NON-SMALL CELL LUNG CARCINOMA STAGE IV WITH BRAIN METASTASIS
Small cell carcinoma
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Transcript of Small cell carcinoma
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Lung cancer is a malignant tumor of the lungs. There are many types of lung cancer, but most can be categorized into two basic types, "small cell" and “non-small cell.”
Small cell lung cancer is generally faster growing than non-small cell, but more likely to respond to chemotherapy.
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Small cell cancer is divided into "limited stage" (generally cancer confined to the chest) and "extensive stage" (cancer that has spread outside the chest).
Lung cancer begins in cells that line the airways and often invade adjacent tissues or spread elsewhere in the body before symptoms are noticed.
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About 20% of all lung cancer cases are small cell lung cancer, meaning about 30,000 patients each year are diagnosed with this disease
At the time of diagnosis, approximately 30% of patients with small cell carcinoma will have tumor confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes. These patients are designated as having limited stage disease, and most 2-year disease-free survivors come from this group.
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In limited stage disease, median survival of 16 to 24 months with current forms of treatment can reasonably be expected. A small proportion of patients with limited stage disease may benefit from surgery with or without chemotherapy; these patients have an even better prognosis.
Government surveys show that as many as 3,000 people each year develop lung cancer from second-hand smoke.
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The treatment depends upon the stage of the cancer.
For small cell cancer, chemotherapy and radiation are usually in the limited stage disease (when the disease is confined to the chest.)
Studies have shown that giving chemotherapy and radiation therapy at the same time is better than giving one after the other. Chemotherapy alone is used for extensive stage disease.
In some cases where a patient with limited stage disease has only one small tumor, the tumor will be surgically removed, followed by chemotherapy. However, very few patients with small cell lung cancer are candidates for surgery.
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Some patients with limited stage disease may need radiation to the entire brain after they have completed chemotherapy and radiation to the chest. This is known as prophylactic cranial irradiation (PCI).
Because patients with small cell lung cancer tend to develop distant metastases, localized forms of treatment, such as surgical resection or radiation therapy, rarely produce long-term survival.
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About 10% of the total population of patients remain free of disease over 2 years from the start of therapy, the time period during which most relapses occur.
However, even these patients are at risk of dying from lung cancer (both small and non-small cell types). The overall survival at 5 years is 5% to 10%
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Cough Bloody sputum Shortness of breath Wheezing Chest Pain Loss of Appetite Weight loss Weakness Swallowing difficulty Nail abnormalities Hoarseness or changing voice Fever Facial Swelling
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Most lung cancers are caused by cigarette smoking. The more cigarettes you smoke per day and the earlier you started smoking, the greater the risk of lung cancer.
Second-hand smoke increases the risk.
High levels of pollution, radiation, and asbestos exposure may also increase risk.
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If you smoke, stop smoking. Try t avoid second-hand smoke.
There is no evidence that screening for small cell lung cancer with chest X-rays, CT scans or other means is beneficial for patients at high risk of developing small cell lung cancer, and such screening is not recommended
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The doctor can sometimes detect fluid that has collected around the lungs from a cancer by listening to your chest with a stethoscope.
Additional test would include:
Chest X-ray, CAT Scan of the chest, a PET scan, a needle biopsy, and more.
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The overall survival depends on the stage of the disease. For limited stage small cell cancer, cure rates may be as high as 25%, while cure rates for extensive stage disease are less than 5%.
The early the better chances of survival
Patients with tumors that have spread beyond the supraclavicular areas are said to have extensive stage disease and have a worse prognosis than patients with limited stage disease. Median survival of 6 to 12 months is reported with currently available therapy, but long-term disease-free survival is rare.
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The pretreatment prognostic factors which consistently predict for prolonged survival include good performance status, female gender, and limited stage disease. Patients with involvement of the central nervous system or liver at the time of diagnosis have a significantly worse outcome.
In general, patients who are confined to bed tolerate aggressive forms of treatment poorly, have increased morbidity, and rarely attain 2-year disease-free survival. However, patients with poor performance status can often derive significant palliative benefit and prolongation of survival from treatment
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Small Cell Lung Cancer Complications
Spread of disease beyond the lung
Side effects of surgery, chemotherapy, or radiation therapy.
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There is a large variety of Small Cell Lung Cancer Support Groups online.
Call your health care provider if you have risk factors for developing lung cancer, or you develop symptoms of lung cancer (particularly if you smoke).