Updated January 19, 2015.
Small cell lung cancer is less common than non-small cell lung cancer, accounting for about 15% of lung cancers. It tends to be more aggressive, growing rapidly and spreading quickly, but often responds well to chemotherapy.
Small cell lung cancer (unlike non-small cell lung cancer), is divided into only 2 stages -– limited and extensive. Roughly 60% to 70% of people have extensive disease at the time of diagnosis.
Definition of Extensive Stage Small Cell Lung Cancer
Extensive stage small cell lung cancer is defined as a small cell lung cancer that has spread (metastasized) to other regions of the body such as another lobe of the lung or the brain.
Symptoms
Symptoms can include:Symptoms related to cancer in the lungs:
- Persistent cough
- Coughing up blood (hemoptysis)
- Swelling in the face and neck
- Shortness of breath
- Wheezing
- Repeated episodes of pneumonia or bronchitis
- Hoarseness
Symptoms due to paraneoplastic syndromes, that is symptoms that are due to hormones secreted by a tumor or by the body’s immune response to a tumor rather than the tumor itself. Some of these include:
- Muscle weakness in the upper limbs, vision changes, and difficulty swallowing (Lambert-Eaton myasthenic syndrome
- Weakness, fatigue, and a low sodium level in the blood (syndrome of inappropriate antidiuretic hormone secretion (SIADH))
- Loss of coordination and difficulty speaking (paraneoplastic cerebellar degeneration)
- Clubbing (rounding) of the fingernails
Symptoms due to spread of the tumor to other regions of the body, for example:
- Pain in the back, hips, or ribs if the tumor has spread to bone
- Difficulty swallowing (dysphagia) due to a tumor being near or invading the esophagus
- Headaches, vision changes, weakness, or seizures if a tumor spreads to the brain
Treatment
The treatment of extensive stage disease consists in chemotherapy administered alone. Sometimes radiation may be used to control symptoms (palliative therapy) related to the spread of cancer, such as bone pain, bleeding from the lungs, tumors that are obstructing the airways and causing shortness of breath, or brain metastases that are causing significant symptoms, such as headaches or weakness.
Clinical trials are in progress for both stages of small cell lung cancer, evaluating new treatments and treatment combinations for this aggressive cancer.
- Lung Cancer Treatment Options
- Chemotherapy
- Radiation Therapy
- Is Surgery Ever Done for Small Cell Lung Cancer?
Prognosis
Survival rates for small cell lung cancer have improved since the addition of radiation therapy to treatment and the use of PCI, but remain low. Currently the overall 5-year survival rate for stage 3 small cell lung cancer is 8%, and only 2% for stage 4 disease. Without treatment, the average life expectancy with extensive disease is 2 to 4 months, and with treatment is 6 to 12 months. Since small cell lung cancer is rapidly growing, and we have come a long way with other fast-growing cancers such as leukemia, it is hoped that better treatments will be found in the future.
What Can I Do To Help Myself
Studies suggest that learning what you can about your lung cancer can improve your quality of life, and possibly even your outcome. Ask questions. Learn about clinical trials. Consider joining a support group. Many of us hesitate to talk about end-of-life issues, but discussing these with your doctor and your family -– even if all of you are hoping for a cure -– is associated with fewer feelings of loneliness and a better quality of life. Never lose hope, even if you have chosen not to pursue further treatment. Hope for quality time with loved ones, with good control of your symptoms. Hope for the future of your loved ones who will remain, with memories of you in their hearts.
Sources:
American Cancer Society. Lung Cancer (Small Cell.) Small Cell Lung Cancer Survival Rates by Stage. Updated 02/11/14. http://www.cancer.org/cancer/lungcancer-smallcell/detailedguide/small-cell-lung-cancer-survival-rates
Hann, C. and C. Rudin. Management of small-cell lung cancer: incremental changes but hope for the future. Oncology (Williston Park). 2008. 22(13):1486-92.
National Cancer Institute. Small Cell Lung Cancer Treatment (PDQ). 02/13/09. http://www.cancer.gov/CANCERTOPICS/PDQ/TREATMENT/SMALL-CELL-LUNG/PATIENT.
National Institute of Health. Medline Plus. Lambert-Eaton Syndrome. 08/07/06. http://www.nlm.nih.gov/medlineplus/ency/article/000710.htm.
National Institute of Health. Medline Plus. Lung Cancer – Small Cell. 03/03/09. http://www.nlm.nih.gov/medlineplus/ency/article/000122.htm.
Samson, D. et al. Evidence for Management of Small Cell Lung Cancer. AACP Evidence-Based Clinical Practice Guidelines (2nd Edition). Chest. 2007. 132(3 Suppl):314S-323S.
rezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum">Small cell lung cancer. Mayo Clinic Proceedings. 2008. 83(3):355-67.
Sorenson, M. et al. Small-cell lung cancer: ESMO Clinical Recommendations for diagnosis, treatment, and follow-up. Annals of Oncology. 2009. 20 Suppl 4:71-2.
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