Small Cell Lung Cancer: The Basics

Author: OncoLink Team
Last Reviewed: September 25, 2019

Lung cancer is caused by lung cells growing out of control. As the number of cells grow, 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 cancermesothelioma and carcinoid tumors. These cancers will not be discussed in this article.

Risks

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 for lung cancer include radonradiationasbestos, and pollution.

Screening

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. Speak 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 signs. Many long-term smokers have a cough that doesn't go away. If there is a change in your cough, see your doctor.
  • 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).
  • 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 (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, typically 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. 

Treatment

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 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 non-small cell lung cancer. You can learn more about your type of lung cancer and treatment by using the links below.

All About Small Cell Lung Cancer

Lung Cancer Web-U-Cation Program: This video will help you learn about lung cancer. The topics include diagnosis, staging, and treatments. It also addresses coping with cancer and concerns surrounding work, insurance and disability.

References

American Cancer Society. Small Cell Lung Cancer. 2019. https://www.cancer.org/cancer/small-cell-lung-cancer/about.html

American Lung Association Lung Cancer Screening: Coverage in Health Insurance Plans. http://www.lung.org/assets/documents/lung-cancer/interactive-library/lung-cancer-screening-implementation.pdf

National Cancer Institute SEER Stat Fact Sheets: Lung and Bronchus Cancer http://seer.cancer.gov/statfacts/html/lungb.html

National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer http://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf

NCCN Guidelines: Small Cell Lung Cancer. Found at: https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf

Centers for Disease Control. Hookahs. Found at: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm

Califano, R., Abidin, A. Z., Peck, R., Faivre-Finn, C., & Lorigan, P. (2012). Management of small cell lung cancer. Drugs72(4), 471-490.

Cuffe, S., Moua, T., Summerfield, R., Roberts, H., Jett, J., & Shepherd, F. A. (2011). Characteristics and outcomes of small cell lung cancer patients diagnosed during two lung cancer computed tomographic screening programs in heavy smokers. Journal of Thoracic Oncology6(4), 818-822.

Früh, M., De Ruysscher, D., Popat, S., Crinò, L., Peters, S., Felip, E., & ESMO Guidelines Working Group. (2013). Small-cell lung cancer (SCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, mdt178.

Demedts, I. K., Vermaelen, K. Y., & Van Meerbeeck, J. P. (2010). Treatment of extensive-stage small cell lung carcinoma: current status and future prospects. European Respiratory Journal35(1), 202-215.

Jett, J. R., Schild, S. E., Kesler, K. A., & Kalemkerian, G. P. (2013). Treatment of small cell lung cancer: Diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST Journal143(5_suppl), e400S-e419S.

Leone, F. T., Evers-Casey, S., Toll, B. A., & Vachani, A. (2013). Treatment of tobacco use in lung cancer: diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST Journal143(5_suppl), e61S-e77S.

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 Network11(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. et.al. (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.

Pietanza, M. C., Byers, L. A., Minna, J. D., & Rudin, C. M. (2015). Small cell lung cancer: will recent progress lead to improved outcomes? Clinical Cancer Research21(10), 2244-2255.

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 oncology24(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* Physics85(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 Journal143(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. Cancer116(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 Lancet385(9962), 36-42.

Stinchcombe, T.E., & Gore, E.M. (2010). Limited-stage small cell lung cancer: current chemoradiotherapy treatment programs. Oncologist, 15(2), 187-195.

US News and World Report. Electronic cigarettes and cancer: A Safer Choice? 2017. Found at: https://health.usnews.com/health-care/patient-advice/articles/2017-04-25/electronic-cigarettes-and-cancer-a-safer-choice

Yu, J.B., Decker, R.H., Detterbeck, F.C., Wilson, L.D.(2010). Surveillance epidemiology and end results evaluation of the role of surgery for stage I small cell lung cancer. Journal of Thoracic Oncology, 5(2), 215-219.

Zhou, H., Zeng, C., Wei, Y. et al.(2013). Duration of chemotherapy for small cell lung cancer: a meta-analysis. PLoS One, 8(8), e73805.

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