Small Cell Lung Cancer

Small cell lung cancer (SCLC) is a rare but fast-growing type of lung cancer. SCLC typically develops in people who have smoked cigarettes for a long time. It usually starts growing in the bronchi, the two air tubes that connect the windpipe and lungs.

Types & Stages

Small cell lung cancer is a type of neuroendocrine tumor. Neuroendocrine tumors (or NETs) start in neuroendocrine cells, which are nerve-like cells that also make hormones.

There are two types of small cell lung cancer:

• Small cell carcinoma. This type can grow and spread quickly. It is the most common type.
   
• Combined small cell carcinoma. This type has characteristics of both small cell lung cancer and non-small cell lung cancer (NSCLC).

If you are diagnosed with SCLC, your doctor will run tests to find out what stage it is. There are two stages of SCLC:

• Limited stage. This means that the cancer is only in one lung or one side of the chest.
   
• Extensive stage. This means that the cancer has spread outside of the lung where it started growing, or has spread to other parts of the body.

SCLC often spreads quickly to other parts of the body, so this cancer is typically discovered at the extensive stage.

Signs & Symptoms

SCLC can cause symptoms like: 

• persistent cough
• shortness of breath
• coughing up blood
• chest pain

However, many people with SCLC don’t have any noticeable symptoms.

Diagnosis

At Stony Brook Cancer Center, our doctors use a combination of tests to diagnose NSCLC, such as:

• Chest X-ray, CT, or PET scan, to look inside the lungs.
   
• Biopsy, to take a sample of lung cells and look at them under a microscope.
   
• Bronchoscopy, to look in your lungs. For this test, a thin, flexible tube with a small video camera on the end (a bronchoscope) is inserted down your throat and into your lungs. During the procedure, doctors can remove suspicious tissue to look at it under a microscope (a biopsy).

Treatment

What treatment you will get depends on many factors, including the type and stage of your SCLC.

Your treatment may include a combination of the following:

• Surgery to remove the cancer if it has not spread. The surgeon may remove part of the lung or the whole lung.
   
• Radiation therapy. At Stony Brook Medicine, most of our radiation treatments are given with x-rays and electron beams generated by machines called linear accelerators.
   
• Chemotherapy, a type of drug that stops the growth of cancer cells.
   
• Immunotherapy, a type of therapy that helps your immune system find and attack your tumors.

At Stony Brook Medicine, our Palliative Care Service is available to everyone, no matter the stage of your cancer. This specialized team helps patients and their families cope with the physical, emotional, and spiritual distress of cancer. They can provide relief from symptoms of SCLC and/or its treatment, such as pain, nausea, fatigue, and loss of appetite.

Causes & Risk Factors

Smoking tobacco is the main factor that raises the risk of developing SCLC. Almost every person who is diagnosed with SCLC (95 percent of people) has a history of smoking.

Other factors that raise the risk of getting SCLC include:

• Being exposed to secondhand smoke.
• Being exposed to radon, a naturally-occurring radioactive gas. You may be exposed to radon in your home, or at work, for example if you are a miner.
• Working with or near toxic chemicals such as asbestos and arsenic.
• Having radiation therapy to your chest or breast.
• Living in an area with high air pollution.

Not everyone with these risk factors will develop SCLC. Sometimes people with no risk factors develop SCLC.

Screening

Screening for lung cancer is done with a test called low dose CT, or LDCT.

Experts recommend getting screened for lung cancer only if you are at high risk of developing the disease. You are considered to be at high risk of developing lung cancer if you: 

• are between 50 and 80 years old,
• have a 20 or more pack-year smoking history,
• and you still smoke or have quit smoking within the last 15 years.

If you are considered to be at high risk, you should get screened with LDCT once a year.