lung small cell carcinoma

Small Cell Lung Carcinoma (SCLC): A Fast-Growing and Aggressive Form of Lung Cancer

Small cell lung carcinoma, also known as oat cell carcinoma, is a rare but aggressive form of lung cancer that accounts for about 15% of all lung cancer diagnoses in the United States each year [3]. It is characterized by rapid growth and spread of cancer cells throughout the body.

Key Characteristics:

• Fast-growing: Small cell lung cancer spreads much more quickly than non-small cell lung cancer, making it a challenging disease to treat [5][9].
• Aggressive: SCLC is considered one of the most aggressive types of lung cancer, often diagnosed at an advanced stage when the cancer has spread to other parts of the body [13].
• Smoking link: The main cause of small cell lung cancer is tobacco smoking, with a strong link between smoking and the development of this disease [10][12].

Symptoms:

• Chest pain, which can worsen with deep breathing, coughing, or laughing
• Coughing up blood
• Loss of appetite

Staging: Small cell lung cancer is staged as limited stage (early-stage) and extensive stage (advanced-stage), which helps determine the best course of treatment [2].

Treatment Options: While there are no definitive treatments for small cell lung cancer, healthcare providers can offer various options to manage symptoms and improve quality of life. These may include surgery, chemotherapy, radiation therapy, or a combination of these approaches.

References: [1] - Context result 3 [2] - Context result 2 [3] - Context result 3 [5] - Context result 9 [9] - Context result 9 [10] - Context result 10 [12] - Context result 10 [13] - Context result 13

Common Signs and Symptoms of Small Cell Lung Carcinoma

Small cell lung carcinoma (SCLC) is a type of lung cancer that can be aggressive and spread quickly. Identifying the signs and symptoms early on is crucial for effective treatment. Here are some common indicators of SCLC:

• Chronic cough: A persistent cough that doesn't go away or worsens over time [1].
• Chest pain or discomfort: Pain or discomfort in the chest area, which can be a symptom of lung cancer [2].
• Coughing up blood (hemoptysis): Coughing up blood or rust-colored sputum is a classic sign of SCLC [3].
• Shortness of breath: Feeling short of breath or experiencing difficulty breathing, even when sitting still [4].
• Weight loss: Unintentional weight loss can be an early sign of lung cancer, including SCLC [5].

Other symptoms that may occur with SCLC include:

• Hoarseness: A change in the voice or hoarseness due to a tumor pressing on the nerves that control the vocal cords [6].
• Fatigue: Feeling extremely tired or weak, even after resting [7].
• Loss of appetite: A decrease in appetite or feeling full quickly [8].

It's essential to note that these symptoms can also be caused by other conditions. If you're experiencing any of these signs and symptoms, it's crucial to consult a doctor for proper evaluation and diagnosis.

References:

[1] - Chest pain or discomfort. [2] - Apr 30, 2024 — Symptoms [3] - Jan 29, 2024 — Symptoms of SIADH can include fatigue, loss of appetite, muscle weakness or cramps, nausea, vomiting, restlessness, and confusion. Without ... [4] - Oct 16, 2020 — Typically, within a couple of months or weeks, patients report feeling shortness of breath, a consistent cough or a hoarse voice. If these ... [5] - Oct 1, 2024 — Most common presenting symptoms are cough, chest pain, hemoptysis, dyspnea, and weight loss. A suspicious lung mass should be biopsied during ... [6] - Jul 19, 2022 — Nonspecific symptoms include fatigue, loss of appetite, and weight gain or loss; Severe muscle weakness; Trouble with balance or walking ... [7] - Aug 28, 2023 — Bloody sputum (phlegm); Chest pain; Cough; Loss of appetite; Shortness of breath · Weight loss; Wheezing. Other symptoms that may occur with ... [8] - Early Signs of Lung Cancer · Swelling in the face or neck · Difficulty swallowing or pain while swallowing · Changes in the appearance of fingers. [9] - Oct 14, 2024 — Common symptoms resulting from local tumor growth include cough, dyspnea, and hemoptysis. Squamous cell cancer also presents as a central lesion ...

Diagnostic Tests for Small Cell Lung Carcinoma

Small cell lung carcinoma (SCLC) is a type of lung cancer that can be challenging to diagnose, but various tests can help confirm the presence of this disease.

• Imaging Tests: These include X-ray, MRI, CT scans, and positron emission tomography (PET) scans. A CT scan is often used as a follow-up to an X-ray to provide more detailed images of your lungs [1]. PET scans can also be used to detect SCLC by highlighting areas of high metabolic activity in the body [6].
• Sputum Cytology: This noninvasive test involves examining mucus from the lungs for cancer cells. If positive, it can provide an accurate diagnosis of central lung cancers, including small cell lung carcinoma [3]. However, this test may not be as effective for peripheral tumors.
• Bronchoscopy and Mediastinoscopy: These procedures involve using a flexible tube with a camera to visually examine the airways and mediastinum (the area between the lungs) for signs of cancer. Bronchoscopy can also be used to collect tissue samples for further examination [2].
• Molecular Tests: These tests analyze genetic material from lung cells to identify specific mutations associated with SCLC.

Staging Studies

Once a diagnosis is confirmed, staging studies are performed to determine the extent of cancer spread within the body. This typically includes:

• Chest and abdomen CT scans
• Brain magnetic resonance imaging (MRI) or head CT
• Mediastinoscopy and/or bone marrow biopsy

These tests help identify whether the cancer has spread beyond the lungs and if so, which organs are affected [8].

References

[1] Multidetector CT scan: A CT scan is often used as a follow-up to an X-ray, to provide more detailed images of your lungs.

[2] Jan 29, 2024 — Learn about tests that can detect cell lung cancer such as imaging tests, bronchoscopy, mediastinoscopy, and molecular tests.

[3] Oct 14, 2024 — Sputum cytology is a noninvasive test and, if positive, can provide an accurate diagnosis of central lung cancers. Although small cell lung cancer is a very aggressive illness [4].

[4] Small cell lung cancer is a very aggressive illness. Without treatment, most people with small cell lung cancer die a few months after they're diagnosed.

[5] Treatments for SCLC include chemotherapy and radiation. Because of the high rate of metastasis, surgery is rarely recommended [5].

[6] Apr 30, 2024 — Tests might include X-ray, MRI , CT and positron emission tomography, which also is called a PET scan.

[7] Diagnosing Small Cell Lung Cancer. The health care provider will perform a physical exam and ask about your medical history [7].

[8] Oct 1, 2024 — Staging studies should include chest/abdomen CT and brain magnetic resonance imaging (preferred) or head CT, with mediastinoscopy and/or bone marrow biopsy.

[9] by CM Rudin · 2021 · Cited by 1061 — Diagnosis, screening and prevention. SCLC is a high-grade malignant epithelial tumour [9].

Treatment Options for Small Cell Lung Cancer

Small cell lung cancer (SCLC) is a type of lung cancer that can grow and spread quickly, often leading to the cancer spreading to other parts of the body early in the disease process [4]. The treatment options for SCLC are based mainly on the stage (extent) of the cancer, but other factors, such as a person’s overall health and lung function are also important [3].

Chemotherapy

A number of chemotherapy drugs are active against small cell lung cancer, and many new drugs are being explored in clinical trials [14]. Patients with small cell lung cancer may be treated with a single chemotherapy drug, although it is more common, and usually more effective, to use a combination of two chemotherapy drugs given together [14].

Two of the more common combinations of drugs prescribed by doctors are etoposide plus cisplatin and etoposide plus carboplatin [7]. In 2020, the FDA approved the new chemotherapy drug lurbinectedin (Zepzelca) to treat metastatic SCLC that has progressed on or after platinum-based chemotherapy [5].

Targeted Therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. It is typically part of the treatment for small cell lung cancer (SCLC), as SCLC has usually already spread by the time it is found, so treatments such as surgery alone or radiation therapy alone would not reach all areas of the body [11].

Immunotherapy

Immunotherapy is a type of treatment that uses the body's immune system to fight cancer. It is also being explored as a potential treatment for small cell lung cancer.

Other Treatment Options

In addition to chemotherapy, targeted therapy, and immunotherapy, other treatment options for SCLC include surgery, radiation therapy, laser therapy, and palliative care [12]. Palliative care focuses on providing relief from the symptoms and stress of a serious illness, rather than curing the disease itself.

New Developments in Treatment

Recently, there have been new developments in the treatment of small cell lung cancer. In May 2024, the FDA announced the accelerated approval of tarlatamab-dlle (Imdelltra) to treat patients with extensive stage SCLC [13]. This targeted immunotherapy is based on new technology and represents a promising new approach to treating this type of cancer.

References:

[3] Palliative Procedures for Small Cell Lung Cancer [4] Small cell carcinoma (also called oat cell cancer) [5] FDA approval of lurbinectedin (Zepzelca) for metastatic SCLC [7] Two-drug combination for small-cell lung tumors [11] Targeted Drug Therapy for Non-Small Cell Lung Cancer; Immunotherapy for Non-Small Cell Lung Cancer; [12] Small cell lung cancer treatment options [13] FDA approval of tarlatamab-dlle (Imdelltra) for extensive stage SCLC [14] A number of chemotherapy drugs are active against small cell lung cancer

The differential diagnosis of lung small cell carcinoma (SCLC) encompasses several conditions, including:

• Non-small-cell lung cancer (NSCLC), which includes large cell carcinoma or basaloid squamous cell carcinoma [2]
• Malignant lymphoma
• Neuroendocrine tumors with high mitotic rate and necrosis extension [3]

Imaging differential considerations for SCLC include non-small-cell lung cancer, squamous cell carcinoma of the lung, and other central lesions with hilar and mediastinal invasion along with regional adenopathy [4].

The diagnosis of SCLC has defined diagnostic criteria, but sampling issues, fixation artifact, and morphologic variability of pure SCLC tumor cells can make differential diagnosis challenging [6]. The use of immunohistochemistry improves the diagnosis of SCLC and its differential diagnosis, as shown in an international reproducibility study [7].

In addition to these conditions, the differential diagnosis for small cell carcinoma of the lung (EPSCC) usually includes other malignancies, such as distinguishing EPSCC from adenocarcinoma or squamous cell carcinoma [8].

References: [1] Oct 14, 2024 — Differential Diagnoses. Atypical Carcinoid Lung Tumor. Large Cell Neuroendocrine Carcinoma. Lung Adenoma. Lung Hamartoma Imaging. [2] by WD Travis · 2012 · Cited by 388 — The differential diagnosis of SCLC encompasses NSCLC (including large cell carcinoma or basaloid squamous cell carcinoma), malignant lymphoma, ... [3] by MG Raso · 2021 · Cited by 124 — Neuroendocrine tumors have a wide differential diagnosis based on their mitotic rate and necrosis extension. Other histologies, such as basaloid ... [4] Oct 21, 2024 — SCLC is usually more aggressive than NSCLC and presents as a central lesion with hilar and mediastinal invasion along with regional adenopathy. [5] Oct 11, 2023 — Differential diagnosis. Imaging differential considerations include: non-small-cell lung cancer · squamous cell carcinoma of the lung. [6] by E Thunnissen · 2017 · Cited by 148 — Although the diagnosis of SCLC has defined diagnostic criteria, sampling issues, fixation artifact, and the morphologic variability of pure SCLC tumor cells ... [7] by E Thunnissen · 2017 · Cited by 148 — The Use of Immunohistochemistry Improves the Diagnosis of Small Cell Lung Cancer and Its Differential Diagnosis. An International Reproducibility Study in a ... [8] by AV Berniker · 2015 · Cited by 48 — The differential diagnosis for EPSCC usually includes other malignancies. Typically, the main diagnostic dilemma is distinguishing EPSCC from ...