Lung cancer, 3D illustration and photo under microscope. Histopathological light micrograph of small cell lung cancer (Source: Shutterstock)
Small Cell Lung Cancer (SCLC)
Definition of SCLC
Small cell lung cancer (SCLC) is a disease in which malignant (cancer) cells form in the tissues of the lung. SCLC previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics.
In Germany yearly around 7.000 to 8.000 people develop the second most common and extremely aggressive type of lung cancer, small cell lung cancer.
In the United States, there are over 200.000 new cases per year and over 150,000 deaths per year attributed to lung cancer. SCLC comprises about 15% of cases. Smoking is strongly associated with developing lung cancer and particularly with SCLC.
In Great Britain are around 47.800 new lung cancer cases ever year. Lung cancer is the 3rd most common cancer in the UK, and 2% of patients diagnosed with Small cell lung cancer (SCLC).
Lung cancer is the most common fatal cancer in men worldwide. In women, lung cancer ranks third after breast cancer and colon cancer.
The small-cell tumors of this disease grow very quickly and form daughter tumors (metastases) in other parts of the body at an early stage. Lung cancer usually grows centrally in the lungs and surrounds Respiratory lungs. Small cell lung carcinoma spreads early on via the blood and lymph vessels to other parts of the body. Because of the rapid growth and early metastasis this disease is very difficult to treat. In most cases, SCLC has already spread by the time it is found, so chemotherapy is usually part of treatment.
Small cell bronchial carcinomas are assigned to neuroendocrine tumors because they originate from APUD cells and how these can produce hormones.
Causes of SCLC
Smoking is the major risk factor for small cell lung cancer: As with other forms of lung cancer, the main risk factor for small cell lung cancer is the consumption of tobacco (active or passive smoking), followed by high air pollution and contact with asbestos.
Symptoms of SCLC
Signs and symptoms of small cell lung cancer include coughing, shortness of breath, and chest pain. An early diagnosis is usually made more difficult by unspecific complaints - similar to a cold or bronchitis - such as dry cough, fatigue and chest pain. There are two main types of small cell lung cancer. Smoking is the major risk factor for small cell lung cancer. Signs and symptoms of small cell lung cancer include coughing, shortness of breath, and chest pain.
As the tumor grows rapidly, symptoms such as fever, shortness of breath, weight loss and bloody sputum (haemoptysis) are added.
If the bronchial carcinoma also releases hormone-like substances into the blood, it can lead to brittle bones and cardiac arrhythmias.
Therapies for the treatment of small cell lung cancer:
The diagnosis is made on the basis of a detailed medical history, physical examination, bronchoscopy (reflection of the bronchi) and computed tomography. Appropriate therapies depend on the stage of lung cancer and the patient's condition.
At a very early stage of the disease, when the cancer is limited to the lungs without metastasizing, small cell lung cancer is operable. Before the operation, the lymph nodes in the chest will be checked for cancer with mediastinoscopy because surgery is unlikely to be a good option if the cancer has spread there.
Nevertheless, the prognosis for this type of cancer is rather poor; at the time of diagnosis, more than two thirds of all patients are in an inoperable stage. If the disease is diagnosed late, the patient must be treated with radiation therapy.
Hyperthermia is a very effective way to complement and increase the effects of radiation therapy or chemotherapy. It can improve the success of the therapy, especially in the case of inoperable lung cancer.
Current studies have shown good results from a combined treatment with hyperthermia and radiation / insulin-potentiated therapy.