Tuesday, 20 September 2016

Small cell lung cancer (SCLC)

Small cell lung cancer (SCLC)

Small cell lung cancer (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. It is a fast-growing type of lung cancer. It spreads much more quickly than non-small cell lung cancer. There are two types of SCLC:
·         Small cell carcinoma (oat cell cancer)
·         Combined small cell carcinoma.
Most SCLCs are of the oat cell type.
Causes
Almost all cases of SCLC are due to smoking, it is pretty rare in people who have never smoked. SCLC is the most aggressive form of lung cancer. It usually starts in the bronchi in the center of the chest. Even if the cancer cells are small but they grow very quickly. These tumors often spread rapidly forming metastasize to other parts of the body.
Symptoms
Small-cell carcinoma of the lung usually presents in the central airways and infiltrates the submucosa leading to narrowing of bronchial airways. Common symptoms include chest pain, cough, dyspnea, weight loss, and debility. Over 70% of patients with small-cell carcinoma present with metastatic disease.
Other symptoms that may occur with this disease, especially in the late stages, include:
·         Facial swelling
·         Fever
·         Hoarseness or changing voice
·         Swallowing difficulty
·         Weakness

Exams and Tests
Tests that may be performed include:
·         Bone scan
·         Chest x-ray
·         Complete blood count (CBC)
·         CT scan
·         Liver function tests
·         MRI
·         Positron emission tomography (PET) scan
·         Sputum test (cytology to look for cancer cells)
·         Thoracentesis (removal of fluid from the chest cavity around the lungs)
In most cases, a piece of tissue is removed from the lungs or other areas to be examined under a microscope by the pathologist. This is called a biopsy. There are several ways to do a biopsy:
·         Bronchoscopy combined with biopsy
·         CT scan-directed needle biopsy
·         Endoscopic esophageal ultrasound (EUS) with biopsy
·         Mediastinoscopy with biopsy
·         Open lung biopsy
·         Pleural biopsy
·         Video-assisted thoracoscopy
In most cases, if a biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. Small cell lung cancer is classified as following:
·         Limited: cancer is only in the chest and can be treated with radiation therapy
·         Extensive: cancer has spread outside the chest

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