Small cell lung cancer: how long do they live with it and how disappointing is the prognosis? What is small cell lung cancer Examination and treatment plan

Small cell lung cancer is a malignant tumor. The disease is accompanied by a general clinical severe course, the formation of metastases. They quickly spread throughout the body and are not amenable to full treatment. According to statistics, multicellular cancer accounts for about 25% of all known types of lung cancer. Life expectancy depends on various factors.

general characteristics

According to experts, multicellular cancer is a systemic disease. Already in the first stages of the disease, metastases begin to develop in the lymph nodes. They affect from 90% of the nodes inside the chest, up to 15% of the liver, up to 55% of the adrenal glands, up to 45% of the bone tissue and up to 22% of the brain. The degree of spread of metastases significantly affects how long patients with diagnosed lung cancer live.

According to studies, this form occurs in 18% of patients. The vast majority of them are men. The disease is most often diagnosed in patients aged 40 to 60 years. But small cell cancer also develops in people at a younger age. Without proper treatment, the prognosis of doctors is disappointing.

The disease does not manifest itself until the formation of a neoplasm in the lungs. Tumors cause symptoms that make it very difficult to recognize cancer. Patients complain of hoarse breathing, cough, chest pain. In the last stages, blood clots appear when coughing. In the most severe cases, when metastases have spread to neighboring organs, signs of cancer can be:

• Headache
• Discomfort while swallowing food
• Backache
• Hoarseness of voice.

When recognizing lung cancer, the process of metastasis formation is of particular importance. Based on the data, a treatment regimen is determined. To diagnose the disease, a tomography of the brain and in the chest area is performed, then an examination of the bone tissue.

Types of small cell lung cancer

Cellular lung cancer is divided into two types:

1. Small cell carcinoma. Refers to oncological diseases with an unfavorable prognosis. This form is characterized by extensive metastases, rapid and aggressive development. Combined polychemotherapy is the only treatment for small cell carcinoma.
2. Combined small cell carcinoma. It is characterized by the presence of symptoms of squamous or oat cell carcinoma, as well as signs of adenocarcinoma.

Depending on the type of disease, the doctor determines the necessary treatment regimen. In addition, the life expectancy of the patient depends on the form of development.

Classification

Scientists distinguish five forms that differ from the location of the tumor.

• Cancer grows into the nerves and vessels of the shoulder. Such patients get to the oncologist quite late, since the symptoms are similar to osteochondrosis of the shoulder joint. In this case, the prognosis of doctors will depend on the degree of spread.
• Hollow form. The tumor is formed due to a lack of nutrition as a result of the collapse of the central part. Metastases can reach 10 cm and are most often confused with cysts, abscesses, or tuberculosis. This greatly complicates the treatment.

1. Pneumonia-like cancer. Before contacting an oncologist, he is treated with antibiotics. The neoplasm occupies most of the right or left lung, is not distributed by the node.
2. atypical forms. These include: brain, bone and liver. They create metastases, but not the tumor itself.

• The hepatic form is characterized by heaviness in the hypochondrium on the right side, enlarged liver and jaundice.
• The brain is like a stroke. Speech is disturbed, there is no motor activity in the limb, headache, bifurcation and convulsions appear. The patient may lose consciousness. The prognosis is unfavorable.
• Bone - pain is localized in the spine, limbs and pelvic region.

1. metastatic formations. They are formed from a tumor of another organ and reduce the level of its performance. Metastases grow up to 10 cm and lead to death from impaired functioning of internal organs. Primary education can not be identified in all cases.

When the first symptoms appear, it is not always possible to correctly diagnose the disease. In many cases, patients begin treatment with antibiotics or other drugs suspecting another illness. An oncologist is usually consulted at later stages, when the cancer has spread to a large part of the organ.

stages

1. Lung cancer stage 1. The neoplasm in diameter reaches 3 cm. It is located in one lobe of the bronchus. No metastases were observed in neighboring lymph nodes.
2. Multicellular lung cancer stage 2. The tumor grows up to 6 cm. It grows into the pleura, causes loss of airiness and blocks the bronchi.
3. Lung cancer stage 3. The neoplasm passes to neighboring organs and increases to 7 cm. Metastases penetrate into the lymph nodes.
4. Small cell lung cancer stage 4. Cancer cells infect large blood vessels and the heart. The symptoms of the disease become more pronounced. Patients often complain about:

• Headache
• General malaise
• Wheezing or loss of voice
• Rapid weight loss
• loss of appetite
• Pain in the back.

How long the patient will live depends on the stage of development. Often, patients do not seek help from a specialist for a long time and metastases spread to other organs, which will complicate the treatment process and significantly reduce the patient's life expectancy.

Forecast

In the event that you do not start during the treatment of lung cancer, the disease in 100% of cases ends in death. The life expectancy of patients directly depends on the degree of spread of the neoplasm. The method of treatment is also of particular importance. When a patient refuses therapy, the prognosis of doctors is not comforting. Live with such a disease for no more than 4 months.

Without treatment, 90% of patients die in the first two years after the onset of the disease. But the chances of survival increase significantly when the neoplasm decreases during treatment. When remission occurs in a short period of time, the prognosis is quite favorable.

It is very important to prevent the development of lung cancer. To do this, you must quit smoking and undergo an examination once a year. You also need to regularly ventilate the apartment, carry out wet cleaning and, if possible, exclude contact with asbestos.

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, 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 the 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 the case of treatment. Small cell lung cancer is the most difficult to treat, in 85% of cases it ends fatally.

The early stages are asymptomatic and are more often determined by chance during preventive examinations or contacting the clinic with other problems.

Symptoms may indicate a 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. Longtime smokers are 23 times more likely to develop lung cancer than non-smokers. 95% of patients with small cell lung carcinoma are male smokers over 40 years of age.
• Inhalation of carcinogenic substances - work in "harmful" industries;
• Unfavorable ecological situation;
• Frequent or chronic lung disease;
• Weakened heredity.

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

Symptoms of lung cancer

• Cough;
• Dyspnea;
• Noisy breathing;
• Deformity of the fingers "drumsticks";
• Dermatitis;
• Hemoptysis;
• weight loss;
• Symptoms of general intoxication;
• Temperature;
• In the 4th stage - obstructive pneumonia, secondary signs appear from the affected organs: bone pain, headaches, confused consciousness.

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

Small cell carcinoma is more often central than peripheral. Moreover, the primary tumor is radiographically detected extremely rarely.

Diagnostics

When identifying the primary signs of pathology 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:

1. Visualization of the tumor by radiation methods: radiography, computed tomography (CT), positron emission tomography (PET-CT).
2. 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.

SCLC stages

1. Neoplasm less than 3 cm in size (measured in the direction of maximum elongation), located in one segment.
2. Less than 6 cm, not extending beyond one segment of the lung (bronchus), single metastases in nearby lymph nodes
3. More than 6 cm, affects the near lobes of the lung, the adjacent bronchus, or exits into the main bronchus. Metastases spread to distant lymph nodes.
4. Cancer neoplasia can go beyond the lung, with growth in neighboring organs, multiple distant metastasis.

International TNM classification

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

T x - data are insufficient to assess the state of the tumor, or it has not been detected,

T 0 - the tumor is not identified

TIS- non-invasive cancer

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

N is an indicator of the state of regional lymph nodes:

N x - data are insufficient to assess their condition,

N 0 - no metastatic lesion was found

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

M - the state of distant metastasis:

M x - insufficient data to determine distant metastases,

M0- no distant metastases were found

M 1 - M 3 - dynamics: from the presence of signs of a single metastasis, to going beyond the chest cavity.

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

Treatment

In the case of this diagnosis, the treatment of small cell lung cancer directly depends on the degree of damage to the organs of a particular patient, taking into account his history.

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

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

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

Therapeutic procedures - early stages

Surgical intervention is, unfortunately, the only way to remove cancer cells today. The method is used at stages I and II: removal of the entire lung, lobe or part of it. 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 confine oneself to tumor removal /. Even in this case, the 5-year survival does not exceed 40%.

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

Medical procedures – 3,4 stages

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

With a common form: polychemotherapy 4-6 courses, radiation therapy - according to indications.

In cases where tumor growth has stopped, we speak of partial remission.

Small cell lung cancer responds very well to chemotherapy, radiotherapy, and radiotherapy. The insidiousness of this oncology is the high probability of relapses, which are already insensitive to such antitumor procedures. Possible course of recurrence - 3-4 months.

Metastasis occurs (cancer cells are carried with the bloodstream) to organs that are most intensively supplied with blood. The brain, liver, kidneys, adrenal glands suffer. Metastases penetrate into the bones, which, among other things, leads to pathological fractures and disability.

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

How long do people live with SCLC

Life expectancy directly depends on the stage of the disease, your general health and the methods of treatment used. According to some reports, women have better sensitivity to treatment.

A short-term illness can give you 8 to 16 weeks if you are unresponsive to or refuse therapy.

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

In the case of combined treatment in stages I and II, the probability of a 5-year survival (after five years we speak of complete remission) 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, a 2-year survival rate is 65-75%, a 5-year survival rate of 5-10% is possible, with good health - up to 25%.

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

Afterword

Someone will look for the causes of cancer, not understanding what it is for him.

Believers endure the disease more easily, perceiving it as a punishment or test. Perhaps this makes them feel better, and may it bring peace and strength of mind in the struggle for life.

A positive attitude is essential for a favorable treatment outcome. Only 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, as well as to understand it. It's good to have family and friends help you.

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- a histological type of a malignant lung tumor with an extremely aggressive course and a poor prognosis. Clinically manifested by cough, hemoptysis, shortness of breath, chest pain, weakness, weight loss; in later stages - symptoms of mediastinal compression. Instrumental methods for diagnosing small cell lung cancer (X-ray, CT, bronchoscopy, etc.) must be confirmed by the results of a biopsy of the tumor or lymph nodes, cytological analysis of pleural exudate. Surgical treatment of small cell lung cancer is advisable only in the early stages; the main role is given to polychemotherapy and radiation therapy.

ICD-10

C34 Malignant neoplasm of bronchi and lung

General information

The problem of histogenesis of small cell lung cancer is currently considered from two positions - endodermal and neuroectodermal. Proponents of the first theory are inclined to the point of view that this type of tumor develops from the cells of the epithelial lining of the bronchi, which are similar in structure and biochemical properties to small cell carcinoma cells. Other researchers are of the opinion that the cells of the APUD system (diffuse neuroendocrine system) give rise to the development of small cell carcinoma. This hypothesis is confirmed by the presence of neurosecretory granules in tumor cells, as well as an increase in the secretion of biologically active substances and hormones (serotonin, ACTH, vasopressin, somatostatin, calcitonin, etc.) in small cell lung cancer.

Classification

Staging of small cell carcinoma according to the international TNM system does not differ from that for other types of lung cancer. However, until now, a classification is relevant in oncology that distinguishes between localized (limited) and widespread stages of small cell lung cancer. The limited stage is characterized by a unilateral tumor lesion with an increase in hilar, mediastinal and supraclavicular lymph nodes. With a common stage, the transition of the tumor to the other half of the chest, cancerous pleurisy, metastases are noted. About 60% of detected cases are in the advanced form (III-IV stage according to the TNM system).

Morphologically, within small cell lung cancer, oat cell carcinoma, intermediate cell type cancer, and mixed (combined) oat cell carcinoma are distinguished. Oat cell carcinoma is microscopically represented by layers of small spindle-shaped cells (2 times larger than lymphocytes) with rounded or oval nuclei. Cancer from cells of the intermediate type is characterized by cells of a larger size (3 times more than lymphocytes) of a round, oblong or polygonal shape; cell nuclei have a clear structure. A combined histotype of a tumor is said to occur when the morphological features of oat cell carcinoma are combined with those of adenocarcinoma or squamous cell carcinoma.

Symptoms of small cell lung cancer

Usually the first sign of a tumor is a prolonged cough, which is often regarded as smoker's bronchitis. An alarming symptom is always the appearance of an admixture of blood in the sputum. Also characterized by chest pain, shortness of breath, loss of appetite, weight loss, progressive weakness. In some cases, small cell lung cancer clinically manifests with obstructive pneumonia caused by bronchus occlusion and atelectasis of a part of the lung, or exudative pleurisy.

In the later stages, when the mediastinum is involved in the process, a mediastinal compression syndrome develops, including dysphagia, hoarseness due to paralysis of the laryngeal nerve, signs of compression of the superior vena cava. Often there are various paraneoplastic syndromes: Cushing's syndrome, Lambert-Eaton myasthenic syndrome, syndrome of inadequate secretion of antidiuretic hormone.

Small cell lung cancer is characterized by early and widespread metastasis to the intrathoracic lymph nodes, adrenal glands, liver, bones and brain. In this case, the symptoms correspond to the localization of metastases (hepatomegaly, jaundice, pain in the spine, headaches, bouts of loss of consciousness, etc.).

Diagnostics

For a correct assessment of the degree of prevalence of the tumor process, clinical examination (examination, analysis of physical data) is supplemented by instrumental diagnostics, which is carried out in three stages. At the first stage, visualization of small cell lung cancer is achieved using radiation methods - chest x-ray, CT of the lungs, positron emission tomography.

The task of the second stage is the morphological confirmation of the diagnosis, for which bronchoscopy with a biopsy is performed,. With this scenario of patient management, the 5-year survival rate within this group does not exceed 40%.

The rest of patients with localized form of small cell lung cancer are prescribed from 2 to 4 courses of treatment with cytostatics (cyclophosphamide, cisplatin, vincristine, doxorubicin, gemcitabine, etoposide, etc.) in monotherapy or combination therapy in combination with irradiation of the primary focus in the lung, lymph nodes root and mediastinum. When remission is achieved, prophylactic irradiation of the brain is additionally prescribed to reduce the risk of its metastatic lesion. Combination therapy can extend the life of patients with localized form of small cell lung cancer by an average of 1.5-2 years.

Patients with locally advanced stage of small cell lung cancer are shown to undergo 4-6 courses of polychemotherapy. With metastatic lesions of the brain, adrenal glands, bones, radiation therapy is used. Despite the sensitivity of the tumor to chemotherapy and radiotherapy, recurrences of small cell lung cancer are very frequent. In some cases, relapses of lung cancer are refractory to anticancer therapy - then the average survival usually does not exceed 3-4 months.

Lung cancer (LC) is a collective diagnosis for different origin, structure, clinical course and prognosis of malignant tumors originating from epithelial cells of the respiratory tract. Another name for it is bronchogenic carcinoma.

According to localization, they distinguish:

1. Central cancer (occurs in the bronchi of large and medium caliber).

2. Peripheral (comes from bronchioles or from lung parenchyma).

The histological structure of the tumor is very important, since carcinomas of different structure have different sensitivity to certain methods of treatment, and the type of tumor initially determines the prognosis.

Currently, oncologists subdivide malignant neoplasms of the lung into two main groups - small cell and non-small cell lung cancer (which, in turn, includes 5 different histological types).

The small cell variant is perhaps the most aggressive tumor, therefore it is separated into a separate group. It is characterized by an extremely rapid course, early metastasis and poor outcome.

Formation of metastases

RL grows from the mucosal epithelium. Further, it grows into the wall of the bronchus, into the pleura, and vessels. With the flow of lymph, cancer cells enter the lymph nodes located around the bronchi, mediastinal, supraclavicular and cervical (this is lymphogenous metastasis), and other parts of the lung. The tumor can grow into neighboring organs, compress them, and spread to the chest wall.

When cancer cells enter the bloodstream, they spread throughout the body and screenings are formed in other organs (this is the hematogenous pathway of metastasis). Lung cancer most often metastasizes to the liver, bones, brain, adrenal glands, kidneys, less often to other organs.

There is a unified international classification of malignant neoplasms according to the TNM system. T - distribution of the primary focus, N - damage to regional (nearby) lymph nodes, M - the presence of distant metastases.

The fourth stage of lung cancer is characterized by a combination of any T and N index, but with the presence of distant tumor screenings, that is, M1. M1 are considered not only foci in other organs, but also in the pleura or pericardium.

Stage 4 cancer is considered inoperable and, in fact, terminal. But this does not mean that it is not treated. Properly selected chemotherapy, radiation therapy, as well as new methods of immunotherapy, including molecular-targeted drugs, can slow down tumor growth, reduce existing foci, prevent the development of new metastases, and as a result, prolong the life of such a patient.

Statistics

Bronchogenic cancer in developed countries is one of the most common malignant tumors and the most common cause of death among all cancer diagnoses.

Lung cancer is 3-10 times more common in men than in women. In Russia, in the structure of cancer incidence in men, bronchial cancer has long and firmly ranked first (17.6% according to 2016), in the overall structure (among both sexes) it is third (10.1%).

An increase in the incidence of the disease is noted with age.

Stage 4 lung cancer is diagnosed in 34% of cases of newly diagnosed malignant tumors of this localization.

Symptoms

In the early stages, lung cancer may be asymptomatic. Manifestations, if any, are non-specific:

1. Prolonged persistent cough. It is more characteristic of central cancer: at first it is dry, obsessive, later it can be with sputum, streaked with blood.
2. Dyspnea. It also often accompanies central cancer, due to impaired airway patency. The larger the caliber of the compressed bronchus, the more pronounced shortness of breath. With the development of pleurisy, the feeling of lack of air is more pronounced.
3. Hemoptysis. This is already a late sign, which immediately frightens the patient and makes him see a doctor.
4. General symptoms of intoxication due to tumor metabolism: weakness, malaise, loss of appetite, nausea, fatigue, subfebrile body temperature.
5. paraneoplastic syndromes. They are explained by the action of biologically active substances that the tumor produces. Thrombophlebitis, arthritis, myositis, vasculitis, neuropathy, dermatitis, pruritus, anemia, thrombocytopenia, Cushing's syndrome can be observed.
6. Cancrotic inflammation. May present as normal pneumonia, with improvement with antibiotic treatment, but without complete resolution on x-ray.
7. Pain in the chest. Appears when the tumor grows into the visceral pleura.
8. Hoarseness of voice due to damage to the recurrent nerve.
9. Swelling of the face, neck, hands with compression of the superior vena cava.
10. Symptoms from organs affected by metastases. In the presence of massive tumor growth in the liver - jaundice, ascites, swelling of the legs. With brain damage - headaches, dizziness, loss of consciousness, convulsions, paralysis. If distant foci are localized in the bones, the patient is tormented by severe pain in the musculoskeletal system. Pathological fractures are also frequent - violations of the integrity of the bones in the area of ​​​​the location of the tumor tissue with minimal physical exertion.

Diagnostics

Basic Methods

• Fluorography or radiography. In the vast majority of patients, lung cancer is detected by X-ray examination. The pictures show either a spherical shadow with fuzzy contours, or indirect signs of bronchial compression: local emphysema, hypoventilation, atelectasis.
• Computed tomography with contrast enhancement. Perhaps the main method of diagnosing tumors today. It is prescribed when a pathology is detected on plain radiographs; or if there are no changes in the pictures, but there are other suspicious signs.
• Sputum examination for atypical cells.
• Fibrobronchoscopy. It is mandatory for all patients with identified pathology on CT.
• Biopsy. A biopsy of the tumor tissue can be performed endoscopically during bronchoscopy, transthoracically - by puncturing the chest wall, or openly.
• Ultrasound of the abdominal cavity and retroperitoneal space, supraclavicular and axillary lymph nodes.

Additional diagnostic methods are prescribed according to indications:

• positron emission tomography (PET);
• thoracoscopy with biopsy of the pleura or peripheral lesions;
• mediastinoscopy;
• with pleurisy - thoracocentesis with evacuation and examination of the fluid;
• scintigraphy of the bones of the skeleton;
• MRI of the brain;
• CT or MRI of the abdomen;
• puncture of the supraclavicular lymph node;
• biopsy of focal formations in the liver;
• determination of oncomarkers CEA, CYFRA 21-1, CA-125 and others.

In addition, all general clinical examinations are carried out - tests, ECG, spirometry, infection markers, ECHO KG, examination by specialist doctors. This is important to determine the general condition of the patient and his readiness to undergo treatment.

Stage 4 lung cancer treatment

The applied methods of treatment depend on the histological type of the tumor and the results of the molecular genetic study, as well as on the somatic status of the patient.

Treatment of non-small cell cancer (NSCLC)

• Cytotoxic drugs. In a satisfactory condition, two-component schemes are used, 4-6 courses with breaks of 2-3 weeks. Chemotherapy significantly reduces the symptoms of the disease, and increases life expectancy. Elderly debilitated patients are treated with a single drug. In chemotherapy, platinum drugs, etoposide, vinorelbine, pemetrexed, gemcitabine and others are used.
• Target therapy. This is a molecular-directed effect on molecules that induce the reproduction of cancer cells. It is prescribed for those patients who have a mutation in the epidermal growth factor receptor EGFR (diagnosed in 15% of patients with NSCLC) or ALK gene translocation (happens in 5% of cases). Targeted therapy for EGFR mutations can be given as the first stage of treatment, or in combination with chemotherapy. Targeted drugs do not cause the toxic effects that cytostatics have, so such treatment can be prescribed to debilitated patients and continue continuously throughout life. These are drugs such as gefitinib, erlotinib, crizotinib.
• Radiation therapy. It is used as a palliative method for local control of tumor size, with severe pain syndrome, to reduce the size of metastases (brain irradiation is most often used).
• With tumor foci in the bones, bisphosphonates are prescribed.

Treatment of small cell cancer (SCLC)

• Chemotherapy.
• Palliative radiotherapy.
• Targeted therapy for SCLC has not been developed. But small cell carcinoma is most sensitive to chemotherapy drugs, so it is possible to stabilize tumor growth for a long time.

Metastases of small cell lung cancer to the brain: before and after treatment (China)

Palliative care

Such treatment is prescribed for severe general condition, if the therapy was ineffective or if chemotherapy is intolerant. The goal is to reduce symptoms and alleviate suffering. With good care and support from loved ones, it can prolong life. Main activities:

• Efficient pain relief according to an increasing scheme: non-narcotic analgesics - weak opiates - potent drugs of the narcotic series.
• Antiemetics.
• Thoracocentesis, laparocentesis with fluid accumulation.
• Infusion therapy for the purpose of detoxification and rehydration.
• Hemostatic drugs for bleeding
• Oxygen therapy.

Forecast

Lung cancer with metastases has a poor prognosis. But in modern oncology, the understanding of incurable tumors is changing. The 4th stage is not perceived as a sentence, but as a chronic disease in which you can help.

Methods of influence have been developed and continue to be developed. A very promising direction is the study of targeted and immunotherapy.

Without treatment, the average survival of patients is 4-5 months. Standard chemotherapy increases this figure to 9. Targeted drugs can extend the patient's life up to 2 years.

Small cell lung cancer is a malignant neoplasm that develops as a result of pathological changes in the cells of the mucous membrane of the respiratory tract. The disease is dangerous because it develops very quickly, already in the initial stages it can metastasize to the lymph nodes. The disease occurs more often in men than in women. At the same time, smokers are most susceptible to its occurrence.

As in any other cases, there are 4 stages of small-cell lung cancer pathology. Let's consider them in more detail:

Of course, the success of treatment, as with any cancer, will depend on the timeliness of its detection.

Important! Statistics show that small cell makes up 25% of all existing varieties of this disease. If metastasis is observed, in most cases it affects 90% of the thoracic lymph nodes. Slightly less will be the share of the liver, adrenal glands, bones and brain.

Clinical picture

The situation is aggravated by the fact that the symptoms of small cell lung cancer at the initial stage are practically not noticeable. They can often be confused with a common cold, because a person will experience a cough, hoarseness, and difficulty breathing. But, when the disease becomes more serious, the clinical picture becomes brighter. A person will notice signs such as:

• a worsening cough that does not go away after taking conventional antitussive drugs;
• pain in the chest area that occurs systematically, increasing its intensity over time;
• hoarseness of voice;
• impurities of blood in sputum;
• shortness of breath even in the absence of physical exertion;
• loss of appetite, and accordingly, weight;
• chronic fatigue, drowsiness;
• difficulty in swallowing.

These symptoms should prompt immediate medical attention. Only timely diagnosis and effective therapy will help improve the prognosis for SCLC.

Diagnosis and features of treatment

Important! Most often, SCLC is diagnosed in people aged 40-60 years. At the same time, the proportion of men is 93%, and women suffer from this form of oncology only in 7% of the total number of cases.

High-precision diagnostics performed by experienced specialists is the key to successful getting rid of the disease. It will allow you to confirm the presence of oncology, as well as determine exactly what kind of it you have to deal with. It is possible that we are talking about non-small cell lung cancer, which is considered a less aggressive type of disease, allows you to make more comforting predictions.

The main diagnostic methods should be:

1. laboratory blood tests;
2. sputum analysis;
3. chest x-ray;
4. body CT;

Important! A lung biopsy is mandatory, followed by examination of the material. It allows you to more accurately determine the features of the neoplasm and its nature. A biopsy may be performed during bronchoscopy.

This is a standard list of studies that a patient must undergo. It can be supplemented with other diagnostic procedures if necessary.

If we talk about the treatment of small cell lung cancer, then its main method remains surgical intervention, as in other types of oncology. It is carried out in two ways - open and minimally invasive. The latter is more preferable, because it is considered less traumatic, has fewer contraindications, and is characterized by high accuracy. Such operations are performed through small incisions on the patient's body, controlled by special video cameras that display the image on the monitor.

Considering the fact that the type of oncology in question progresses very quickly, often being detected already at the stage of metastasis, doctors will use chemotherapy or radiation therapy as additional methods of treating SCLC. At the same time, irradiation or therapy with anticancer drugs can be carried out before surgery, with the goal of stopping tumor growth, destroying cancer cells, and are often performed after surgery - here they are needed to consolidate the result and prevent relapse.

Additional therapies can be used in combination. This way you can achieve more significant results. Sometimes doctors resort to polychemotherapy, combining several drugs. Everything will depend on the stage of the disease, the characteristics of the state of health of a particular patient. Radiation therapy for SCLC can be either internal or external, depending on the size of the tumor and the extent of metastases.

As for the question - how many people live with SCLC, it is difficult to give an unambiguous answer here. Everything will depend on the stage of the disease. But, given the fact that pathology is often detected already in the presence of metastasis, the main factors determining life expectancy will be: the number of metastases and their location; professionalism of attending physicians; the accuracy of the equipment used.

In any case, even with the last stage of the disease, there is a chance to extend the life of the patient by 6-12 months, significantly alleviating the symptoms.