Small Cell Lung Cancer

Small Cell Lung Cancer, is a disease in which cancer (malignant) cells are found in the tissues of the lungs. The lungs are a pair of cone-shaped organs that take up much of the room inside the chest. The lungs bring oxygen into the body and take out carbon dioxide, which is a waste product of the body's cells. Tubes called bronchi make up the inside of the lungs. There are two kinds of lung cancer based on how the cells look under a microscope: small cell and non-small cell. Small cell lung cancer is usually found in people who smoke or who used to smoke cigarettes. Like most cancer, Small Cell Lung Cancer is best treated when it is found (diagnosed) early.

You should see your doctor if you have any of the following problems:
A cough or chest pain that doesn't go away, a wheezing sound in your breathing, shortness of breath, coughing up blood, hoarseness, or swellinginyour face and neck. If you have symptoms, your doctor may want to look into the bronchi through a special instrument, called a bronchoscope, that slides down the throat and into the bronchi. This test, called Bronchoscopy, is usually done in the hospital. Before the test, you will be given a local anesthetic (a drug that makes you lose feeling for a short period of time) in the back of your throat. You may feel some pressure, but you usually do not feel pain. Your doctor can take cells from the walls of the bronchi tubes or cut small pieces of tissue to look at under the microscope to see if there are any cancer cells. This is called a biopsy. Your doctor may also use a needle to remove tissue from a place in the lung that may be hard to reach with the bronchoscope. A cut will be made in your skin and the needle will be put in between your ribs. This is called a Needle Aspiration Biopsy. Your doctor will look at the tissue under the microscope to see if there are any cancer cells. Before the test, you will be given a local anesthetic to keep you from feeling pain. Your chance of recovery (prognosis) and choice of treatment depend on the stage of your cancer (whether it is just in the lung or has spread to other places) and your general state of health.

Explanation Of Stages Of Small Cell Lung Cancer: Once Small Cell Lung Cancer has been found, more tests will be done to find out if cancer cells have spread from one or both lungs to other parts of the body (staging). Your doctor needs to know the stage of your disease to plan treatment.

The following stages are used for Small Cell Lung Cancer:
Limited Stage: Cancer is found only in one lung and in nearby lymph nodes. (Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.)
Extensive Stage: Cancer has spread outside of the lung where it began to other tissues in the chest or to other parts of the body.
Recurrent Stage: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the lungs or in another part of the body.

How Small Cell Lung Cancer Is Treated: There are treatments for all patients with small cell lung cancer.
Three kinds of treatment are used:
Surgery (taking out the cancer) Radiation Therapy (using high-dose x-rays or other high-energy rays to kill cancer cells), and Chemotherapy (using drugs to kill cancer cells).
Chemotherapy is the most common treatment for all stages of Small Cell Lung Cancer. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the lungs, including cancer cells that have spread to the brain.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiationtherapy for Small Cell Lung Cancer usually comes from a machine outside the body (external beam radiation therapy). It may be used to kill cancer cells in the lungs or in other parts of the body where the cancer has spread.  Radiation therapy may also be used to prevent the cancer from growing in the brain. This is called Prophylactic Cranial Irradiation (PCI). Because PCI may affect your brain functions, your doctor will help you decide whether to have this kind of radiation therapy. Radiation therapy can be used alone or in addition to surgery and/or chemotherapy.

Surgery may be used if the cancer is found only in one lung and in nearby lymph nodes. Because this type of lung cancer is usually not found in only one lung, surgery alone is not often used. Occasionally, surgery may be used to help determine exactly which type of lung cancer you have.

If you do have surgery, your doctor may take out the cancer in one of the following operations:
Wedge Resection removes only a small part of the lung. Lobectomy removes an entire section (lobe) of the lung. Pneumonectomy removes the entire lung. During surgery, your doctor will also take out lymph nodes to see if they contain cancer.

Treatment By Stage:
Treatment for Small Cell Lung Cancer depends on the stage of the disease, your age, and your overall condition. You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Most patients are not cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, Clinical Trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.

Clinical trials are going on in most parts of the country for most stages of Small Cell Lung Cancer. If wish to know more about Clinical Trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Limited Stage Small Cell Lung Cancer:
Your treatment may be one of the following:
1. Chemotherapy and Radiation Therapy to the chest with or without Radiation Therapy to the brain to prevent spread of the cancer (Prophylactic Cranial Irradiation).
2. Chemotherapy with or without Prophylactic Cranial Irradiation.
3. Surgery followed by Chemotherapy with or without Prophylactic Cranial Irradiation. Clinical Trials are testing new drugs and new ways of giving all of the above treatments.

Extensive Stage Small Cell Lung Cancer:
Your treatment may be one of the following:
1. Chemotherapy with or without Radiation Therapy to the brain to prevent spread of the cancer (prophylactic cranial irradiation).
2. Chemotherapy and Radiation Therapy to the chest with or without prophylactic cranial irradiation.
3. Radiation Therapy to places in the body where the cancer has spread, such as the brain, bone or spine, to relieve symptoms. Clinical Trials are testing new drugs and new ways of giving all of the above treatments.

Recurrent Small Cell Lung Cancer:
Your treatment may be one of the following:
1. Radiation Therapy to reduce discomfort.
2. A Clinical Trial testing new drugs.

To Learn More..... To learn more about Small Cell Lung Cancer, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with someone who can answer your questions. The Cancer Information Service can also send you booklets.

The following booklets about lung cancer may be helpful to you:
1.What You Need To Know About Lung Cancer Research Report.
2. Cancer of the Lung.

Thefollowing general booklets on questions related to cancer may also be helpful:
1.What You Need To Know About Cancer Taking Time.
2.Support for People with Cancer and the People Who Care About Them. (What Are Clinical Trials All About?)
3.Chemotherapy and You.
4.A Guide to Self-Help During Treatment Radiation Therapy and You.
5.A Guide to Self-Help During Treatment Eating Hints for Cancer Patients Advanced Cancer.
6.Living Each Day When Cancer Recurs.
7.Meeting the Challenge Again.

There are other places where you can get material about cancer treatment and information about services to help you. You can check the social service office at your hospital for local and national agencies that help with your finances, getting to and from treatment, care at home, and dealing with your problems. You can also write to the National Cancer Institute at this address: National Cancer Institute Office of Cancer Communications 31 Center Drive, MSC 2580 Bethesda, MD 20892-2580 If you want to know more about cancer and how it is treated, or if you if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.