Small Cell Lung Cancer (SCLC) • More aggresive • More often metastatic • More central/mediastinal • Tightly assoc. with smoking hx (ie. rare to occur without smoking hx) • Limited (one side); extensive (spread) • Prognosis: poorer • <15% (5 year survival)
| **Small Cell Lung Cancer (SCLC)**from the small, immature neuro endocrine cells → 🚬Smoking | |
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| Presentation | Constitutional symptoms: fever, night sweat, weightless Symptoms are usually rapid-onset and begin 8 to 12 weeks before presentation. They may include a cough, wheezing, and hemoptysis. Local intrathoracic tumor growth can affect the superior vena cava (resulting in superior vena cava syndrome), chest wall, or esophagus. Extrapulmonary distant spread can present with neurological problems, recurrent nerve pain, fatigue, and anorexia. Can cause Paraneoplastic syndromes:· **SIADH (syndrome of inappropriate antidiuresis)**ADH - weakness, dysgeusia (w/ clinical euvolemia)· Ectopic Cushing syndromeACTH – elevated free cortisol, edema, proximal myopathy, and hypokalemic alkalosis.· Lambert-Eaton Myasthenic syndromeAntibody against neurons - weakness of proximal arms and legs, relieved temporarily after exercise. Can involve ANS |
| Staging | Veterans Administration Lung Cancer Study Group staging system:· **Limited Disease (LD)· Extensive Disease (ED)**Depends on whether a reasonable radiation plan can safely encompass disease extent. Surgical patients staged by TNM system. |
| Prognosis | Close to 70% of patients with SCLC have disseminated disease at the time of presentation. At this stage, the cancer is not curable, and the prognosis is poor. Even with chemotherapy, the majority of patients are dead within 24 months, and less than 2% are alive at five years. For individuals with localized lung disease, treatment with chemotherapy and radiation does offer a better survival of 80% at two years, but less than 15% are alive at five years. |