Small Cell Lung Cancer Health Article

General Information About Small Cell Lung Cancer

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.

The lungs are a pair of cone-shaped breathing organs that are found within the chest. The lungs bring oxygen into the body when breathing in and take out carbon dioxide when breathing out. Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

There are two types of lung cancer: small cell lung cancer and non-small cell lung cancer. This summary provides information on small cell lung cancer. (Refer to the PDQ summary on Non-Small Cell Lung Cancer Treatment for more information.)

There are three types of small cell lung cancer.

These three types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:

• Small cell carcinoma (oat cell cancer).

• Mixed small cell/large cell carcinoma.

• Combined small cell carcinoma.

Smoking tobacco is the major risk factor for developing small cell lung cancer.

Cigarette smoking is the most common cause of lung cancer. Risk factors for small cell lung cancer include:

• Smoking cigarettes, cigars, or pipes now or in the past.

• Being exposed to second hand smoke.

• Being exposed to asbestos or radon.

Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath.

These and other symptoms may be caused by small cell lung cancer or by other conditions. A doctor should be consulted if any of the following problems occur:

• A cough that doesn’t go away.

• Shortness of breath.

• Chest pain that doesn’t go away.

• Wheezing.

• Coughing up blood.

• Hoarseness.

• Swelling of the face and neck.

• Loss of appetite.

• Unexplained weight loss.

• Unusual tiredness.

Tests and procedures that examine the lungs are used to detect (find) and diagnose small cell lung cancer.

The following tests and procedures may be used:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

  

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

• Sputumcytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).

• Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.

• Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.

  

• Fine needle aspiration biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. A pathologist views the tissue or fluid under a microscope to look for cancer cells. This procedure is also called a needle biopsy.

  

• Thoracentesis: Removal of fluid from the pleural cavity (the space between the lungs and chest wall) through a needle inserted between the ribs.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The stage of the cancer (whether it is in the chest cavity only or has spread to other places in the body).

• The patient’s gender and general health.

• The blood level of lactate dehydrogenase (LDH), a substance found in the blood that may indicate cancer when the level is higher than normal.

For most patients with small cell lung cancer, current treatments do not cure the cancer.

If lung cancer is found, participation in one of the many clinical trials being done to improve treatment should be considered. Clinical trials are taking place in most parts of the country for patients with all stages of small cell lung cancer. Information about ongoing clinical trials is available from NCI Web site

Stages of Small Cell Lung Cancer

After small cell lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the chest or to other parts of the body.

The process used to find out if cancer has spread within the chest or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

• Bone marrow biopsy: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views both the bone and the bone marrow samples under a microscope to look for signs of cancer.

• CT scan (CAT scan) of brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

• Radionuclide bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

• PET scan (positron emission tomography scan): A procedure to find malignanttumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells.

  

The following stages are used for small cell lung cancer:

Limited-Stage Small Cell Lung Cancer

In limited-stage, cancer is found in one lung, the tissues between the lungs, and nearby lymph nodes only.

Extensive-Stage Small Cell Lung Cancer

In extensive-stage, cancer has spread outside of the lung in which it began or to other parts of the body.