Small Cell Lung Cancer Treatment (PDQ®)–Patient Version

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General Information About Small Cell Lung Cancer

KEY POINTS

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
There are two main types of small cell lung cancer.
Smoking is the major risk factor for small cell lung cancer.
Signs and symptoms of small cell lung cancer include coughing, shortness of breath, and chest pain.
Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
For most patients with small cell lung cancer, current treatments do not cure the 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 in the chest. The lungs bring oxygen into the body when you breathe in and take out carbon dioxide when you breathe 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 affected by lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

Respiratory anatomy; drawing shows right lung with upper, middle, and lower lobes; left lung with upper and lower lobes; and the trachea, bronchi, lymph nodes, and diaphragm. Inset shows bronchioles, alveoli, artery, and vein. — Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown. Oxygen is inhaled into the lungs and passes through the thin membranes of the alveoli and into the bloodstream (see inset).

There are two types of lung cancer: small cell lung cancer and non-small cell lung cancer.

This summary is about small cell lung cancer and its treatment. See the following PDQsummaries for more information about lung cancer:

There are two main types of small cell lung cancer.

These two 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).
Combined small cell carcinoma.

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

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for lung cancer.

Risk factors for lung cancer include the following:

Smoking cigarettes, pipes, or cigars, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer.
Being exposed to secondhand smoke.
Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace.
Being exposed to radiation from any of the following:
- Radiation therapy to the breast or chest.
- Radon in the home or workplace.
- Imaging tests such as CT scans.
- Atomic bomb radiation.
Living where there is air pollution.
Having a family history of lung cancer.
Being infected with the human immunodeficiency virus (HIV).
Taking beta carotene supplements and being a heavy smoker.

Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

When smoking is combined with other risk factors, the risk of lung cancer is increased.

Signs and symptoms of small cell lung cancer include coughing, shortness of breath, and chest pain.

These and other signs and symptoms may be caused by small cell lung cancer or by other conditions. Check with your doctor if you have any of the following:

Chest discomfort or pain.
A cough that doesn’t go away or gets worse over time.
Trouble breathing.
Wheezing.
Blood in sputum (mucus coughed up from the lungs).
Hoarseness.
Trouble swallowing.
Loss of appetite.
Weight loss for no known reason.
Feeling very tired.
Swelling in the face and/or veins in the neck.

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

The following tests and procedures may be used:

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, including smoking, and past jobs, illnesses, and treatments will also be taken.
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.
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.
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X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.
CT scan (CAT scan) of the 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 injectedinto 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.
Sputum cytology : A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The different ways a biopsy can be done include the following:
- Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluidfrom the lung, using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to find the abnormal tissue or fluid in the lung. A small incisionmay be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
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  Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
- Bronchoscopy : A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
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  Bronchoscopy. A bronchoscope is inserted through the mouth, trachea, and major bronchi into the lung, to look for abnormal areas. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a cutting tool. Tissue samples may be taken to be checked under a microscope for signs of disease.
- Thoracoscopy : A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomymay be done. In this procedure, a larger incision is made between the ribs and the chest is opened.
- Thoracentesis : The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
- Mediastinoscopy : A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
Light and electron microscopy : A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.

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 age, gender, and general health.

For certain patients, prognosis also depends on whether the patient is treated with both chemotherapy and radiation.

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

If lung cancer is found, patients should think about taking part in one of the many clinical trials being done to improve treatment. 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 the NCI website.

Next section >
Stages of Small Cell Lung Cancer