health Insurance Plans.

Barrows, E. D., Blackburn, M. J., & Liu, S. V. (2022, February). Evolving role of immunotherapy in small cell lung cancer. In Seminars in cancer biology. Academic Press.

National Cancer Institute SEER Stat Fact Sheets: Lung and Bronchus Cancer

National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer

NCCN Guidelines: Small Cell Lung Cancer. Found at:

Centers for Disease Control. Hookahs. Found at:

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Kalemkerian, G.P. (2011) Advances in the treatment of small-cell lung cancer. Seminars is Respiratory and Critical Care Medicine, 32(1), 94-101.

Kalemkerian, G.P (2011) Staging and imaging of small cell lung cancer. Cancer Imaging, 11(1).253-258.

Kalemkerian, G. P., Akerley, W., Bogner, P., Borghaei, H., Chow, L. Q., Downey, R. J., ... & Hayman, J. (2013). Small cell lung cancer. Journal of the National Comprehensive Cancer Network, 11(1), 78-98.

Kalemkerian, G.P. & Gadgeel, S.M. (2013) Modern staging of small cell lung cancer. Journal of the National Comprehensive Cancer Network, 11(1), 99-104

Pesch, B., Kendzia, B., Gustavsson, P. (2012). Cigarette smoking and lung cancer-relative risk estimates for the major histological types from a pooled analysis of case-control studies. International Journal of Cancer, 131(5), 1210-1219.

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Reck, M., Bondarenko, I., Luft, A., Serwatowski, P., Barlesi, F., Chacko, R., ... & Lynch, T. J. (2013). Ipilimumab in combination with paclitaxel and carboplatin as first-line therapy in extensive-disease-small-cell lung cancer: results from a randomized, double-blind, multicenter phase 2 trial. Annals of oncology, 24(1), 75-83.

Reymen, B., Van Loon, J., van Baardwijk, A., Wanders, R., Borger, J., Dingemans, A. M. C., ... & Lambin, P. (2013). Total gross tumor volume is an independent prognostic factor in patients treated with selective nodal irradiation for stage I to III small cell lung cancer. International Journal of Radiation Oncology* Biology* Physics, 85(5), 1319-1324

Rivera, M. P., Mehta, A. C., & Wahidi, M. M. (2013). Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST Journal, 143(5_suppl), e142S-e165S.

Rudin, C. M., Ismaila, N., Hann, C. L., Malhotra, N., Movsas, B., Norris, K., ... & Giaccone, G. (2015). Treatment of Small-Cell Lung Cancer: American Society of Clinical Oncology Endorsement of the American College of Chest Physicians Guideline. Journal of Clinical Oncology, JCO-2015.

Schild, S. E., Foster, N. R., Meyers, P., Ross, H. J., Stella, P. J., Garces, Y. I., ... & Adjei, A. A. (2012). Prophylactic cranial irradiation in small-cell lung cancer: Findings from a North Central Cancer Treatment Group Pooled Analysis. Annals of Oncology, mds123.

Schreiber, D., Rineer, J., Weedon, J., Vongtama, D., Wortham, A., Kim, A., ... & Rotman, M. (2010). Survival outcomes with the use of surgery in limited?stage small cell lung cancer. Cancer, 116(5), 1350-1357.

Slotman, B. J., van Tinteren, H., Praag, J. O., Knegjens, J. L., El Sharouni, S. Y., Hatton, M., ... & Senan, S. (2015). Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomized controlled trial. The Lancet, 385(9962), 36-42.

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