Small cell lung cancer is a fast moving, lethal variant of this disease. About 15% of all lung cancer cases are classified as small cell; the rest fall into various categories of non-small cell lung cancer. It is closely identified with smoking, even more so than the more common types of lung cancer. Small cell lung cancer is more common in men than in women. It usually starts in the bronchi, the tubes that connect the trachea with the lungs, and fairly quickly develops into a substantial tumor.
The term small ‘small cell lung cancer’ stems from the fact that it is characterized by small, round cells called oat cells because of their shape. The other type of small cell lung cancer is called mixed small cell lung cancer because it contains both oat cells and non-small cell cancer cells. Though the mixed variety has some of the more standard lung cancer cells, it still is very aggressive and fast moving which is why it is classified as a type of small cell lung cancer.
Stages of Small Cell Lung Cancer
Staging defines not only the extent of cancer but also what treatment protocols are in order. Because of the link to treatment there are typically four stages of cancer – I, II, III, and IV – with each category often having its own subdivisions. Small cell lung cancer is different, having only two areas of classification: limited, and extensive. Limited means the cancer is confined to one side of the body; one lung and perhaps the nearby lymph nodes. Extensive small cell lung cancer means the disease has spread to remote parts of the body. Because small cell lung cancer is rarely diagnosed early, even limited small cell lung cancer may refer to a cancer that has spread locally – to lymph nodes or within the lung.
Small Cell Lung Cancer Symptoms
The symptoms for this disease are fairly subtle as the disease begins to spread, which is why an early diagnosis is relatively rare. Once it has established itself, SCLC manifests with these common symptoms:
- Coughing up bloody sputum
- Chest pain
- Persistent cough
- Shortness of breath
- Loss of appetite, loss of weight
- Swallowing difficulty
Other, less common symptoms include swelling in the face, weakness, and fever. If the disease has metastasized to other organs or remote lymph nodes, there may be swelling and pain in those areas as well.
Because small cell lung cancer is rarely diagnosed early surgery is usually not considered an option. For those lucky few patients who are diagnosed early in the limited stage, resection of the tumor may be a possibility but in the large majority of cases the disease has already moved beyond localized status. Radiation and chemotherapy are the two forms of treatment used with small cell lung cancer.
The oat cells that characterize this disease respond well to radiation treatment; in fact one of the definition points for limited SCLC is the fact that the malignant area can fit within a single cone of radiation. In all cases the radiation is supported with chemotherapy which can weaken cancer cells if not eliminate them. For extensive small cell lung cancer the chemotherapy becomes a primary treatment mode. For mixed SCLC the selection of chemotherapy drugs will be dictated by the type of non-small cell cancer cell that has been identified in the diagnostic tests.