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Small Cell Lung Cancer - Types, Causes, Diagnosis, and Treatment

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Small Cell Lung Cancer - Types, Causes, Diagnosis, and Treatment

4 min read


Small cell lung cancer is a rapidly growing lung cancer. This article illustrates the causes, symptoms, and management of small lung cancer.

Written by

Dr. Vidyasri. N

Medically reviewed by

Dr. Kaushal Bhavsar

Published At July 25, 2022
Reviewed AtSeptember 14, 2022


Small cell lung cancer is one rare but fast-growing lung cancer that arises from the lung tissues. It is also referred to sometimes as oat cell cancer due to the appearance of small, oval-shaped cells similar to oat grains under the microscope. Small cell lung cancer constitutes approximately 15 % of all lung cancers.

What Are Some of the Different Types of Small Cell Lung Cancer?

Small cell lung cancer is classified into two main types such as,

  • Small cell carcinoma (the lung cancer that arises from the tissues of the lungs only, and the lesions resemble oat grains).

  • Combined small cell carcinoma (cancer arising from the lung tissues combined with one or more components of non-small cell lung carcinoma).

What Are Some of the Major Causes and Risk Factors of Small Cell Lung Cancer?

Various causes are responsible for causing small cell lung cancer. Smoking is a major risk factor. Smokers are at greater risk than nonsmokers. People with a long history of tobacco use are also at higher risk. Several other risk factors include-

  • Radiation exposure or exposure to radioactive substances during cancer treatments.

  • The individuals whose family members have been diagnosed with lung cancer.

  • People who have been exposed to secondhand smoking might develop small cell lung cancer.

  • Human immunodeficiency virus (HIV).

  • Air pollution.

  • Exposure to asbestos, nickel, arsenic, tar, or other chemicals in the working environment.

What Are Some of the Common Signs and Symptoms of Small Cell Lung Cancer?

In the early stages, the disease does not present with any symptoms. However, a patient may present with symptoms as the disease progresses, and these include:

  • Hemoptysis (coughing up blood).

  • Chronic cough.

  • Chest pain.

  • Difficulty in breathing.

  • Facial swelling.

  • Fatigue.

  • Loss of appetite.

  • Hoarseness of voice.

  • Sudden unexplained weight loss.

  • Wheezing.

  • Swollen neck veins.

Under What Different Stages Can Small Cell Lung Cancer Be Classified?

There are two different stages of small cell lung cancer, and they are as follows:

  • Limited Small Cell Lung Cancer- This type of cancer involves one lung and nearby lymph nodes. Other organs are not affected.

  • Extensive Small Cell Lung Cancer- In this type, cancer involves both the lung lobes and lymph nodes. It can also include bones, the brain, and other organs.

What Are the Complications of Small Cell Lung Cancer?

The rapid rate of spreading or metastasis increases the risk of complications. It can grow rapidly and spread cancer to other organs involving the liver, brain, bones, and adrenal glands. These cancers are managed by various treatments but cannot be completely cured. Various complications include-

  • The lung cancer might recur after the treatment procedure is complete which is harmful for the patient.

  • Pain.

  • Shortness of breath.

  • Pleural effusion (buildup of fluid in the area lining the lungs).

What Are the Various Diagnostic Methods for Small Cell Lung Cancer?

Specific tests are performed to diagnose the presence of small cell lung cancer. It includes-

  • Chest X-Ray: Chest X-ray is the initial screening step involved in any type of lung cancer. If the findings reveal any suspicious spots on the lungs, several other investigations are further performed.

  • Computed Tomography (CT) and Positron Emission Tomography (PET): Both the tests are performed to detect lung tumors. Computed tomography scans are the primarily recommended scans to diagnose lung cancer. These tests can also help in tracking or recording the spread of cancer.

  • Sputum Cytology: Sputum cytology tests help check the presence of cancer cells in sputum; mucus coughed up from the lungs.

  • Bronchoscopy: The tube is inserted with a camera at the tip, which provides a detailed picture of the tumor inside the lungs. It also helps to obtain tissue samples for biopsy.

  • Biopsy: A technique called needle biopsy (fine-needle aspiration) is used to remove tissue samples from the lungs to rule out the growth of cancer cells. A tissue sample is removed from the lungs using a thin needle and examined under the microscope to check for any presence of cancer cells.

How to Treat Small Cell Lung Cancer?

Various treatment approaches are carried out to treat different stages of cancer. These include:

1) Surgery:

  • Surgery is indicated in the case of cancer involved in one lung or both the lungs and lymph nodes.

  • During the surgery, lymph nodes are also removed in a few cases.

  • The untreated cells left after the surgery are destroyed with radiation therapy or chemotherapy.

  • Treatment provided after the surgery is called adjuvant therapy.

2) Chemotherapy:

  • In chemotherapy, a series of drugs are used to treat cancer and stop the progression of the disease.

  • The chemotherapy is based on the severity and the type of cancer.

3) Radiation Therapy:

  • In radiation therapy, high-energy X-rays kill the cancer cells and inhibit their growth.

  • External radiation therapy is used to treat small cell lung cancer and is also managed as palliative therapy to relieve symptoms.

Various treatment approaches manage different stages of small cell lung tumors.

1) Limited-Stage Small Cell Lung Cancer:

  • In this therapy, initially, a combination of both radiation and chemotherapy to the chest is provided.

  • In patients contraindicated to radiation therapy, chemotherapy is given.

  • After the completion of chemotherapy, surgery can be done.

  • Surgery can be performed, followed by radiotherapy and chemotherapy.

  • Later radiation therapy can be performed on the brain after receiving a positive response from the previous chemotherapy treatments.

2) Extensive-Stage Small Cell Lung Cancer:

  • Both the immune checkpoint inhibitor and combination chemotherapy are recommended in this therapy.

  • Combination chemotherapy.

  • Radiation therapy to the chest is provided to patients who have a positive response to chemotherapy.

  • Radiation therapy to the brain, bone, spine, or other parts of the body is recommended as palliative therapy to relieve symptoms.

  • To prevent the spread of cancer to the brain, radiation therapy to the brain is given to patients received with complete response.

3) Recurrent Small Cell Lung Cancer:

Various treatments are recommended in the case of recurrence of small cell lung cancer, and these include-

  • Immunotherapy can be performed with immune checkpoint inhibitors.

  • Chemotherapy.

  • Radiation therapy is carried out to relieve the symptoms and improve well-being of life.

  • Laser therapy, internal radiation therapy, or stent placement are followed to improve the breathing process and improve the quality of life.


Small cell lung cancer is uncommon but considered a severe life-threatening disease because of the rapidly growing tendency of cancer cells. Therefore, preventive measures such as quitting smoking, eating a nutritious diet, exercising regularly, testing home for radon (natural, odorless radioactive gas), and protecting oneself from cancer-causing chemicals from the environment are recommended.

Frequently Asked Questions


What Is the Survival Rate for Small Cell Lung Cancer?

The survival rate for small cell lung cancer (SCLC) can vary depending on several factors, including the stage at diagnosis, the overall health of the patient, and the treatment received. Normally, survival rates are expressed as the proportion of individuals who manage to live for a specified duration following their diagnosis. These rates are general estimates and cannot predict individual outcomes. People with limited-stage SCLC who survive for five years or more are around 15% to 20%, which means that about 15% to 20% of people diagnosed with limited-stage SCLC are expected to be alive five years after their diagnosis. Individuals with extensive-stage SCLC who survive for five years or more are generally less than 5%. However, the majority of people diagnosed with extensive stage SCLC do not survive for five years.


Can small cell lung cancer be cured?

Small cell lung cancer is generally considered a highly aggressive and fast-growing cancer. Normally it is difficult to find a cure, but there are cases where SCLC can be effectively treated and go into remission. The potential for a cure is highest when SCLC is diagnosed at an early stage, referred to as a limited stage, where the cancer is bound to one side of the lung and potentially the nearby lymph nodes.


How Serious Is Small Cell Lung Cancer?

Small cell lung cancer is considered a serious and aggressive form of lung cancer. It grows and spreads rapidly, making early detection and treatment crucial. SCLC has a higher tendency to metastasize (spread) to various parts of the body, such as the liver, bones, brain, and lymph nodes. The fast growth and early metastasis contribute to the overall seriousness of the disease.


Where Does Small Cell Lung Cancer Spread First?

Small cell lung cancer is known for its high tendency to spread early in the disease course. It can spread to various parts of the body through the bloodstream and lymphatic system. The most common sites of initial spread for SCLC include lymph nodes, other parts of the lungs, pleura, and distant organs like the liver, adrenal gland, bones, and brain.


What Treatment Is Most Effective for Small Cell Lung Cancer?

The treatment approach for small cell lung cancer (SCLC) typically involves a combination of different therapies, like

- Chemotherapy.

- Radiation therapy.

- Surgery.

- Prophylactic cranial irradiation.

- Targeted therapy.


How Does Small Cell Cancer Start?

SCLC is a type of cancer that originates in the cells covering the respiratory passages within the lungs. Although not wholly comprehended, the process by which healthy lung cells evolve into malignant cells is believed to be due to a combination of genetic alterations and exposure to particular hazards. Smoking is the primary risk factor. Other risk factors for SCLC include exposure to secondhand smoke, occupational exposure to certain substances like asbestos, radon, or diesel exhaust, and a history of prior lung diseases. Once genetic mutations occur in the lung cells, they can disrupt the normal control mechanisms that regulate cell growth, division, and death. This disruption allows the cancer cells to multiply and form a tumor.


What Stage Is Small Cell Lung Cancer?

Small cell lung cancer is typically divided into two main stages: limited stage and extensive stage. This staging system is specific to SCLC and is different from the staging system used for non-small cell lung cancer. The majority of individuals diagnosed with SCLC are typically in the advanced or extensive stages of the disease, commonly referred to as stage 4 (IV).


What Is the First Stage of Small Cell Lung Cancer?

Different approaches are taken to stage small cell and non-small cell lung cancer. Small-cell lung cancer is differentiated into two stages. The limited stage is the first stage, and it refers to cancer that is confined to one lung and potentially the nearby lymph nodes on the same side of the chest. It may also include tumors that have spread to the tissues between the lungs. In limited-stage SCLC, the cancer is generally considered more localized and has not spread extensively throughout the body. This stage accounts for about one-third of SCLC cases.


What Is the Main Cause of Small Cell Lung Cancer?

The main cause of small cell lung cancer is primarily attributed to cigarette smoking. Smoking is the primary contributing factor to the development of SCLC, with approximately 98% of SCLC cases being linked to smoking. Other forms of tobacco use, such as pipe smoking and cigar smoking, also increase the risk of SCLC, although to a lesser extent.


Can Chemo Shrink Small Cell Lung Cancer?

Yes, chemotherapy is a primary treatment for small cell lung cancer (SCLC) and can often shrink the tumor. SCLC is known for its responsiveness to chemotherapy, and chemotherapy is typically a key component of the treatment approach for both limited-stage and extensive-stage SCLC. Chemotherapy drugs for SCLC are typically administered in combination rather than as single agents. The most common combination for SCLC treatment is etoposide and a platinum-based drug, such as cisplatin or carboplatin. Additional medications could be included in the treatment schedule based on the particular course of therapy.


Can Chemotherapy Cure Lung Cancer?

Chemotherapy can be an important component of treatment for lung cancer, but its ability to cure the disease depends on factors like the type and stage of cancer and the overall health of the patient. In some cases, chemotherapy can lead to complete remission, where all signs of cancer disappear and the patient is considered cancer-free. However, achieving a cure with chemotherapy alone is more common in certain types of cancer, such as testicular cancer or some types of lymphoma, rather than lung cancer.


What Constitutes the Final Phase of Lung Cancer?

The last stage of lung cancer is often referred to as stage IV or advanced stage lung cancer. The highest level of lung cancer, Stage IV, indicates that cancer has disseminated from the lungs to other regions such as bones, the brain, or other organs. In stage IV lung cancer, the cancer is considered to be metastatic, meaning it has spread beyond the primary tumor site in the lungs. This stage is typically characterized by the widespread dissemination of cancer cells, making it more challenging to treat and manage compared to earlier stages.


What Are Some of the Initial Indications That May Suggest the Presence of Lung Cancer?

The early signs and symptoms of lung cancer can vary among individuals, and in some cases, lung cancer may not cause noticeable symptoms until it reaches an advanced stage. Some common signs include

- Persistent cough.

- Shortness of breath.

- Chest pain.

- Unexplained weight loss.

- Weakness and fatigue.

- Hoarseness of voice.

- Recurrent respiratory infections.


Is Small Cell Lung Cancer Painful?

Pain is one of the symptoms of SCLC and may not occur if the cancer has not spread to other parts. The level and impact of pain may differ from person to person, impacted by various elements such as the position and magnitude of the growth, the impact on neighboring structures, and an individual's susceptibility to pain. Pain in SCLC may arise from different sources like chest pain, bone pain if cancer has spread to the bones, and neurologic pain if the nerves are involved or compressed.


Is Lung Cancer Death Sudden?

In some cases, the death of a person with lung cancer can be sudden, particularly if there is a sudden and severe complication or if the cancer has already reached an advanced stage. However, the progression and outcome of lung cancer can vary widely among individuals. In general, lung cancer is often diagnosed at advanced stages when symptoms become noticeable and the cancer has already spread beyond the lungs. At advanced stages, lung cancer becomes more challenging to treat and manage effectively.


How Long Do Lung Cancer Patients Live?

The lifespan of individuals with lung cancer can vary immensely, relying on elements such as the cancer's type and stage, the person's overall well-being, age, reaction to treatment, and other unique characteristics. Recognizing that survival rates are general estimates based on large groups and do not reflect an individual's prognosis is essential.


Is Lung Cancer Painful in the End?

In the advanced stages of lung cancer, individuals may experience various symptoms, including pain. Pain management is an essential aspect of end-stage lung cancer care, and healthcare professionals strive to provide adequate pain control and support to improve the quality of life for individuals facing advanced lung cancer. Medications, such as opioids or other pain-relieving medications, can be prescribed to alleviate pain.


Is Lung Cancer Painful in the End?

In the advanced stages of lung cancer, individuals may experience various symptoms, including pain. Pain management is an essential aspect of end-stage lung cancer care, and healthcare professionals strive to provide adequate pain control and support to improve the quality of life for individuals facing advanced lung cancer. Medications, such as opioids or other pain-relieving medications, can be prescribed to alleviate pain.

Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


lung cancersmall cell lung cancer
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