Small Cell Lung Cancer: Symptoms, Diagnosis, and Treatment

How common is small cell lung cancer?

Small cell lung cancer (SCLC) is a serious form of lung cancer. The cancer cells can spread quickly to the lymph nodes, brain, bones, liver, and other organs.

SCLC and non-small cell cancer (NSCLC) are the two main types of lung cancer.

Types of small cell lung cancer

There are two types of small cell lung cancer:

• Small cell carcinoma
• Combined small cell carcinoma

The latter represents roughly 2-5% of all small-cell lung cancers. Small-cell carcinoma is the most aggressive of the two, making it more challenging to treat.

Small cell lung cancer symptoms

Common SCLC symptoms include:

• A chronic or persistent cough that won’t go away or worsens over time
• Shortness of breath or wheezing
• Chest pain or discomfort
• Fatigue and weakness
• Loss of appetite or unexplained weight loss
• Bone pain

There are other signs of small cell lung cancer to be aware of, such as difficulty swallowing, hoarseness, and swelling of the face or neck. If you experience symptoms of small cell lung cancer, consult a health care professional immediately for proper evaluation and diagnosis.

Visit our lung cancer screening program if you believe you’re at higher risk for developing lung cancer.

What causes small cell lung cancer?

Smoking is the leading cause of small cell lung cancer.

How quickly does small cell lung cancer progress?

Because small cell lung cancer tends to spread rapidly, it generally gets classified into the following two stages:

1. Limited stage: In this stage, the cancer is limited to one lung and may have spread to nearby lymph nodes.
2. Extensive stage: This stage means the cancer has spread to the other lung or other organs and tissues such as the brain, bones, or liver.

Learn more about diagnosing and treating small cell lung cancer.

Our approach to lung cancer care

At the Mass General Brigham Cancer Institute, you receive care from an experienced team dedicated to diagnosing and treating lung cancer. Together, they develop a personalized treatment plan based on the type and stage of cancer, genetic and molecular findings, and your overall health and goals.

Risk prevention for small cell lung cancer

You can take steps to reduce the risk of developing the disease. Here are some preventive measures:

• Quit smoking: Because smoking is the leading cause of small cell lung cancer, the best way to reduce the risk of developing SCLC is to give up all forms of tobacco, including cigarettes, cigars, and pipes.
• Avoid secondhand smoke: Limiting exposure to secondhand smoke, especially in confined spaces, can decrease your risk of developing lung problems.
• Adopt healthy lifestyle choices: Eating a balanced diet, exercising, and maintaining a healthy weight can reduce the risk of developing many forms of cancer, including small cell lung cancer.
• Limit exposure to harmful chemicals: Regular exposure to carcinogens and toxins like asbestos, exhaust fumes, and other workplace hazards increases the risk of developing lung conditions. You can lessen the risk by practicing safe guidelines for handling and disposing of dangerous substances.
• Take early detection measures: If you’re a person who has smoked or worked with potentially toxic materials, you may be at risk of developing various forms of lung cancer. You can take preemptive measures like getting screened and regularly visiting your health care provider. Multiple tests, including chest X-rays, CT scans, blood work, and biopsies, may be done if signs point toward lung cancer. Learn more about lung cancer early detection.

Diagnosing small cell lung cancer

If you experience small cell lung cancer symptoms, consult with your health care provider immediately. Common signs include a chronic cough, shortness of breath, chest pain, and fatigue. The process begins with a physical exam, where your physician will review your medical and family history and risk factors like whether you have smoked.

Your physician may order a series of diagnostic tests based on the physical exam results. Common procedures include:

• Chest X-ray: This test is typically the first step in checking for lung cancer. Chest X-rays are quick and painless, but they can detect abnormal masses or nodules on the lungs. Based on your X-ray results, your physician may order additional imaging tests.
• Biopsy: This medical procedure involves removing a small tissue sample from your lung or nearby lymph nodes to confirm if cancer is present in the lungs. A biopsy is also helpful in differentiating between small cell lung cancer and non-small cell lung cancer. The results of the biopsy play a critical role in determining a small cell lung cancer treatment plan.
• CT scan: A computerized tomography (CT) scan is an imaging procedure that uses a computer to create detailed images of your body’s internal structures, such as bones and soft tissues. A CT scan provides more in-depth, multi-angle views of the body than a traditional X-ray.
• MRI: A magnetic resonance imaging (MRI) scan uses radio waves and magnets to create three-dimensional images that provide detailed views of internal structures. Unlike a CT scan, an MRI focuses on soft tissues like the brain, spinal cord, and liver. That helps determine if small cell lung cancer has spread to your brain.
• PET Scan: A positron emission tomography (PET) scan uses a radioactive substance to detect metabolic cellular activity, an indicator of cancer cells. Because SCLC is a quickly spreading cancer, a PET scan is critical in diagnosing if the cancer has spread to other parts of your body.
• Bone scan: This diagnostic imaging test involves injecting radioactive material to detect bone abnormalities. Because small cell lung cancer tends to metastasize to other parts of the body, including the bones, this test can assess if any bones are affected.

Getting a second opinion

Being diagnosed with small cell lung cancer can be overwhelming and leave you feeling uncertain. Getting a second opinion can help confirm the initial diagnosis and provide a deeper understanding of the disease so you can make informed decisions about your care and treatment. If you would like a second opinion, our specialists at Mass General Brigham Cancer Institute can assist you online without having to travel to our facility.

We’re also here to provide supportive care services to you and your loved ones as you navigate your diagnosis and treatment. Mass General Brigham Cancer Institute offers various support resources, including workshops, support groups, and educational materials.

Small cell lung cancer treatment

Once you’ve received a small cell lung cancer diagnosis, your health care team will work with you to develop a treatment plan based on the location and stage of the cancer and your overall health.

There are various small cell lung cancer treatments available. Non-surgical procedures are commonly used for SCLC treatment, but your physician may recommend surgery if the cancer has not spread extensively. Treatment options include:

• Chemotherapy: Intravenous or oral medications kill cancer cells or prevent them from growing. Regardless of how advanced small cell lung cancer may be, chemotherapy is a common form of treatment. That’s because the disease has often spread by the time of diagnosis, so treatments like radiation therapy or surgery alone aren’t enough. Learn more about chemotherapy for lung cancer.
• Radiation therapy: This form of small cell lung cancer therapy uses high-energy beams to target cancer cells. Radiation therapy may be used alone or with chemotherapy and can help shrink tumors and relieve symptoms. Depending on the location and size of the tumor, your physician may deliver radiation externally or internally.
• Immunotherapy: This innovative treatment approach uses your body’s immune system to fight cancer cells. Immunotherapy drugs, such as checkpoint inhibitors, work with the immune system to recognize and attack cancer cells. Find out more about lung cancer and immunotherapy.

Treating SCLC based on your stage

While all of the above treatment options are considered by your care team, the stage at which your SCLC has spread will be an important determining factor for how your SCLC is treated. Limited stage and extensive stage treatments will vary based on what’s most effective.

Patients with limited stage may undergo surgery to remove a small tumor to prevent the cancer from spreading, whereas patients with extensive stage SCLC may need more aggressive chemotherapies to slow the growth of the cancer, manage symptoms, and improve quality of life.

Find lung cancer clinical trials using Mass General Brigham Cancer Institute’s search tool.

Small cell lung cancer FAQs