Small cell lung cancer, unlike non-small cell lung cancer, is divided into only 2 stages -- limited and extensive. Only 30 to 40% of people have limited stage small cell lung cancer at the time of diagnosis.
Small cell lung cancer is less common than non-small cell, accounting for about 15% of lung cancers. It tends to be more aggressive, growing rapidly and spreading quickly, but often responds well to chemotherapy.
Definition of Limited Stage Small Cell Lung Cancer
Limited stage small cell lung cancer involves cancer that is present in only one lung and may have spread to nearby lymph nodes or the tissue between the lungs, but has not spread (metastasized) to other regions of the body.Symptoms of Limited Stage Small Cell Lung Cancer
Symptoms of limited stage lung cancer can include:- Persistent cough
- Coughing up blood (hemoptysis)
- Swelling in the face and neck
- Shortness of breath
- Wheezing
- Repeated episodes of pneumonia or bronchitis
- Hoarseness
Small cell lung cancer can also result in a broad variety of symptoms due to paraneoplastic syndromes, that is symptoms that are due to hormones secreted by a tumor or by the body’s immune response to a tumor rather than the tumor itself. 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)
- Clubbing (rounding) of the fingernails
Treatment of Limited Stage Small Cell Lung Cancer
Many people respond well to a combination of chemotherapy and radiation therapy; with limited stage cancer, this can offer the potential for a cure. If individuals respond well to treatment, prophylactic cranial irradiation (PCI) -- preventative radiation therapy to the brain -- is recommended to lower the risk that any cancer cells that have spread to the brain, but aren’t seen on radiology studies, will grow and cause symptoms.
Surgery is rarely performed for small cell lung cancer (it is usually considered inoperable), but is occasionally considered if a tumor is present in only one lung and nearby lymph nodes. Adjuvant chemotherapy (chemotherapy after surgery) is usually recommended if surgery is done for small cell lung cancer.
Clinical trials are in progress for both stages of small cell lung cancer, evaluating new treatments and treatment combinations for this aggressive cancer.
Prognosis With Limited Stage Small Cell Lung Cancer
Survival rates for small cell lung cancer have improved since the addition of radiation therapy to treatment and the use of PCI, but they still remain low. The overall 5-year survival for small cell lung cancer (limited and extensive) is only about 6%. Only 10% of people with limited stage disease show no evidence of cancer 2 years after diagnosis. Since small cell lung cancer grows rapidly, and we have come a long way with other fast-growing cancers such as leukemia, it is hoped that better treatments will be found in the future.What Can I Do to Help Myself With Limited Small Cell Lung Cancer?
Studies suggest that learning what you can about your lung cancer can improve your treatment. Ask questions. Find out about clinical trials that might be appropriate for you. Consider joining a support group. Ask for -- and let -- your loved ones help you in your journey with cancer.Sources:
Hann, C. and C. Rudin. Management of small-cell lung cancer: incremental changes but hope for the future. Oncology (Williston Park). 2008. 22(13):1486-92.
National Cancer Institute. Small Cell Lung Cancer Treatment (PDQ). 02/13/09. http://www.cancer.gov/CANCERTOPICS/PDQ/TREATMENT/SMALL-CELL-LUNG/PATIENT.
National Institute of Health. Medline Plugs. Lambert-Eaton Syndrome. 08/07/06. http://www.nlm.nih.gov/medlineplus/ency/article/000710.htm.
National Institute of Health. Medline Plus. Lung Cancer – Small Cell. 03/03/09. http://www.nlm.nih.gov/medlineplus/ency/article/000122.htm.
Samson, D. et al. Evidence for Management of Small Cell Lung Cancer. AACP Evidence-Based Clinical Practice Guidelines (2nd Edition). Chest. 2007. 132(3 Suppl):314S-323S.
Sher, T. et al. Small cell lung cancer. Mayo Clinic Proceedings. 2008. 83(3):355-67.
Sorenson, M. et al. Small-cell lung cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Annals of Oncology. 2008. 10 Suppl 2:ii41-2.
