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Lung Cancer Small Cell - Diagnosis and Treatment for Small Cell Lung Cancer

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Lung cancer of the small cell variety is a cancer that progresses quickly. It often starts in the middle of the chest and spreads to the bone, liver and brain. The cancer cells start out very small but quickly grow to become large tumors. Small cell lung cancer accounts for 15% of all lung cancers and is commonly found in men. Smoking is almost always the cause; it is rare to find small cell lung cancer in those who have never smoked. There are three main types: small cell carcinoma (the most common), mixed small cell/large cell carcinoma and combined small cell carcinoma. Symptoms include bloody phlegm, coughing, breathing problems, chest pain, loss of appetite and weight loss.

Your doctor will perform a physical exam and ask about your history regarding smoking. He will listen to your chest with a stethoscope and look for any signs of cancer, such as fluid around the lungs or a collapsed lung.

If cancer is suspected, your doctor may perform one or more of the following tests:
- Chest X-ray
- Bone scan
- CT scan
- Complete blood count
- Liver function tests
- Sputum test

If there is excessive fluid around the lungs, your doctor may perform a thoracentesis, which involves using a long needle inserted into the chest to remove the fluid. In some cases, a biopsy may need to be performed. A biopsy is the removal of a piece of lung tissue for laboratory examination. If cancer is revealed, more tests are usually done to determine the size and extent of the cancer. Small cell lung cancer is classified as limited (only found in the chest and treatable with radiation) or extensive (has spread to other organs). Most cases are classified as extensive. By the time small cell lung cancer is diagnosed, it has usually spread to other organs.

Decisions regarding treatment must be made immediately after diagnosis. Without treatment, a patient is likely to survive 2-4 months. Patients undergoing treatment usually live up to a year longer, but will most likely not be cured. Only 6% of patients are still alive after five years. Because small cell lung cancer is aggressive, treatment must include chemotherapy, which consists of drugs taken orally or by injection. Etoposide, carboplatin and cisplatin are the most commonly used chemotherapy drugs in the United States.

For patients with extensive small cell lung cancer, treatment may consist of chemotherapy taken in conjunction with radiation therapy. However, the treatment will not cure the cancer; it will only alleviate the symptoms and make the patient more comfortable. Those with extensive disease cannot be helped by surgery because the cancer has spread. However, surgery may be an option for patients with limited disease if there is only one localized tumor that has not spread. The patient will still need radiation and chemotherapy after surgery.

Sometimes small cell lung cancer will spread to the brain without any symptoms being present. In these cases, patients may receive radiation directly to the brain if the cancer is small or if they have responded well to chemotherapy. This type of radiation is called prophylactic cranial irradiation.

Once you receive a diagnosis of small cell lung cancer, the results are almost always fatal. However, you can prevent this disease by not smoking. If you do smoke, quit. Quitting smoking will reduce your chance of getting cancer, plus it will improve your overall health and prevent other diseases.

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