by Justin Lee

Created on: February 22, 2009

Small-cell lung cancer explained

There are two types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC is much more common than SCLC (roughly 85% of lung cancers are NSCLC and 15% are SCLC), but the prognosis for SCLC is much worse. Small-cell lung cancers (sometimes called "oat cell cancers") grow rapidly and spread quickly. Although they respond well to initial radiation or chemotherapy treatments, SCLC's tend to quickly gain resistance to these therapies, making the disease extremely difficult to treat.

Smoking tobacco is the major risk factor for small cell lung cancer: it is extremely rare for someone who has never smoked to develop SCLC. Other factors that increase one's chance of developing small cell lung cancer include: smoking cigars or pipes, being exposed to secondhand or thirdhand smoke, and inhaling or ingesting asbestos or radon.

SCLC usually starts in the bronchi near the center of the chest, and it tends to spread widely throughout the body early in the course of the disease (before causing any noticeable symptoms). Widespread metastasis is common among patients diagnosed with small-cell lung cancer, and surgery alone cannot be used to treat the disease.

Possible signs of small cell lung cancer include: coughing (a cough that doesn't go away), chronic chest pain, and shortness of breath. Other symptoms to be wary of include: hoarseness of voice, wheezing, coughing up blood (blood in sputum), swelling of the face and neck, unexplained loss of appetite or weight loss, and unusual tiredness.

The exact prognosis (and recommended treatment regimen) for patients with small cell lung cancer is dependent on the stage of the disease. Small cell lung cancers can be in a "limited stage" or an "extensive stage." SCLC's in the limited stage are confined to one lung and the lymph nodes on the same side of the chest. If a SCLC has spread to the other lung, to the fluid around the lung, to lymph nodes on the other side of the chest, or to distant organs, it is classified as in the extensive stage.

Patients with limited-stage small cell lung cancer have a median survival of 16 to 24 months and 5-year survival rate of 14%, and patients with extensive-stage small cell lung cancer have a median survival time of 6 to 12 months, and their 5-year survival rates are less than 1%. The extensive stage indicates extensive disease, and SCLC's in this stage are not readily treatable by localized treatments such as radiation therapy.

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