Patient Education - Lung Cancer Program at UCLA
yourself about lung cancer:
cancer - small cell; SCLC
Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It tends to spread much
more quickly than non-small cell lung cancer.
There are three different types of small cell lung cancer:
- Small cell carcinoma (oat cell cancer)
- Mixed small cell/large cell carcinoma
- Combined small cell carcinoma
Most small cell lung cancers are the oat cell type.
Cancer - lung - small cell; Small cell lung cancer; SCLC
About 15% of all lung cancer cases are small cell lung cancer, according to the American
Cancer Society. Small cell lung cancer is a bit more common in men than women.
Smoking almost always causes small cell lung cancer. This type of lung cancer is rare
in those who have never smoked.
Small cell lung cancer usually starts in the air tubes (bronchi) in the center of the
chest. Although the cancer cells are small, they grow quickly and create large masses (tumors)
that can rapidly spread to other parts of the body, including the brain, liver, and bone.
- Bloody sputum
- Shortness of breath
- Chest pain
- Loss of appetite
- Weight loss
Additional symptoms that may be associated with this disease:
- Swallowing difficulty
- Nail abnormalities
- Hoarseness or changing voice
- Facial swelling
Exams and Tests
The health care provider will perform a physical exam and ask questions
about your medical history. You will be asked if you smoke, and if so, how long you have
When listening to the chest with a stethoscope, the health care provider can sometimes
hear fluid around the lungs, which could (but doesn't always) suggest cancer.
Small cell lung cancer has usually spread by the time it is diagnosed.
Tests that may be performed include:
- Chest x-ray
- Sputum test
- Bone scan
- CT scan
- Positron emission tomography (PET) scan
In some cases, the health care provider may need to remove a piece of tissue
from your lungs for examination under a microscope. This is called a biopsy. There are several
ways to do this:
- Bronchoscopy combined with biopsy
- Pleural biopsy
- CT scan directed needle biopsy
- Mediastinoscopy with biopsy
- Open lung biopsy
- Endoscopic esophageal ultrasound (EUS) with biopsy
Usually, if a biopsy reveals cancer,
more imaging tests are done to find out the stage of the cancer. (Stage means how big the
tumor is and how far it's spread.) However, the traditional staging system, which uses numbers
to tell how bad the cancer is, is usually not used for patients with SCLC. Instead, SCLC
is grouped as either:
- Limited (cancer is only in the chest)
- Extensive (cancer has spread outside the chest)
Most cases are extensive.
Because small cell lung cancer spreads quickly throughout the
body, treatment must include cancer-killing drugs (chemotherapy) taken by mouth or injected
into the body. Chemotherapy may be combined with high-powered x-rays (radiation therapy).
Surgery is rarely used to treat small cell lung cancer. It is only considered if it is
limited small cell lung cancer with only one tumor that hasn't spread. Chemotherapy or radiation
will be needed after surgery. However, because the disease has usually spread by the time
it is diagnosed, very few patients with small cell lung cancer are candidates for surgery.
Combination chemotherapy and radiation treatment is given to persons with extensive small
cell lung cancer. However, the treatment only helps relieve symptoms; it does not cure the
Some patients with limited small cell lung cancer may receive radiation therapy to the
head after they have completed treatment for the lung area. This method, called prophylactic
cranial irradiation (PCI), helps prevent any lung cancer from spreading to the brain.
For additional information and resources, see cancer support
How well a patient does depends on how much the lung
cancer has spread. This type of cancer is very deadly. Only about 6% of people with this
type of cancer are still alive after 5 years.
- Cancer spreads to other parts of the body
- Side effects of surgery, chemotherapy, or radiation
When to Contact a Medical Professional
Call your health care provider if you have symptoms
of lung cancer (particularly if you smoke).
If you smoke, stop smoking. It's never too early to quit.
Try to avoid secondhand smoke.
Routine screening for lung cancer is not recommended. Many studies have been done to look
at the idea, but scientists have concluded that, at this time, screening would not help improve
a person’s chance for a cure.
American Cancer Society. Cancer Facts and Figures 2006. Atlanta, Ga: American Cancer Society;
U.S. Preventive Services Task Force. Lung cancer screening. Ann Int Med. 2004;140:738-739.
Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 3rd
ed. Orlando, Fl: Churchill Livingstone; 2004:1708-1722.
Jackman DM, Johnson BE. Small-cell lung cancer. Lancet. 2005;366:1385-1396.
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University
of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
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