Small cell lung cancer symptoms can be similar to symptoms of other forms of lung cancer, but can also be different in several ways. Usually, unlike non-small cell lung cancers, symptoms are present for only a short while before a diagnosis is made.
Symptoms Related to Location of the TumorSmall cell lung cancers tend to grow near the central airways of the lungs, and as such, create symptoms by irritating the airways or obstructing air flow. They also tend to spread (metastasize) early, and it isn’t uncommon for the first symptoms of small cell lung cancer to be related to its effect on other organs, such as the brain. Some common symptoms include:
- A persistent cough
- Coughing up blood
- Shortness of breath
- Repeated infections such as pneumonia or bronchitis, or lung collapse (atelectasis) due to narrowing of the airways
Symptoms Due to Spread to the MediastinumSmall cell lung cancers tend to spread to the area between the lungs (the mediastinum) fairly early on in the course of the disease. When cancer spreads to the mediastinum, it can place pressure on structures in this area, such as:
- The esophagus – causing difficulty swallowing
- The trachea (windpipe) – causing shortness of breath and a whistling sound while breathing in
- The heart – sometimes causing fluid to build up within the tissues that line the heart (a pericardial effusion)
Small cell lung cancer can also result in symptoms referred to as superior vena cava syndrome (SVC syndrome). When a tumor is present in the mediastinum, it can press on the superior vena cava (the large blood vessel in the chest that returns blood to the heart), causing symptoms such as swelling in the face, neck, and upper chest. SVC syndrome is more common with small cell lung cancers than with some other forms of lung cancer, and may be the first symptom of the disease.
Small cell lung cancer can also result in a broad variety of symptoms due to paraneoplastic syndromes. In some cases, paraneoplastic symptoms may be the first symptom of lung cancer. Some of these include:
- Muscle weakness in the upper limbs, vision changes, and difficulty swallowing (Lambert-Eaton myasthenic sydrome)
- Weakness, fatigue, and a low sodium level in the blood (syndrome of inappropriate antidiuretic hormone secretion (SIADH))
- Loss of coordination and difficulty speaking (paraneoplastic cerebellar degeneration)
- Weight gain, high blood pressure, mental changes, and skin changes such as stretch marks on the abdomen and a darkening of the skin (Cushing Syndrome)
- Clubbing (rounding) of the fingernails
Symptoms When Lung Cancer SpreadsSince small cell lung cancer spreads (metastasizes) early in the course of the disease, the first symptoms may be related to effects the cancer has on distant organs. Some of these symptoms may include:
- Symptoms due to brain metastases – such as headaches, dizziness, weakness of one side of the body, or speech difficulties (learn more about how lung cancer spreads to the brain)
- Symptoms due to bone metastasis – such as back pain and/or compression of the spinal cord causing arm or leg pain (learn more about how lung cancer spreads to bone)
- Symptoms due to spread to the liver – such as abdominal pain and yellowing of the skin (learn more about how lung cancer spreads to the liver)
General Symptoms Found with Small Cell Lung CancerSmall cell lung cancers can also cause general symptoms of cancer, such as:
American Cancer Society. Lung Cancer (Small Cell). Updated 07/28/10. http://www.cancer.org/Cancer/LungCancer-SmallCell/DetailedGuide/small-cell-lung-cancer-diagnosis
McClelland, M. Paraneoplastic syndromes related to lung cancer. Clinical Journal of Oncology Nursing. 2010. 14(3):357-64.
Pelosof, L. and D. Gerber. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clinic Proceedings. 2010. 85(9):838-54.