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Small-Cell Lung Cancer

Small-Cell Lung Cancer represents 15% of all lung cancers and tends to be responsive to chemo therapy and radiation

Small Cell Lung Cancer aka SCLC

Oncology Terms

InShort

Small-Cell Lung Cancer Photomicrograph
Small-Cell Lung Cancer Photomicrograph

Definition of Small Cell Lung Cancer

Small Cell Lung Cancer (SCLC) is a poorly differentiated neuroendocrine tumor of the lung that represents 15% of all lung cancers. It is distinguished from other lung cancers in its rapid growth pattern and its typically disseminated presentation. It tends to be very responsive to chemotherapy and radiation, more so than non-small cell lung cancer (NSCLC), and prophylactic treatment for brain metastases is commonly considered.


The cancer is staged into two categories: limited-stage (disease confined to a potential radiation portal in the thorax) with median survival of 15-20 months and 5-year survival of 10-13%, and extensive-stage with median survival of 8-10 months and 5-year survival of 1-2%.


Causes and Risk Factors of SCLC

SCLC is almost exclusively seen in smokers, and most common in heavy smokers. Incidence of SCLC has decreased in recent decades, most attributed to a decrease in smoking in men. Second hand smoke exposure can also be a risk factor. Age is a common risk factor, as most patients are seen between the ages of 60-80 years old.


Signs and Symptoms of SCLC

Patients may commonly present in later stage, with symptoms of cough and hemoptysis as well as weight loss, fatigue, and/or fevers. Metastasis is common at presentation and patients may present with cholestatic findings or neurologic findings associated with liver or brain metastasis, respectively.

Paraneoplastic syndromes are also common. SIADH is one of the most common syndromes associated with SCLC, and patients may present with findings of hyponatremia before any pulmonary symptoms. Other common paraneoplastic syndromes include neurologic syndromes, with symptoms ranging from ataxia, opsoclonus, myoclonus, and psychosis.


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Further Reading:

1. Small-cell lung cancer: what we know, what we need to know and the path forward. Nature Cancer Reviews 2017 (https://www.nature.com/articles/nrc.2017.87)

2. Treatment for small cell lung cancer, where are we now?-a review. Translational Lung Cancer Review 2016 (https://www.ncbi.nlm.nih.gov/pubmed/26958491)


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