Based on researches that our team in Healthowealth has done, small cell lung cancer is a particularly aggressive kind of lung cancer. It is distinguished by the fast and uncontrolled development of specific cells in the lungs. A tumor grows eventually, and cancer can spread (metastasize) to other parts of the body. Tobacco use is the key risk factor; practically all afflicted persons smoke or have a history of smoking.
Signs vary from person to person, and there are seldom any symptoms early in the disease’s progression. small cell lung cancer is classified into two stages: limited-stage illness, which is possibly treatable in roughly 20% to 25% of persons, and extensive-stage disease, which is more difficult to treat. Chemotherapy and, in certain cases, radiation treatment are used to treat affected patients.
The nature of SCLC!
Because the cancer cells include characteristics of both nerve cells and endocrine (hormone-secreting) cells, small cell lung cancer is classified as neuroendocrine carcinoma. Endocrine tissue is a specialized tissue that includes cells that secrete hormones. These hormones serve a number of roles in the body.
Symptoms & Signs of Small cell lung cancer
The signs and symptoms of small cell lung cancer differ from person to person. The precise position and size of the tumor, the amount of tumor invasion into neighboring tissue or organs, and whether the illness has stayed localized or progressed to other regions of the body all influence specific results (metastasized).
Common symptoms include a persistent cough, chest discomfort that worsens while coughing, laughing, or taking a big breath, shortness of breath, blood in the cough (hemoptysis), and hoarseness or wheezing. Some people who are impacted may have appetite reduction, unexpected weight loss, lethargy, and recurring bouts of lung infections such as pneumonia or bronchitis.
When small cell lung cancer spreads (metastasizes), the lymph nodes, brain, liver, adrenal glands, bone, and bone marrow are the most typically afflicted sites. Symptoms will vary based on the exact area(s) afflicted and the severity of the condition. Symptoms of cancer spreading to the bones include bone pain; yellowing of the eyes, skin, and mucous membranes (jaundice); headaches, dizziness, double vision, seizures, or a sensation of numbness or tingling in the hands, arms, feet, and legs when cancer spreads to the brain; and small lumps or growths on the skin when cancer has spread to the skin or lymph nodes.
Individuals suffering from small cell lung cancer may also develop paraneoplastic syndromes. These syndromes are uncommon illnesses characterized by either aberrant hormone production or an inappropriate immunological response to a malignant tumor.
The condition of incorrect antidiuretic hormone secretion is a prevalent paraneoplastic illness in small cell lung cancer. This illness is characterized by an increase in antidiuretic hormone production, which causes patients to retain water and reduces salt (sodium) levels in the body, resulting in weariness, lethargy, and disorientation.
Causes of Small cell lung cancer
Cancer-causing substances (carcinogens) present in tobacco smoke are the primary cause of small cell lung cancer. These carcinogens induce DNA (deoxyribonucleic acid genes) damage in cells, which leads to cancer. However, it is unknown why normal cells turn malignant.
Multiple variables, including hereditary and environmental factors, are most likely involved in the development of small cell lung cancer in certain persons. Oncogenes and tumor suppressor genes can be affected by genetic alterations in small cell lung cancer. These gene alterations occur during life and are not inherited. They are acquired due to environmental influences such as smoking, or they arise randomly for unknown reasons (spontaneously).
These gene alterations are altered or partial versions of normal genes that affect cell development and division. An erroneous oncogene promotes uncontrollable growth (cancer). Tumor suppressor genes generally inhibit or prevent cell development. When tumor suppressor genes are changed (mutated), cells reproduce (proliferate) erratically, resulting in cancer. When the normal gene is present, they appear to inhibit the development of cancer.
small cell lung cancer has been connected to a variety of oncogenes and tumor suppressor genes. The TP53 gene, which has been connected to many cancers, and the RB1 gene, which has been linked to retinoblastoma and other malignancies, are two tumor suppressor genes that have been linked to many patients with small cell lung cancer.
The TP53 gene is mutated in 75% of small cell lung cancers, whereas the RB1 gene is altered in 90% of small cell lung cancers.
small cell lung cancer is connected with a number of risk factors. A risk factor is something that increases a person’s likelihood of developing a disease. Having a risk factor does not guarantee that a person will get that ailment, and persons with no risk factors can nevertheless develop a condition.
Having a risk factor does not guarantee that a person will get that ailment, and persons with no risk factors can nevertheless develop a condition.
Effects of Smoking on small cell lung cancer
Smoking is the leading cause of small cell lung cancer, with approximately 95 percent of those afflicted being current or past smokers. Heavy smokers are especially vulnerable to small cell lung cancer. Chronic secondhand smoke exposure raises the risk of lung cancer.
Other risk factors
Other less prevalent environmental risk factors include exposure to chloromethyl esters, which are utilized in chemical manufacture, asbestos, and radon. Radon is a radioactive gas that is colorless and odorless. It occurs naturally in the environment as uranium degrades in soil or rock.
Populations Affected by Small cell lung cancer
The incidence of small cell lung cancer has been decreasing in the United States over the previous two decades, which most researchers ascribe to the country’s decrease in smoking. As a group, lung cancer is the second most frequent kind of cancer in the United States.
Small cell lung cancer accounts for around 10% To 15% of all lung cancer cases. Each year, around 30,000 to 35,000 new cases of small cell lung cancer are identified in the United States. Almost everyone who develops small cell lung cancer has a smoking history. It is quite uncommon among those who have never smoked.
Diagnosis of Small cell lung cancer
Identification of distinctive symptoms, a complete patient history, a thorough clinical assessment, and a range of specialist tests are used to make a diagnosis of small cell lung cancer. small cell lung cancer is a very aggressive disease, and by the time a person is diagnosed, cancer has already spread.
Workup and Clinical Testing
A simple x-ray (radiography) of the chest can reveal the presence of a tumor or mass in the lungs. If a mass is discovered, more advanced imaging techniques can be performed to assess the presence of cancer, the degree of the illness, and whether cancer has spread to other locations. Computerized tomography (CT), positron emission tomography (PET), and magnetic resonance imaging are examples of imaging methods (MRI).
A computer and x-rays are used to produce cross-sectional pictures of the interior of the body during CT scanning. A CT scan of the chest can detect tiny tumors that are not visible on standard x-rays, as well as if cancer has spread to adjacent lymph nodes. A CT scan of other parts of the body can reveal whether cancer has spread (metastasized) to those locations.
Positron emission tomography (PET scan) is another sophisticated imaging technology that may be performed. A radioactive sugar is delivered into the body during a PET scan. This sugar will accumulate in places of the body when energy is in short supply.
PET scans are frequently used to determine whether lung cancer has migrated to other regions of the body. A PET scan, for example, can assess whether cancer has migrated to the bones. Previously, a bone scan was required, but with the use of a PET scan, a bone scan is no longer required. PET scans are nearly typically performed in combination with a CT scan (PET/CT). The PET/CT scan collects data on how much metabolic activity (glucose uptake, as determined by PET) a tumor has while simultaneously imaging the surrounding bodily structures.
During a bone scan, a radioactive dye that is generally innocuous is injected into the blood and is taken up by abnormal regions of bone. To evaluate if small cell lung cancer has spread to other parts of the body, a special camera that detects dye in the bones is utilized to produce an image of the skeleton.
MRI for diagnosis the small cell lung cancer
An MRI creates cross-sectional pictures of certain organs and body tissues by using a magnetic field and radio waves. To assess whether cancer has progressed to the brain, an MRI of the brain may be required.
To establish the precise kind of cancer, a portion of the tumor (biopsy) from the lungs or another region of the body must be obtained. A bronchoscopy or a needle biopsy is frequently recommended by doctors to get a tumor sample.
A bronchoscopy is performed when a physician inserts a bronchoscope via the mouth and down into the affected person’s lungs to get a sample of tissue to be evaluated (biopsy). Another form of biopsy is fine needle aspiration. It entails inserting a thinner, hollow needle into the tumor to remove tissue. The needle is connected to a syringe, which is used to withdraw (aspirate) a sample of tissue and fluid from the mass or tumor.
A narrow tube with a built-in camera (thoracoscope) is put into the chest through a small surgical cut (incision) to allow a physician to examine the lungs and acquire tissue samples during video thoracoscopy.
This is often a formal operational procedure carried out in an operating room or comparable environment, and it may necessitate general anesthesia with a temporary breathing tube.
A mediastinoscopy may be ordered by a doctor to determine whether cancer has progressed to the lymph nodes in the center of the chest. Making a tiny cut around the top of the breastbone, which is the thin bone that runs down the middle of the chest, is required.
A mediastinoscopy is a short thin tube that is inserted below the breastbone through the windpipe to allow clinicians to observe and obtain tissue samples from the mediastinum, which is the area between the lungs in the center of the chest.
Staging of this diseases
The Veterans Administration Lung Study Group (VALG) staging approach is the most often utilized for small cell lung cancer. This method divides the disease into two stages:
- Restricted stage small cell lung cancer
- Extended stage small cell lung cancer
The term “limited stage” refers to cancer that is restricted to one side of the chest and may be treated inside a single radiation field or port. A radiation field, also known as a port, is a location on the body where radiation is focused to destroy cancer cells. If the cancer is limited to a small location, it can be treated in a single radiation field or port.
When cancer has gone beyond one side of the chest, it is said to be at an extensive stage. The major purpose of staging in small cell lung cancer is to assess whether cancer has spread.
The International Association for the Study of Lung Cancer (IASLC) has suggested that clinicians use the Tumor Node Metastasis or TNM Staging Method, which is a cancer staging system designed by the American Joint Committee on Cancer. This approach is based on the size of the tumor (T), whether or not cancer has spread to the lymph nodes (N), and whether or not cancer has migrated to other parts of the body (metastasized) (M). It is a more intricate staging method.
Treatment using Standard Therapies
Individuals with small cell lung cancer may require the coordinated efforts of a team of medical professionals, such as physicians who specialize in the diagnosis and drug treatment of cancer (medical oncologists), physicians who specialize in the treatment of cancer with radiation (radiation oncologists), pathologists who specialize in examining tissues and cells to find disease and determine what disease is present (pathologists), and physicians who specialize in examining tissues and cells to find disease and determine what disease is present (pathologists).
Psychosocial help for the entire family is also required. Several of the organizations offer assistance and information about lung cancer or lung illness. Individuals with small cell lung cancer who continue to smoke are actively advised to stop. The significance of stopping smoking cannot be overstated.
Specific therapeutic procedures and interventions may differ depending on a variety of factors, including disease stage, tumor size, whether cancer has spread (metastasized) and to which organs it has spread, the presence or absence of certain symptoms, an individual’s age and overall health, and/or other factors.
Physicians and other members of the health care team should make decisions about the use of specific drug regimens and/or other treatments in careful consultation with the patient based on the specifics of his or her situation; a thorough discussion of the potential benefits and risks, including possible side effects and long-term effects; patient preference; and other appropriate factors.
Individuals with restricted-stage small cell lung cancer who have a tiny tumor that has not progressed to adjacent lymph nodes (early stage or stage 1 small cell lung cancer) can occasionally be treated with surgical excision of the tumor in rare cases. However, in the majority of cases, the tumor is not isolated, and because it is generally a fast-growing malignancy, it has spread to neighboring lymph nodes or other parts of the chest.
The majority of patients with restricted-stage small cell lung cancer are treated with a combination of chemotherapy and radiation treatment administered concurrently.
Chemotherapy refers to the use of certain drugs to kill or slow the development of cancer cells. Cancer cells proliferate and divide quickly, making them vulnerable to chemotherapy medicines. A chemotherapy regimen is the employment of several combinations of drugs. Etoposide in combination with cisplatin or carboplatin is the most often used chemotherapy treatment for small cell lung cancer. Because carboplatin and cisplatin are used, this is known as platinum-based chemotherapy.
Carboplatin is linked with fewer and milder adverse effects than cisplatin. small cell lung cancer is very sensitive to treatment, and improvement can be swift and dramatic at times. However, cancer frequently returns and may develop resistance to the chemotherapy treatment that was previously effective.
Radiation treatment is typically used in conjunction with chemotherapy (chemoradiotherapy) to treat people with early-stage small cell lung cancer. Radiation treatment uses high-powered x-rays to kill cancer cells directly. The major lung tumor and lymph nodes to which the malignancy has disseminated are treated with radiation treatment delivered to the chest (thoracic radiotherapy).
Individuals who have successfully had chemotherapy and radiation treatment to the chest may also get prophylactic cranial irradiation (PCI), which is a type of preventative radiation therapy to the brain. Because small cell lung cancer is dangerous cancer that can spread to the brain, PCI is used to destroy any microscopic cancer cells that have made it there.
PCI is typically administered to patients who have had a positive response to initial therapy and are in good enough health to undergo the procedure.
With timely treatment with chemotherapy and radiation therapy, around 25% of people with limited-stage small cell lung cancer can be cured!
Extensive-stage small cell lung cancer is treated primarily with platinum-based chemotherapy, similar to that used in limited-stage disease. Doctors may use irinotecan instead of etoposide in conjunction with cisplatin or carboplatin.
In Japanese persons, the combination of irinotecan and a platinum drug appears to be more successful; in Caucasians, etoposide appears to be similarly effective and is linked with fewer severe side effects. Recently, the inclusion of atezolizumab, an immunotherapy medicine that enhances the body’s immune system to attack cancer, to the usual carboplatin plus etoposide regimen was demonstrated to improve the result of certain patients with advanced stage small cell lung cancer.
However, the Food and Drug Administration (FDA) in the United States has not authorized this drug combination. Although advanced stage illness is incurable, chemotherapy will decrease the tumor, relieve symptoms, and lengthen life for the vast majority of patients. Treatment aims to alleviate symptoms, preserve the quality of life, and extend life.
In persons with advanced-stage small cell lung cancer, thoracic radiation may be suggested following chemotherapy in some cases. Because of the significant risk of small cell lung cancer spreading to the brain, regular MRI examinations of the brain are frequently advised.
Recurrence in SCLC
Although small cell lung cancer responds well to the first treatment, the disease frequently recurs. When cancer resurfaces, it is frequently more resistant to previously effective chemotherapy treatments.
Various chemotherapy regimens can be tried, although they are typically ineffective. When cancer recurs, it can be exceedingly aggressive. Topotecan, a chemotherapeutic medication, is the only second-line treatment licensed in the United States for small cell lung cancer.
Several more medications are available that can reduce or delay the tumor, but the outcomes are often poor. Newer medicines are being tested in clinical studies as second-line treatment for small cell lung cancer patients.
The FDA authorized nivolumab in 2017 for the treatment of people with small cell lung cancer whose cancer has spread (metastasized) and who have previously been treated with two forms of therapy. Nivolumab is an immunotherapy drug. Immunotherapy is the most recent contribution to cancer treatment. It is intended to activate the body’s immune system to fight cancer.
Therapy for Advocacy
Individuals who are affected may require supporting therapy. Many people with small cell lung cancer have significantly reduced lung function and may require therapy to help them breathe. Bronchodilators, which enlarge the airways of the lungs, and supplementary oxygen treatment are examples of such medications.
Individuals who are affected are advised to consider participating in clinical studies. Participating in a clinical trial can provide a patient with access to new medications. This decision should be taken after extensive discussion with an individual’s oncologist and medical team.
Targeted therapies are being investigated as potential treatments for people suffering from small cell lung cancer. Targeted treatments are medications and other substances that slow or stop the spread of cancer by blocking or inhibiting specific molecules (typically proteins) involved in the development of certain tumors.
In general, targeted therapies are less hazardous than conventional cancer treatments. Several research studies are now being conducted to investigate potential targeted therapeutics for small cell lung cancer. More study is needed to discover which genetic variables (e.g., changed genes) contribute to the formation of small cell lung cancer and what sorts of targeted medicines may be available to treat these tumors.
Additional immunotherapy medications, such as nivolumab, are being investigated as possible treatments. Clinical studies with immune agents in small cell lung cancer are now underway in an attempt to best define the usage of these medicines in treating this kind of cancer. Several immunotherapy medicines, including atezolizumab and pembrolizumab, are being investigated as possible therapies.
If, after reading the article “All about small cell lung cancer! “, you liked it and became interested in studying other fields of health and medicine, we suggest you read the following articles from the category cancer on our website.