Small cell lung cancer: how long do you live with it and how bad is the prognosis? Small cell lung cancer - what is it? Small cell cancer stage 3

Lung cancer ranks first in the frequency of diagnosis among all cancers. The most aggressive form of lung oncology is small cell lung cancer, which is characterized by a latent course of the disease, early metastasis and an unfavorable prognosis.

What is small cell lung cancer

Small cell cancer is a malignant neoplasm that is localized in the human respiratory system. This tumor can initially be divided into two types - small cell carcinoma of the left and right lung. The name of this disease can be explained by the size of the cellular structures, which are small in size, only 2 times larger than the size of blood cells (erythrocytes).

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Small cell cancer is not as common as non-small cell cancer (diagnosed in 80% of cases). Most often, this pathology is observed in smoking men aged 50-62 years. Due to the increasing number of female smokers, the number of cases among women is also increasing.

The tumor almost always begins as a central cancer; this type is fleeting - it spreads very quickly, seeding the entire lung tissue, forming metastases in neighboring organs. This type of lung oncology is an intensively proliferating subtype of tumors with a high malignancy potential. Metastases affect not only the retroperitoneal organs and lymph structures, but also the brain.

This type of oncology is based on cancerous degeneration of the epithelium of lung tissue and impaired air exchange. This type of lung cancer is the most difficult to treat; it is fatal in 85% of cases.

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Causes

The causes of tumor pathogenesis can be:

smoking. This is the root cause of the beginning of the transformation of the cell structure of the lung tissue;
heredity (the presence of a similar disease in relatives in the medical history increases the risk of getting this disease);
unfavorable ecology in the patient’s area of residence;
previously suffered severe lung diseases (asthma, chronic obstructive pulmonary disease, pulmonary tuberculosis, and other infectious diseases and pathological neoplasms);
prolonged contact with carcinogenic substances (arsenic, nickel, chromium). Contact is possible both at places of residence and at places of work;
the impact of radioactive ions on the body (for example, possible during various man-made disasters);
pulmonary asbestosis;
dust exposure;
influence of radon.

Symptoms of the disease

At the initial stages of formation, small cell cancer is not expressed by specific symptoms; the symptoms can be disguised as other pathologies of the pulmonary system. But with the further spread of small cell lung cancer and its rapid metastasis, the symptoms begin to be clearly visible and become noticeable.

In the early stages, it is possible to suspect this type of lung cancer only by some indirect signs:

cough (at the initial stages, dry and lingering, later acquiring a paroxysmal character and becoming persistent, with sputum and blood discharge);
pain in the chest area;
mediastinal compression;
causeless shortness of breath that occurs from time to time;
weakness, general malaise;
severe loss of appetite, sudden weight loss, cachexia;
Possible decreased vision;
hoarseness occurs when breathing, hoarseness in the voice when speaking (dysphonia).

With late diagnosis, metastases of this cancer spread and the clinical picture is complemented by the following symptoms:

intense headaches of various types (pulsating and pulling, localized in one place, to migraine-like tingling that covers the entire head);
pain localized in the entire back, often radiating to the projection of the spine, bone pain, aching joints (this is associated with metastases in bone tissue).

In the final stages, when mediastinal tissues are involved in the cancer process, mediastinal compression syndrome develops, consisting of:

dysphagia (eating disorder, when it becomes difficult for the patient to swallow food or it is simply impossible);
hoarseness (appears with laryngeal nerve paralysis);
abnormal swelling of the neck and face (usually unilateral, appears when the superior vena cava is compressed).

With metastases in the liver, icterus of the skin and the development of hepatomegaly are possible. Hyperthermic manifestations, paraneoplastic syndrome (Lambert-Eaton myasthenic syndrome, antidiuretic hormone secretory disorder syndrome, Cushingoid manifestations) may occur.

At stage 4, speech impairment is observed and high-intensity headaches occur, noisy breathing, dermatitis may appear, deformation of the fingers in the image of “drum sticks” is observed, symptoms of general intoxication, temperature increases, obstructive pneumonia, and confused consciousness occurs.

Signs of pathology may vary depending on the location of the original neoplasm.

Small cell cancer is usually central; peripheral cancer is less common. A primary tumor (as opposed to a secondary tumor) is detected extremely rarely by radiography.

Stages of the disease and types of cancer

The division of small cell cancer according to the TNM classification has no fundamental differences and consists of the following positions: T - shows the state of the primary tumor, N - the state of regional lymph nodes, M - the presence and absence of distant metastasis.

A clear division into stages helps determine the methods of treating the tumor - surgical or therapeutic.

Stage 1 – tumor size is within 3 cm, the tumor affects one lung, there are no metastases.

Stage 2 – the size of the neoplasm is 3-6 cm, it blocks the bronchus and penetrates the pleura, causing atelectasis;

Stage 3 – cancer quickly spreads to neighboring organs, the tumor grows to 6-7 cm, atelectasis of the entire lung occurs, and metastases are present in neighboring lymph nodes.

Stage 4 – malignant cells are present in distant organs.

More than half of patients are diagnosed with stage 3 or 4, so this type of cancer is considered according to the criteria of two important categories: localized (limited) or widespread cancer:

the localized form involves only one lung in the process (right-sided and left-sided forms are divided);
the common variant (it is comparable to stages 3-4 according to the TNM system) occurs in 60-65% of cases. It covers two parts of the chest together with the tumor process, with the addition of cancerous pleurisy and the rapid appearance of metastases.

According to histology, lung cancer is divided into the following types:

Squamous cell (epidermoid) carcinoma, which has subspecies:

highly differentiated;
moderately differentiated;
poorly differentiated.

Small cell cancer It happens:

oat cell, fine granular, spindle cell;
intermediate (intercellular);
pleomorphic (multicellular).

Adenocarcinoma divided into:

highly differentiated;
moderately differentiated;
poorly differentiated (poorly differentiated);
bronchoalveolar.

Large cell carcinoma has two subspecies:

clear cell;
giant cell.

Mixed type cancer happens:

adenocarcinoma and small cell;
squamous cell and adenocarcinoma, etc.

The histological characteristics are rather arbitrary, since the clinical course may differ even in tumors with the same structure.

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*Only upon receipt of information about the patient’s disease, a representative of the clinic will be able to calculate the exact price for treatment.

Diagnosis of the disease

To make a diagnosis, various instrumental and laboratory tests are carried out, consisting of:

chest x-ray;
MRI, PET, computed tomography (CT);
skeletal scintigraphy;
liver function tests;
blood test;
sputum analysis (cytology test to detect cancer cells);
thoracentesis (sampling of fluid from the chest cavity near the lungs);
IAP (intra-abdominal pressure) measurements;
analysis for tumor markers;
biopsy of the tumor or nearby lymph nodes.

There are several ways to do a biopsy, using:

bronchoscopy;
endoscopic ultrasound examination;
mediastinoscopy.

Also do:

pleural biopsy;
open lung biopsy;
videothoracoscopy.

Treatment of small cell lung cancer

The main methods of treating this cancer are: polychemotherapy and radioirradiation. It makes sense to perform surgical intervention only in the early stages.

Lung cancer therapy is also carried out using other treatment methods:

immunotherapy
brachytherapy;
photodynamic therapy;
targeted therapy;
laser coagulation;
radiofrequency ablation;
cryodestruction;
chemoembolization;
radioembolization;
biotherapy.

Each of these methods can be used in the treatment of lung cancer.

The goal of therapy for small cell lung cancer is to achieve absolute remission, which is confirmed by biopsy, bronchial examination (bronchoscopy), and bronchoalveolar lavage. The effectiveness of treatment can be assessed 6-12 weeks after the start of therapy, and then a prognosis for life expectancy can be made.

Chemotherapy is considered the most effective treatment for lung cancer, carried out as an independent method of treatment and as an addition to radiation exposure. Women are more sensitive to treatment.

Chemotherapy is used only when neither chemotherapy nor radiotherapy has been performed before, there are no concomitant severe diseases, heart or liver failure, and bone marrow potential is within normal limits. If the patient's condition does not meet these indicators, the dosage of chemotherapy is reduced to avoid serious side effects.

Chemotherapy for small cell cancer is effective at any stage - in the initial stages it can prevent the spread of metastases, in the latter stages it helps alleviate the course of the disease and prolong the patient’s life. Avastin is also used to suppress tumor angiogenesis, which affects this process of tumor development by binding to the VEGF protein.

A limited form of lung tumor (right or left) requires a small number (2-4) courses of chemotherapy. Cytostatic drugs are usually used: Doxorubicin, Cyclophosphamide, Gemcitabine, Cisplatin, Etoposide, Vincristine and others. Cytostatics are used as monotherapy or in combination with irradiation of the primary tumor site. During remission, radioirradiation of the brain is additionally performed to reduce the risk of metastatic contamination.

Combination therapy for a limited form of small cell cancer gives a chance to prolong life up to 2 years. With an advanced form of lung cancer, the number of chemotherapy courses increases to 4-6. In the presence of metastases in nearby and distant organs (adrenal glands, skeletal system, brain and others), chemotherapy is carried out accompanied by radiotherapy.

Drug (palliative) treatment is more often used to maintain the vital functions of already affected organs and alleviate the patient’s condition. This type of treatment is supportive. Drugs of various pharmacological groups are used:

pain medications (including narcotic drugs),
anti-inflammatory drugs;
antibiotic substances to prevent infection and worsen the disease;
medications to protect the liver (Essentiale);
means for supplying oxygen to cell structures (“Pantogam”, “Glycine”) - in case of damage to brain cells;
lowering temperature (Nimesulide, Paracetamol, Ibuprofen) for hyperthermia.

Surgical intervention for small cell cancer is carried out at stages 1-2 and is necessarily accompanied by a course of postoperative chemotherapy. When excision of malignant organ tissues, life expectancy increases. If this lung cancer is determined to be in the last stages and the cancer process has spread to other organs, surgical treatment is not performed due to the increasing risk of death during the operation. In addition to the classic method of tumor removal, gentle surgical intervention can be used using a cyber knife.

Treatment of localized small cell cancer and prognosis

When treating this form of cancer, the prognosis is as follows:

tumor regression occurs in 45-75% of cases;
effectiveness of therapy - 65-90%;
2-year survival rate - 40-50%;
The 5-year survival rate is 10-25% for patients who begin treatment in good general health.

The main method of treating a localized form of this cancer is chemotherapy (2-4 courses) in combination with radiation therapy. Radiation therapy is carried out during chemotherapy or after the patient has received several courses of chemotherapy. During remission, irradiation of the brain is performed, since this type of cancer has a tendency to quickly and aggressively metastasize to the brain.

Treatment regimens used:

combined: chemotherapy and radiation therapy with prophylactic cranial irradiation (PCR) in the presence of remission;
chemotherapy with or without PCO, for patients with deteriorating respiratory function;
surgical resection in combination with adjuvant therapy for patients at stage 1;
combined use of chemotherapy and thoracic radiation therapy - used for patients with limited stage.

How to treat advanced small cell cancer

In the case of a common form, combined treatment is carried out; irradiation makes sense when the following indicators occur:

ongoing process of metastasis in the adrenal glands;
bone metastases;
metastasis in the lymph nodes, mediastinum with compression syndrome of the superior vena cava;
metastases in the brain.

Methods of therapy used:

combination chemotherapy with or without cranial irradiation;
"Ifosfamide" together with "Cisplatin" and "Etoposide";
"Cisplatin" + "Irinotecan";
combination of Etoposide, Cisplatin and Carboplatin;
"Cyclophosphamide" together with "Doxorubicin", "Etoposide" and "Vincristine";
combination of Doxorubicin with Cyclophosphamide and Etoposide;
Cyclophosphamide in combination with Etoposide and Vincristine.

Radiation is used when chemotherapy is ineffective, especially for metastases in the spinal cord, brain or bones.

The combination of Cisplatin and Etoposide gives a good effect. Although Cisplatin often has significant side effects, leading to serious consequences for those with cardiovascular diseases. Carboplatin is not as toxic as Cisplatin.

Nutrition for lung cancer, as for other types of oncology, should be gentle and nutritious; adherence to a diet, diet and giving up bad habits is mandatory.

The use of folk remedies is possible as an addition to the main treatment and only with the permission of the attending physician. Refusal of basic treatment in favor of traditional medicine can lead to a deterioration in the patient’s condition and the transience of the disease, followed by death.

It is useful to drink decoctions of medicinal herbs during the stages of remission, as well as to reduce pain syndromes during the main treatment, informing the doctor.

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How long do you live with small cell lung cancer?

With timely diagnosis and treatment, there is a chance of recovery.

A transient disease provides about 8-16 weeks of life (after which the patient dies) if treatment is refused or resistant to it.

All patients who have crossed the 3-year life expectancy threshold belong to the group of complete remission; their survival rate can reach 70-92% of the total number of this disease.

If the size of the tumor after treatment has decreased by half or more from its original size, then this indicates partial remission, and the life expectancy of these patients is half as long as the previous one.

Only 5-11% of all patients overcome the five-year survival threshold.

The general prognosis for life expectancy depends on:

timely diagnosis;
stage of the detected disease;
high-quality comprehensive treatment;
postoperative (or after a course of polychemotherapy) observation;
the general health of the patient.

With combined treatment at stages I and II, the chances of crossing the 5-year threshold are about 40%.

In later stages, with combination therapy, life expectancy increases by an average of two years.

In patients with a localized tumor (not an early stage, but without distant metastasis) using complex therapy, the two-year survival rate is about 65-75%, about 5-10% of patients can overcome the 5-year threshold, with good health the chances of surviving up to 5 years increase in 25% of patients.

For advanced stage 4 lung cancer, survival is usually up to 1 year. The prognosis for absolute cure (without relapses) is unlikely.

Cancer is a malignant neoplasm that destroys healthy cells of the body as a result of mutation. According to the International Agency for Research on Cancer, its most common location is the lungs.

According to its morphology, lung cancer is divided into non-small cell (including adenocarcinoma, squamous cell, large cell, mixed) - about 80-85% of the total incidence, and small cell - 15-20%. Currently, there is a theory of the development of small cell lung cancer as a result of degeneration of the cells of the epithelial lining of the bronchi.

Small cell lung cancer is the most aggressive, characterized by early metastasis, latent course and the most unfavorable prognosis, even in case of treatment. Small cell lung cancer is the most difficult to treat, ending in death in 85% of cases.

The early stages are asymptomatic and are more often detected by chance during routine examinations or when visiting a clinic with other problems.

Symptoms may indicate the need for testing. The appearance of symptoms in the case of SCLC may indicate an already advanced stage of lung cancer.

Reasons for development

Small cell lung cancer is directly related to smoking. Long-time smokers are 23 times more likely to develop lung cancer than non-smokers. 95% of people with small cell lung carcinoma are men over 40 who smoke.
Inhalation of carcinogenic substances - working in “harmful” industries;
Unfavorable environmental conditions;
Frequent or chronic lung diseases;
Burdened heredity.

Not smoking is the best prevention of small cell lung cancer.

Symptoms of lung cancer

Cough;
Dyspnea;
Noisy breathing;
Finger deformity “drum sticks”;
Dermatitis;
Hemoptysis;
Weight loss;
Symptoms of general intoxication;
Temperature;
In the 4th stage - obstructive pneumonia, secondary symptoms appear from the affected organs: bone pain, headaches, confused consciousness.

Signs of pathology may differ depending on the location of the original neoplasm.

Small cell cancer is often central, less often peripheral. Moreover, the primary tumor is rarely detected radiographically.

Diagnostics

When primary signs of pathology are identified on fluorography and according to clinical indications (smoking, heredity, age over 40 years, gender and others), more informative diagnostic methods recommended in pulmonology are used. Main diagnostic methods:

Visualization of the tumor using radiation methods: radiography, computed tomography (CT), positron emission tomography (PET-CT).
Determination of tumor morphology (i.e. its cellular identification). To conduct a histological (cytological) analysis, a puncture is taken using bronchoscopy (which is also a non-radiation imaging method), and other methods of obtaining material.

Stages of SCLC

The tumor is less than 3 cm in size (measured in the direction of maximum elongation) and is located in one segment.
Less than 6 cm, not extending beyond one segment of the lung (bronchus), single metastases in nearby lymph nodes
More than 6 cm, affects the nearest lobes of the lung, the adjacent bronchus, or the outlet into the main bronchus. Metastases spread to distant lymph nodes.
Cancer neoplasia can spread beyond the lungs, with growth into neighboring organs, multiple distant metastasis.

International classification TNM

Where T is the indicator of the condition of the primary tumor, N is the regional lymph nodes, M is distant metastasis

T x – the data is insufficient to assess the condition of the tumor, or it has not been identified,

T 0 – the tumor is not detected,

T IS – non-invasive cancer

and from T 1 to T 4 – stages tumor growth from: less than 3 cm, to a size where size does not matter; and stages of location: from local in one lobe, to involvement of the pulmonary artery, mediastinum, heart, carina, i.e. before growing into neighboring organs.

N – indicator of the condition of regional lymph nodes:

N x – the data is insufficient to assess their condition,

N 0 – no metastatic lesion was detected,

N 1 – N 3— characterize the degree of damage: from the closest lymph nodes to those located on the side opposite the tumor.

M – state of distant metastasis:

M x – there is insufficient data to determine distant metastases,

M 0 – no distant metastases were found,

M 1 – M 3 – dynamics: from the presence of signs of a single metastasis to expansion beyond the chest cavity.

More than 2/3 of patients are diagnosed with stage III-IV, so SCLC continues to be considered according to the criteria of two significant categories: localized or widespread.

Treatment

If this diagnosis is made, treatment for small cell lung cancer directly depends on the degree of damage to the organs of a particular patient, taking into account his medical history.

Chemotherapy in oncology is used to form the boundaries of a tumor (before its removal), in the postoperative period to destroy possible cancer cells, and as a main part of the treatment process. It should reduce the tumor, radiation therapy should consolidate the result.

Radiation therapy is ionizing radiation that kills cancer cells. Modern devices generate highly targeted beams that minimally damage nearby areas of healthy tissue.

The need and sequence of surgical and therapeutic methods is determined directly by the attending oncologist. The goal of therapy is to achieve remission, preferably complete.

Treatment procedures - early stages

Surgical intervention is, unfortunately, the only option today for removing cancer cells. The method is used at stages I and II: removal of the entire lung, lobe or part thereof. Postoperative chemotherapy is a mandatory component of treatment, usually with radiation therapy. In contrast to non-small cell lung cancer, in the initial stage of which it is possible to limit oneself to tumor removal. Even in this case, the 5-year survival rate does not exceed 40%.

The chemotherapy regimen is prescribed by an oncologist (chemotherapist) - medications, their dosages, duration and quantity. Assessing their effectiveness and based on the patient’s well-being, the doctor can adjust the course of treatment. As a rule, additional antiemetic drugs are prescribed. Various alternative treatments, dietary supplements, including vitamins, can worsen your condition. It is necessary to discuss their use with your oncologist, as well as any significant changes in your health.

Treatment procedures - stages 3 and 4

The usual regimen for localized forms of more complex cases is combination therapy: polychemotherapy (poly means the use of not one, but a combination of drugs) - 2-4 courses, preferably in combination with radiation therapy for the primary tumor. When remission is achieved, prophylactic irradiation of the brain is possible. This therapy increases life expectancy to an average of 2 years.

For the common form: polychemotherapy 4-6 courses, radiation therapy - according to indications.

In cases where tumor growth has stopped, it is referred to as partial remission.

Small cell lung cancer responds very well to chemotherapy, radiotherapy and radiation therapy. The insidiousness of this oncology is that there is a high probability of relapses, which are no longer sensitive to such antitumor procedures. Possible course of relapse is 3-4 months.

Metastasis occurs (cancer cells are transferred through the bloodstream) to organs that are most intensively supplied with blood. The brain, liver, kidneys, and adrenal glands are affected. Metastases penetrate the bones, which also leads to pathological fractures and disability.

If the above treatment methods are ineffective or impossible to use (due to the age and individual characteristics of the patient), palliative treatment is carried out. It is aimed at improving the quality of life, mainly symptomatic, including pain relief.

How long do people live with SCLC?

Your life expectancy depends on the stage of the disease, your general health and the treatment methods used. According to some data, women have better sensitivity to treatment.

A transient disease can give you from 8 to 16 weeks, in case of insensitivity to therapy or refusal of it.

The treatment methods used are far from perfect, but it increases your chances.

In the case of combined treatment in stages I and II, the probability of 5-year survival (after five years complete remission is said) is 40%.

At more serious stages, life expectancy with combination therapy increases by an average of 2 years.

In patients with a localized tumor (i.e. not an early stage, but without distant metastasis) using complex therapy, 2-year survival is 65-75%, 5-year survival is possible in 5-10%, with good health - up to 25%.

In the case of advanced SCLC - stage 4, survival up to a year. The prognosis for a complete cure in this case: cases without relapse are extremely rare.

Afterword

Someone will look for the causes of cancer without understanding why they need it.

Believers tolerate illness more easily, perceiving it as a punishment or test. Perhaps this will make them feel better, and may this bring peace and fortitude in the struggle for life.

A positive attitude is necessary for a favorable treatment outcome. Just how to find the strength to resist pain and remain yourself. It is impossible to give the right advice to a person who has heard a terrible diagnosis, nor to understand it. It’s good if your family and friends help you.

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Small cell lung cancer is one of the most malignant tumors according to histological classification, which is very aggressive and gives extensive metastases. This form of cancer accounts for about 25% of other types of lung cancer and, if not detected early and treated properly, is fatal.

For the most part, this disease affects men, but recently there has been an increase in incidence among women. Due to the absence of signs of the disease in the early stages, as well as the rapid growth of the tumor and the spread of metastases, in most patients the disease takes an advanced form and is difficult to cure.

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We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
Health to you and your loved ones! Do not give up

Causes

Smoking is the first and most important cause of lung cancer. The age of the person who smokes, the number of cigarettes per day and the duration of the habit affect the likelihood of developing small cell lung cancer.

A good prevention is to give up cigarettes, which will significantly reduce the possibility of disease, however, a person who has ever smoked will always be at risk.

Statistically, smokers develop lung cancer 16 times more often than non-smokers, and lung cancer is diagnosed 32 times more often in those who started smoking in adolescence.

Nicotine addiction is not the only factor that can trigger the disease, so there is a possibility that non-smokers may also be affected by lung cancer.

Heredity is the second most important reason that increases the risk of the disease. The presence of a special gene in the blood increases the likelihood of developing small cell lung cancer, so there are fears that those people whose relatives suffered from this type of cancer may also get sick.

Ecology is a reason that has a significant impact on the development of lung cancer. Exhaust gases and industrial waste poison the air and, along with it, enter the human lungs. Also at risk are people who have frequent contact with nickel, asbestos, arsenic or chromium due to their professional activities.

Severe lung diseases are prerequisites for the development of lung cancer. If a person has had tuberculosis or chronic obstructive pulmonary disease throughout his life, this may cause the development of lung cancer.

Symptoms

Lung cancer, like most other organs, at the initial stage does not bother the patient and does not have pronounced symptoms. It can be noticed with timely fluorography.

Depending on the stage of the disease, the following symptoms are distinguished:

the most common symptom is a persistent cough. However, it is not the only accurate sign, since in people who smoke (and it is in them that a malignant tumor is diagnosed more often than in non-smokers), chronic cough is observed even before the disease. At a later stage of cancer, the nature of the cough changes: it intensifies, is accompanied by pain and expectoration of bloody fluid
with small cell lung cancer, a person often experiences shortness of breath, which is associated with difficult air flow through the bronchi, which disrupts the proper functioning of the lung;
At stages 2 and 3 of the disease, sudden fevers or periodic increases in temperature are not uncommon. Pneumonia, which often affects smokers, can also be one of the signs of lung cancer;
systematic chest pain when coughing or trying to breathe deeply;
The greatest danger is posed by pulmonary bleeding, which is caused by tumor growth into the pulmonary vessels. This symptom indicates the neglect of the disease;
when the tumor increases in size, it can depress neighboring organs, which can result in pain in the shoulders and limbs, swelling of the face and hands, difficulty swallowing, hoarseness in the voice, prolonged hiccups;
in the advanced stage of cancer, the tumor seriously affects other organs, which further worsens the unfavorable picture. Metastases that reach the liver can cause jaundice, pain under the ribs, metastases to the brain lead to paralysis, loss of consciousness and disorders of the speech center of the brain, metastases to the bones cause pain and aches in them;

All of the above symptoms may be accompanied by sudden weight loss, loss of appetite, chronic weakness and fatigue.

Based on how intense the symptoms manifest themselves and how promptly a person seeks help from a doctor, we can make a forecast about the chances of his recovery.

You can learn about the symptoms of lung cancer in the early stages here.

Diagnostics

Adults, especially those who smoke, should be periodically screened for lung cancer.

Diagnosis of a tumor in the lung consists of the following procedures:

Fluorography to detect any changes in the lungs. This procedure is carried out during a medical examination, after which the doctor prescribes other examinations that will help in making the correct diagnosis.
Clinical and biochemical blood test.
Bronchoscopy is a diagnostic method that examines the extent of lung damage.
Biopsy is the surgical removal of a tumor sample to determine the type of tumor.
Radiation diagnostics, which includes X-ray examination, magnetic resonance imaging (MRI) and positive emission tomography (PET), which allows you to determine the location of tumor foci and clarify the stage of the disease.

Video: About early diagnosis of lung cancer

Treatment

Treatment tactics for small cell lung cancer are developed based on the clinical picture of the disease and the general well-being of the patient.

There are three main methods of treating lung cancer, which are often used in combination:

surgical removal of the tumor;
radiation therapy;
chemotherapy.

Surgical removal of the tumor makes sense at an early stage of the disease. Its purpose is to remove the tumor or part of the affected lung. This method is not always possible for small cell lung cancer due to its rapid development and late detection, therefore more radical methods are used to treat it.

The possibility of surgery is also excluded if the tumor affects the trachea or neighboring organs. In such cases, chemotherapy and radiation therapy are immediately resorted to.

Chemotherapy for small cell lung cancer can give good results if used in a timely manner. Its essence lies in taking special medications that destroy tumor cells or significantly slow down their growth and reproduction.

The patient is prescribed the following medications:

The drugs are taken at intervals of 3-6 weeks and at least 7 courses must be completed to achieve remission. Chemotherapy helps reduce the size of the tumor, but cannot guarantee complete recovery. However, it can prolong a person’s life even at the fourth stage of the disease.

Radiation therapy, or radiotherapy, is a method of treating cancer using gamma radiation or X-rays to kill or slow the growth of cancer cells.

It is used for inoperable lung tumors, when the tumor has affected the lymph nodes, or when surgery is not possible due to the patient’s unstable condition (for example, a serious disease of other internal organs).

During radiation therapy, the affected lung and all areas of metastasis are irradiated. For greater effectiveness, radiation therapy is combined with chemotherapy if the patient is able to tolerate such combination treatment.

One of the possible options for providing care to a patient with lung cancer is palliative treatment. It is applicable when all possible methods to stop the development of the tumor have failed, or when lung cancer is detected at a very late stage.

Palliative care is designed to ease a patient's final days, provide psychological support, and relieve pain from severe cancer symptoms. Methods of such treatment depend on the person’s condition and are purely individual for each person.

There are various traditional methods of treating small cell lung cancer, which are popular in narrow circles. Under no circumstances should you rely on them and self-medicate.

Every minute is important for a successful outcome, and often people waste precious time in vain. At the slightest sign of lung cancer, you should immediately consult a doctor, otherwise death is inevitable.

The choice of treatment method for a patient is an important stage on which his future life depends. This method should take into account the stage of the disease and the psycho-physical condition of the patient.

This article will tell you what radiology diagnostics of central lung cancer is.

You can learn more about the treatment methods for peripheral lung cancer in this article.

How long do people live (life expectancy) with small cell lung cancer?

Despite the transient course of small cell lung cancer, it is more sensitive to chemotherapy and radiotherapy compared to other forms of cancer, so with timely treatment the prognosis can be favorable.

The most favorable outcome is observed when cancer is detected at stages 1 and 2. Patients who start treatment on time manage to achieve complete remission. Their life expectancy already exceeds three years and the number of people cured is about 80%.

At stages 3 and 4, the prognosis worsens significantly. With complex treatment, the patient's life can be extended by 4-5 years, and the percentage of survivors is only 10%. If left untreated, the patient dies within 2 years from the date of diagnosis.

Lung cancer is one of the most common cancer diseases, which is very difficult to cure, but there are many ways to prevent its occurrence. First of all, it is necessary to cope with nicotine addiction, avoid contact with harmful substances and undergo regular medical examination.

Timely detection of small cell lung cancer in the early stages significantly increases the chances of defeating the disease.

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Do not self-medicate. Consult your healthcare provider.

Small cell lung cancer stage 3

Small cell carcinoma is an extremely malignant tumor with an aggressive clinical course and widespread metastasis. This form accounts for 20-25% of all types of lung cancer. Some researchers regard it as a systemic disease, in which there are almost always metastases in regional and extrathoracic lymph nodes already in the initial stages. The majority of patients are male, but the percentage of affected women is increasing. The etiological connection of this cancer with smoking is emphasized. Due to the rapid growth of the tumor and widespread metastases, most patients suffer from severe disease.

Symptoms

A new cough or a change in the cough that is usual for a patient who is a smoker.

Fatigue, lack of appetite.

Shortness of breath, chest pain.

Pain in the bones, spine (with metastases to bone tissue).

An attack of epilepsy, headaches, weakness in the limbs, speech impairment - possible symptoms of brain metastases at stage 4 of lung cancer./blockquote>

Forecast

Small cell lung cancer is one of the most aggressive forms. How long such patients live depends on the treatment. Without treatment, death occurs within 2-4 months, and survival rates reach only 50 percent. With the use of treatment, the life expectancy of cancer patients can increase several times - up to 4-5. The prognosis is even worse after 5 years of illness - only 5-10 percent of patients remain alive.

Stage 4

Stage 4 small cell lung cancer is characterized by the spread of malignant cells to distant organs and systems, which causes symptoms such as:

headaches, etc.

Treatment

Chemotherapy plays an important role in the treatment of small cell lung cancer. Without treatment, half of patients die 6-17 weeks after diagnosis. Polychemotherapy allows you to increase this indicator. It is used both as an independent method and in combination with surgery or radiation therapy.

The goal of treatment is to achieve complete remission, which must be confirmed by bronchoscopic methods, including biopsy and bronchoalveolar lavage. The effectiveness of treatment is assessed 6-12 weeks after its start. Based on these results, it is already possible to predict the probability of cure and the patient’s life expectancy. The most favorable prognosis is for those patients who managed to achieve complete remission during this time. All patients whose life expectancy exceeds 3 years belong to this group. If the tumor mass has decreased by more than 50% and there are no metastases, they speak of partial remission. The life expectancy of such patients is shorter than in the first group. If the tumor is untreatable or progresses, the prognosis is poor.

Once the stage of the disease has been determined (early or late, see “Lung cancer: stages of the disease”), the patient’s general condition is assessed to determine whether he is able to tolerate induction chemotherapy (including as part of a combination treatment). It is carried out only if neither radiation therapy nor chemotherapy have been previously carried out, if the patient has maintained working capacity, there are no severe concomitant diseases, heart, liver and kidney failure, bone marrow function is preserved, PaO2 when breathing atmospheric air exceeds 50 mm Hg . Art. and no hypercapnia. However, even in such patients, mortality during induction chemotherapy reaches 5%, which is comparable to mortality during radical surgical treatment.

If the patient's condition does not meet these criteria, the dose of antitumor drugs is reduced to avoid severe side effects.

Induction chemotherapy should be administered by an oncologist; special attention is required in the first 6.12 weeks. During treatment, infectious, hemorrhagic and other severe complications are possible.

Treatment of localized small cell lung cancer (SCLC)

the effectiveness of treatment is 65-90%;

The 5-year survival rate is about 10%, while for patients who started treatment in good general condition this figure is about 25%.

The basis for the treatment of a localized form of SCLC is chemotherapy (2-4 courses) according to one of the regimens indicated in the table in combination with radiation therapy of the primary lesion, mediastinum and lung root in a total focal dose of Gy. It is advisable to start radiation therapy against the background of chemotherapy (during or after 1-2 courses). If the patient experiences complete remission, it is also advisable to irradiate the brain with a total dose of 30 Gy, since SCLC is characterized by a high probability (about 70%) of metastasis to the brain.

Patients with advanced MDR are treated with combination chemotherapy (see table), and it is advisable to carry out irradiation only if there are special indications: for metastatic damage to the bones, brain, adrenal glands, mediastinal lymph nodes with compression syndrome of the superior genital vein, etc.

For metastatic brain lesions, it may be advisable to consider treatment with Gamma Knife in some cases.

According to statistics, the effectiveness of chemotherapy in the treatment of advanced SCLC is about 70%, while in 20% of cases complete regression is achieved, which gives survival rates close to those of patients with a localized form.

Chemotherapy

At this stage, the tumor is located within one lung, and nearby lymph nodes may also be involved. The following treatment methods are possible:

Combined chemotherapy/radiation therapy followed by prophylactic cranial irradiation (PCR) in remission.

Chemotherapy with or without PCO for patients with worsened respiratory function.

Surgical resection with adjuvant therapy for patients with stage I.

The combined use of chemotherapy and thoracic radiotherapy is the standard approach for patients with limited-stage small cell LC. According to statistics from various clinical studies, combination therapy compared with chemotherapy without radiation increases the 3-year survival prognosis by 5%. Platinum and etoposide are the most commonly used drugs.

Average prognostic indicators are a month's life expectancy and a 2-year survival rate within 40-50%. The following ways to improve the prognosis were ineffective: increasing the dose of drugs, using additional types of chemotherapy drugs. The optimal course duration has not been determined, but should not exceed 6 months.

The question of the optimal use of radiation also remains open. Several clinical studies suggest the benefits of early radiation therapy (during cycles 1-2 of chemotherapy). The duration of the irradiation course should not exceed more. It is possible to use both a standard irradiation regimen (once a day for 5 weeks) and a hyperfractionated one (2 or more times a day for 3 weeks). Hyperfractionated thoracic radiotherapy is considered preferable and results in a better prognosis.

Age over 70 years significantly worsens the prognosis of treatment. Elderly patients respond much worse to radiochemotherapy, which results in low effectiveness and complications. Currently, the optimal therapeutic approach for elderly patients with small cell LC has not been developed.

In rare cases, with good respiratory function and limited tumor process within the lung, surgical resection with or without subsequent adjuvant chemotherapy is possible.

Patients who have achieved remission of the tumor process are candidates for prophylactic cranial irradiation (PCR). Research results indicate a significant reduction in the risk of metastases in the brain, which is 60% without the use of PCO. PCO improves the prognosis of 3-year survival from 15% to 21%. Often, patients who survive non-small cell lung cancer experience impairments in neurophysiological function, but these impairments are not associated with undergoing PCO.

The tumor spreads beyond the lung in which it originally appeared. Standard treatment approaches include the following:

Combined chemotherapy with or without prophylactic cranial irradiation.

etoposide + cisplatin or etoposide + carboplatin is the most common approach, the effectiveness of which is confirmed by clinical studies. Other approaches have not yet shown significant benefits.

cyclophosphamide + doxorubicin + etoposide

ifosfamide + cisplatin + etoposide

cyclophosphamide + doxorubicin + etoposide + vincristine

cyclophosphamide + etoposide + vincristine

Radiation therapy - used in case of a negative response to chemotherapy, especially for metastases in the brain, spinal cord or bones.

The standard approach (cystplatin and etoposide) gives a positive response in 60-70% of patients and leads to remission in 10-20%. Clinical studies indicate the benefits of combination chemotherapy that includes platinum. However, cisplatin is often accompanied by significant side effects, which can lead to serious consequences in patients suffering from cardiovascular diseases. Carboplatin is less toxic compared to cisplatin. The advisability of using higher doses of chemotherapy drugs remains an open question.

As for the limited stage, in case of a positive response to chemotherapy for the extensive stage of small cell lung cancer, prophylactic cranial irradiation is indicated. The risk of metastases in the central nervous system within 1 year is reduced from 40% to 15%. No significant deterioration in health was detected after PCO.

Often, patients diagnosed with advanced SCLC have a deteriorating health status that complicates aggressive therapy. However, clinical studies have not revealed an improvement in survival prognosis when reducing drug doses or switching to monotherapy. However, the intensity in this case should be calculated from an individual assessment of the patient’s health status.

Lifespan

How long do people live with lung cancer and how can one determine the life expectancy with lung cancer? It’s sad, but with such a terrifying diagnosis, patients without surgical intervention always face death. About 90% of people die in the first 2 years of life after the disease is diagnosed. But you should never give up. It all depends on what stage your disease was detected at and what type it is. First of all, there are two main types of lung cancer - small cell and non-small cell.

Small cell, mainly affecting smokers, is less common, but spreads very quickly, forming metastases and affecting other organs. It is more sensitive to chemical and radiation therapy.

How long do they live?

The prognosis for lung cancer depends on many factors, but primarily on the type of disease. The most disappointing is small cell cancer. Within 2-4 months after diagnosis, every second patient dies. The use of chemotherapy treatment increases life expectancy by 4-5 times. The prognosis for non-small cell cancer is better, but also leaves much to be desired. If treatment is started in a timely manner, the 5-year survival rate is 25%. There is no definite answer to how long people live with lung cancer; life expectancy is affected by the size and location of the tumor, its histological structure, the presence of concomitant diseases, etc.

Small cell lung cancer

In the structure of oncological diseases, lung cancer is one of the most common pathologies. It is based on malignant degeneration of the epithelium of the lung tissue and impaired air exchange. The disease is characterized by high mortality. The main risk group is older men who smoke. A feature of modern pathogenesis is a decrease in the age of primary diagnosis, an increase in the likelihood of lung cancer in women.

Small cell cancer is a malignant tumor that has the most aggressive course and widespread metastasis. This form accounts for about 20-25% of all types of lung cancer. Many scientific experts regard this type of tumor as a systemic disease, in the early stages of which there are almost always metastases in the regional lymph nodes. Men suffer from this type of tumor most often, but the percentage of affected women is growing significantly. Almost all patients have a fairly severe form of cancer, which is associated with rapid tumor growth and widespread metastasis.

Causes of small cell lung cancer

In nature, there are many reasons for the development of malignant neoplasms in the lungs, but there are main ones that we encounter almost every day:

smoking;
radon exposure;
pulmonary asbestosis;
viral infection;
dust exposure.

Clinical manifestations of small cell lung cancer

Symptoms of small cell lung cancer:

Fatigue and feeling of weakness

a cough of a prolonged nature, or a new cough with changes in the patient’s usual cough;
lack of appetite;
weight loss;
general malaise, fatigue;
shortness of breath, pain in the chest and lungs;
voice change, hoarseness (dysphonia);
pain in the spine and bones (occurs with bone metastases);
epilepsy attacks;
Lung cancer, stage 4 - speech impairment occurs and severe headaches appear.

Grades of small cell lung cancer

Stage 1 - the tumor size is up to 3 cm in diameter, the tumor has affected one lung. There is no metastasis.
Stage 2 – the size of the tumor in the lung is from 3 to 6 cm, blocks the bronchus and grows into the pleura, causing atelectasis;
Stage 3 - the tumor rapidly spreads to neighboring organs, its size has increased from 6 to 7 cm, and atelectasis of the entire lung occurs. Metastases in neighboring lymph nodes.
Stage 4 small cell lung cancer is characterized by the spread of malignant cells to distant organs of the human body, which in turn causes symptoms such as:

headache;
hoarseness or loss of voice altogether;
general malaise;
loss of appetite and sudden weight loss;
back pain, etc.

Diagnosis of small cell lung cancer

Despite all the clinical examinations, history taking and listening to the lungs, a high-quality diagnosis of the disease is also necessary, which is carried out using methods such as:

skeletal scintigraphy;
chest x-ray;
detailed, clinical blood test;
computed tomography (CT);
liver function tests;
magnetic resonance imaging (MRI)
positron emission tomography (PET);
sputum analysis (cytological examination to detect cancer cells);
thoracentesis (sampling of fluid from the chest cavity around the lungs);
Biopsy is the most common method for diagnosing malignancy. It is carried out in the form of removing a particle of a fragment of the affected tissue for further examination under a microscope.

There are several ways to perform a biopsy:

bronchoscopy in combination with biopsy;
puncture biopsy is performed using CT;
endoscopic ultrasound with biopsy;
mediastinoscopy in combination with biopsy;
open lung biopsy;
pleural biopsy;
videothoracoscopy.

Treatment of small cell lung cancer

The most important place in the treatment of small cell lung cancer is chemotherapy. Without appropriate treatment for lung cancer, the patient dies 5-18 weeks after diagnosis. Polychemotherapy helps to increase the mortality rate to 45–70 weeks. It is used both as an independent method of therapy and in combination with surgery or radiation therapy.

The goal of this treatment is complete remission, which must be confirmed by bronchoscopic methods, biopsy and bronchoalveolar lavage. As a rule, the effectiveness of treatment is assessed 6-12 weeks after the start of therapy, and based on these results, the likelihood of cure and the patient’s life expectancy can be assessed. The most favorable prognosis is for those patients who achieve complete remission. This group includes all patients whose life expectancy exceeds 3 years. If the tumor has decreased by 50%, and there is no metastasis, it is possible to talk about partial remission. Life expectancy is correspondingly shorter than in the first group. For tumors that cannot be treated and are actively progressing, the prognosis is poor.

After determining the stage of lung cancer, it is necessary to assess the patient’s health from the point of view of whether he is able to tolerate induction chemotherapy combined with combination treatment. It is carried out in the absence of previous chemotherapy and radiation therapy, also if the patient maintains working capacity, there are no severe concomitant diseases, heart or liver failure, bone marrow function is preserved, PaO2 when breathing atmospheric air exceeds 50 mm Hg. Art. and no hypercapnia. But it is also worth noting that the mortality rate from induction chemotherapy is present and reaches 5%, which is comparable to the mortality rate with radical surgical treatment.

If the patient’s health condition does not meet the specified standards and criteria, the dose of antitumor drugs is reduced to avoid complications and severe side effects. An oncologist should carry out induction chemotherapy. The patient requires special attention in the first 4 months. Infectious, hemorrhagic and other severe complications are also possible during the treatment process.

Localized form of small cell lung cancer (SCLC) and its treatment

The treatment statistics for this form of SCLC have good indicators:

treatment efficiency 65-90%;
tumor regression is observed in 45-75% of cases;
median survival reaches months;
2-year survival rate is 40-50%;
The 5-year survival rate is 10% and reaches 25% for patients who began treatment in good general health.

Fundamental in the treatment of localized forms of SCLC is chemotherapy (2-4 courses) in combination with radiation therapy in a total focal dose of Gy. It is considered correct to start radiation therapy against the background of chemotherapy during or after 1-2 courses. When observing remission, it is advisable to perform brain irradiation with a total dose of 30 Gy, since SCLC is characterized by rapid and aggressive metastasis to the brain.

Treatment of advanced small cell lung cancer (SCLC)

In the case of a common form of SCLC, combined treatment is indicated, and it is advisable to carry out irradiation in the presence of special indicators:

the presence of metastasis in the bones;
metastasis, brain;
metastasis in the adrenal glands;
metastasis in the lymph nodes, mediastinum with compression syndrome of the superior vena cava.

Note! In case of metastasis to the brain, treatment with a gamma knife is possible.

After a statistical study, it was revealed that the effectiveness of chemotherapy in the treatment of advanced SCLC is about 70%, while in 20% of cases complete remission is achieved, which gives survival rates close to those of patients with a localized form.

Chemotherapy

Limited stage

At this stage, the tumor is located within one lung, and nearby lymph nodes may also be involved.

Treatment methods used:

combined: chemo+radiation therapy followed by prophylactic cranial irradiation (PCR) during remission;
chemotherapy with or without PCO, for patients who have deteriorating respiratory function;
surgical resection with adjuvant therapy for patients with stage 1;
The combined use of chemotherapy and thoracic radiotherapy is the standard approach for patients with limited-stage, small cell LC.

According to clinical trial statistics, combination treatment compared to chemotherapy without radiation therapy increases the 3-year survival prognosis by 5%. Drugs used: platinum and etoposide. Prognostic indicators for life expectancy are months and a 2-year survival rate forecast of 50%.

Ineffective ways to increase your forecast:

increasing the dose of drugs;
effect of additional types of chemotherapy drugs.

The duration of the chemotherapy course is not defined, but, nevertheless, the duration of the course should not exceed 6 months.

Question about radiation therapy: Many studies show its benefits during 1-2 cycles of chemotherapy. The duration of the course of radiation therapy should not exceed more than one day.

It is possible to use standard radiation courses:

1 time per day for 5 weeks;
2 or more times a day for 3 weeks.

Hyperfractionated thoracic radiotherapy is considered preferable and results in a better prognosis.

Older patients (65-70 years old) tolerate treatment much worse; the treatment prognosis is much worse, since they respond rather poorly to radiochemotherapy, which in turn manifests itself in low effectiveness and major complications. Currently, the optimal therapeutic approach for elderly patients with small cell LC has not been developed.

Extensive stage

The tumor spreads beyond the lung in which it originally appeared.

Standard therapy methods:

combination chemotherapy with or without prophylactic cranial irradiation;
etoposide + cisplatin or etoposide + carboplatin is the most common approach with proven effectiveness. Other approaches have not yet shown significant benefits;
cyclophosphamide + doxorubicin + etoposide;
ifosfamide + cisplatin + etoposide;
cisplatin + irinotecan;
cyclophosphamide + doxorubicin + etoposide + vincristine;
cyclophosphamide + etoposide + vincristine.

Radiation is given for negative responses to chemotherapy, especially for metastases in the brain, spinal cord or bones.

A fairly positive response of 10-20% remission is given by cystplatin and etoposide. Clinical studies show the benefits of combination chemotherapy that includes platinum. But despite this, cisplatin is often accompanied by significant side effects, which can lead to serious consequences in patients suffering from cardiovascular diseases. Carboplatin is less toxic compared to cisplatin.

Note! The use of increased doses of chemotherapy drugs remains an open question.

For limited stage, in case of a positive response to chemotherapy, extensive stage small cell lung cancer, prophylactic cranial irradiation is indicated. The risk of metastases in the central nervous system within 1 year is reduced from 40% to 15%. No significant deterioration in health was detected after PCO.

Combined radiochemotherapy does not improve the prognosis compared to chemotherapy, but thoracic irradiation is advisable for palliative treatment of distant metastases.

Patients diagnosed with advanced SCLC have a deteriorating health status that complicates aggressive therapy. Clinical studies have not revealed an improvement in survival prognosis when reducing drug doses or switching to monotherapy, but, nevertheless, the intensity in this case should be calculated from an individual assessment of the patient’s health status.

Disease prognosis

As mentioned earlier, small cell lung cancer is one of the most aggressive forms of all cancers. The prognosis of the disease and how long patients live depends directly on the treatment of lung cancer. A lot depends on the stage of the disease and what type it is. There are two main types of lung cancer - small cell and non-small cell.

SCLC, which affects smokers, is less common, but spreads very quickly, forming metastases and affecting other organs. It is more sensitive to chemical and radiation therapy.

Small cell lung cancer, life expectancy in the absence of appropriate treatment, ranges from 6 to 18 weeks, and the survival rate reaches 50%. With the use of appropriate therapy, life expectancy increases from 5 to 6 months. The worst prognosis is for patients with a 5-year illness period. Approximately 5-10% of patients remain alive.

Informative video on the topic: Smoking and lung cancer

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In oncological practice, such a terrible disease as small cell lung cancer is often encountered. Any form of cancer poses a potential threat to the life of the sick person. The disease is often discovered accidentally during an X-ray examination. What are the causes, symptoms and treatments for this form of lung cancer?

Development of small cell lung cancer

Small cell lung cancer is a tumor characterized by a malignant course. The prognosis is unfavorable. This histological type of cancer is diagnosed less frequently than others (adenocarcinoma, squamous cell and large cell carcinoma). It accounts for up to 20% of all cases of this pathology. The risk group includes actively smoking men.

The peak incidence occurs between 40 and 60 years of age. Females are less susceptible to this disease. Initially, the large bronchi are affected. This form is called central cancer. As the disease progresses, the mediastinal and bronchopulmonary lymph nodes become involved. The peculiarity of this form of the disease is that regional metastases are detected already in the early stages.

Clinical forms and stages

The stage of cancer is of great importance when making a diagnosis. The health prognosis depends on when the patient sought medical help. There are 4 stages of cancer. At stage 1, a neoplasm up to 3 cm in size without metastatic foci is detected. The process involves the pulmonary segment or segmental bronchus. The disease is almost never detected at stage 1. An increase in tumor up to 6 cm with single metastatic foci indicates stage 2 of the disease.

Stage 3 is different in that neighboring bronchi, the main bronchus or an adjacent lobe of the organ are affected. At this stage, the lymph nodes located near the tracheal bifurcation and the tracheobronchial nodes are often affected. If stage 4 is detected, the prognosis for life worsens sharply, since it has distant metastases, which cannot be eliminated even with the help of surgery and radiation therapy. In 6 out of 10 people, cancer is detected at stages 3 and 4.

There are 2 types of small cell cancer: oat cell and pleomorphic. The first develops most often. This form of the disease is characterized by increased production of adrenocorticotropic hormone and the development of Cushing's syndrome. Outwardly, this practically does not appear. In oat cell carcinoma, histological examination of lung tissue reveals spindle cells. They have round kernels. Mixed forms are less commonly diagnosed, when there is a combination of signs of small cell cancer and adenocarcinoma.

Why does a tumor start to grow?

The following reasons for the development of lung cancer in humans are identified:

smoking;
burdened heredity;
prolonged contact with carcinogens (arsenic, asbestos, chromium, nickel);
presence of pulmonary tuberculosis;
nonspecific lung diseases;
exposure to ionizing radiation;
bad ecology.

Risk factors include advanced age, long smoking history, and living together with smokers. The most important factor is nicotine addiction. Many people start smoking in childhood and adolescence and cannot stop. Smoking leads to addiction. People who smoke are 16 times more likely to get sick.

An aggravating factor is the age at which smoking began. The earlier a person starts smoking, the higher the likelihood of developing small cell lung cancer. This disease often develops in people with occupational hazards. This pathology often develops in welders and people in contact with asbestos and various metals (nickel). The condition of the lungs is influenced by the composition of the surrounding air. Living in polluted areas increases the risk of developing pulmonary pathology.

How to recognize small cell cancer

Symptoms of the disease depend on the stage. Cancer manifests itself with the following symptoms:

cough;
change in voice (dysphonia);
swallowing disorders;
weight loss;
general malaise;
weakness;
chest pain;
shortness of breath;
bone pain.

The cough gradually gets worse. It becomes paroxysmal, constant and productive. Blood streaks are found in the sputum. Central small cell carcinoma is characterized by noisy breathing and hemoptysis. In later stages, body temperature rises. The development of obstructive pneumonia is possible.

Dysphagia and hoarseness are observed when the trachea and laryngeal nerve are compressed. Patients' appetite decreases, as a result of which they quickly lose weight. A common symptom of cancer is superior vena cava syndrome. It is manifested by swelling of the face and neck, shortness of breath, and cough. If other organs are affected, severe headaches, enlarged liver, and development of jaundice may occur. Manifestations of small cell carcinoma include Cushing's syndrome and Lambert-Eaton syndrome.

Examination and treatment plan

Treatment is prescribed by a doctor after detecting a tumor and determining the stage of cancer. The following studies are required:

X-ray of the chest organs;
tomography;
biopsy;
examination of the bronchi endoscopically;
general blood and urine analysis;
pleural puncture;
sputum analysis for the presence of Mycobacterium tuberculosis.

If necessary, thoracoscopy is organized. The life expectancy of patients depends on the condition of other organs. Surgical treatment is effective at stages 1 and 2. Chemotherapy is required after surgery. Experienced doctors know how long such patients live.

With stage 1 and 2 cancer and adequate treatment, the five-year survival rate does not exceed 40%.

Video recording of a scientific report on small cell lung cancer:

In stages 3 and 4, chemotherapy is combined with radiation. Cytostatics are used (Methotrexate, Cyclophosphamide, Vincristine, Cisplatin). To protect the brain for prophylactic purposes, it can be irradiated. Thus, the main method of fighting cancer is to quit smoking or introduce a state ban on the sale of tobacco products.

Small cell lung cancer (SCLC) is one of the most severe forms of cancer. First of all, because of the rapid and dynamic development. In addition, statistics indicate that this type of cancer is quite common - it accounts for about 25% of all lung cancers. Men who smoke are at particular risk (95% of confirmed diagnoses), and if we consider the age limit, the disease mainly affects people over 40 years of age.

The main and most significant cause of small cell cancer is considered to be smoking, and the main aggravating factors are the person’s age, smoking history and the volume of cigarettes smoked per day. Since nicotine addiction is increasingly affecting women, it is not surprising that the incidence of this type of cancer among women has increased.

But no less serious risk factors include:

difficult working conditions (interaction with Ni, Cr, As);
poor ecology in the place of residence;
genetic predisposition.

In addition, pathology often occurs after tuberculosis or against the background of chronic obstructive pulmonary disease. Now the problem of the histogenesis of the disease is considered from two sides - neuroectodermal and endodermal. Proponents of the latter theory believe that this type of oncology develops from bronchial epithelial cells, which have a similar biochemical composition to small cell cancer cells.

Experts who adhere to the neuroectodermal theory believe that such an oncological disease arises from cells of the diffuse neuroendocrine system. It is worth noting that the logical nature of this version is evidenced by the presence of neurosecretory granules in tumor cells, an increase in the concentration of hormones and the release of bioactive substances. But it is impossible to say for sure why this type of oncology occurs, since there have been cases when the pathology was diagnosed in people who followed a healthy lifestyle and did not have an oncological predisposition.

External manifestations

As a rule, the first manifestation of this pathology is a prolonged cough. It is often mistaken for smoker's bronchitis. A particularly warning sign for a person should be the appearance of blood streaks in the sputum. In addition, with this pathology, shortness of breath, chest pain, poor appetite, all-encompassing weakness and causeless loss of body weight are often observed. Sometimes the disease can be mistaken for obstructive pneumonia, so careful diagnosis is very important.

Prolonged hacking cough is the first manifestation of SCLC

At stages 3-4, new unpleasant symptoms appear: hoarseness due to paralysis of the vocal nerves and symptoms of compression of the superior vena cava. Paraneoplastic symptoms may also be observed: Cushing's syndrome, Lambert-Eaton, inadequate secretion of antidiuretic hormone. In addition, this pathology is typically characterized by the earlier appearance of metastases in the intrathoracic lymph nodes, liver, adrenal glands, bones and brain. In such circumstances, symptoms will appear indicating the localization of metastases (jaundice, pain in the spine or head).

Classification of the disease

The division into stages of this disease is identical to that for other types of lung cancer. But until now, oncology of this type is divided into a limited (localized) and widespread stage of the disease. The limited stage is characterized by tumor involvement on one side, with concomitant enlargement of the supraclavicular, mediastinal and hilar lymph nodes. In the case of an advanced stage, the formation of the other half of the chest is captured, the appearance of pleurisy and metastases. Unfortunately, more than half of patients have this particular form of small cell cancer.

If we consider the morphology, then within small cell oncology there are:

oat cell carcinoma;
cancer from intermediate cells;
mixed (combined) cancer.

In the first case, the formation is formed by layers of tiny spindle-shaped cells with round and oval nuclei. For intermediate type cancers, fairly large round, oblong and polygonal cells with a clear nuclear structure are typical. As for combined cancer, it is spoken of when oat cell cancer with manifestations of adenocarcinoma or squamous cell carcinoma is detected.

Diagnosis of pathology

To correctly assess the extent of the spread of pathology, clinical studies (visual assessment of the physiological state) are often combined with instrumental diagnostics. The latter includes 3 stages.

Visualization of manifestations of pathology using radiation techniques: x-ray of the sternum, CT of the lungs, positron emission tomography.
Morphological confirmation: bronchoscopy, biopsy, diagnostic thoracoscopy, pleural puncture with fluid removal. Further, the biomaterial is also sent for histological and cytological examination.
At the last stage of research, they try to exclude distant metastases. For this purpose, MRI of the brain, MSCT of the peritoneum and bone scintigraphy are performed.

Chest X-ray is the first step in diagnosing SCLC

Treatment

Dividing pathology into stages helps specialists navigate how to treat it and outlines the possibilities of its surgical or conservative treatment. It should be noted right away that the surgical method of treating small cell lung cancer is used only in the initial stages of cancer. But it is necessarily accompanied by several courses of postoperative chemotherapy.

To date, treatment of small cell lung cancer in this way has shown fairly good results.

If the patient refuses complex therapy and chemotherapy in particular, then with such a malignant formation of the lung, his life expectancy is unlikely to exceed 17 weeks.

The disease is usually treated with 2-4 courses of polychemotherapy using cytostatic agents. For example:

Etoposide;
Cisplatin;
Vincristine;
Cyclophosphamide;
Doxorubicin.

This type of treatment is combined with radiation. The initial foci of formation and lymph nodes are susceptible to radiation therapy. If a patient undergoes such a combination treatment against small cell lung cancer, the prognosis for his life expectancy improves - the person can live two years longer. However, it is important to understand that 100% healing in this case is impossible.

When the pathology is widespread, the patient is prescribed at least 5 courses of polychemotherapy. If metastasis spreads to the adrenal glands, brain and bones, then a course of radiation therapy is also strongly recommended. Although small cell lung cancer has an extremely increased sensitivity to polychemotherapy treatment and radiation, there is still a fairly high risk of relapse.

After completion of therapy, the patient is advised to undergo systematic examinations for timely detection of secondary spread of oncology. However, if relapses of small cell cancer are resistant to antitumor therapy, a person’s life expectancy is rarely more than four months.

Forecast

The first question that interests patients with a confirmed diagnosis of small cell lung cancer is how long they live with such a disease. Without complex therapy for this type of oncology, the development of the pathological process invariably leads to death. It is foolish to expect that the disease will go away on its own. With small cell lung cancer, the patient's life expectancy directly depends on the correctly chosen treatment, as well as the intensity of development of the pathological process.

If the disease is detected at the initial stage, then five-year survival is observed in 22-39% of patients. When this type of oncology is detected at a terminal stage, only 9% of patients reach the five-year mark. When, during treatment, doctors observe a decrease in the size of the formation, most experts agree that this is a favorable sign.

In this case, the patient has a good chance of living longer. Even if the therapy led to only a partial remission effect, the survival rate is 50%. If it is possible to achieve complete remission, then 70-90% of patients survive to the five-year mark. Therefore, even with such a depressing diagnosis, you should not despair and give up.