Small cell lung cancer: a rare disease review. Small cell lung cancer Stage 4 central small cell carcinoma of the left lung

In the structure of oncological diseases, lung cancer is one of the most common pathologies. It is based on a malignant degeneration of the epithelium of the lung tissue, a violation of air exchange. The disease is characterized by high mortality. The main risk group is smoking men aged 50-80 years. A feature of modern pathogenesis is a decrease in the age of primary diagnosis, an increase in the likelihood of lung cancer in women.

Small cell carcinoma is a malignant tumor that has the most aggressive course and widespread metastasis. This form accounts for about 20-25% of all types. Many scientific experts regard this type of tumor as a systemic disease, in the early stages of which, it is almost always present in the regional lymph nodes. , suffer from this type of tumor most often, but the percentage of cases is growing significantly. Almost all patients have a fairly severe form of cancer, this is due to the rapid growth of the tumor and widespread metastasis.

Small cell lung cancer

Causes of small cell lung cancer

In nature, there are many reasons for the development of a malignant neoplasm in the lungs, but there are the main ones that we encounter almost every day:

smoking;
exposure to radon;
asbestosis of the lungs;
viral damage;
dust impact.

Clinical manifestations of small cell lung cancer

Symptoms of small cell lung cancer:

a cough of a prolonged nature, or a newly appeared cough with changes in the patient's usual;
lack of appetite;
weight loss;
general malaise, fatigue;
shortness of breath, pain in the chest and lungs;
voice change, hoarseness (dysphonia);
pain in the spine with bones (occurs with bone metastases);
epileptic seizures;
lung cancer, stage 4 - there is a violation of speech and severe headaches appear.

Grades of small cell lung cancer

Stage 1 - the size of the tumor in diameter up to 3 cm, the tumor affected one lung. There is no metastasis.
Stage 2 - the size of the tumor in the lung is from 3 to 6 cm, blocks the bronchus and grows into the pleura, causing atelectasis;
Stage 3 - the tumor rapidly passes into neighboring organs, its size has increased from 6 to 7 cm, atelectasis of the entire lung occurs. Metastases in neighboring lymph nodes.
Stage 4 small cell lung cancer is characterized by the spread of malignant cells to distant organs of the human body and causes symptoms such as:

headache;
hoarseness or even loss of voice;
general malaise;
loss of appetite and a sharp decrease in weight;
back pain, etc.

Diagnosis of small cell lung cancer

Despite all the clinical examinations, history taking and listening to the lungs, quality is also needed, which is carried out using methods such as:

skeletal scintigraphy;
chest x-ray;
detailed, clinical blood test;
computed tomography (CT);
liver function tests;
magnetic resonance imaging (MRI)
positron emission tomography (PET);
sputum analysis (cytological examination to detect cancer cells);
pleurocentesis (fluid collection from the chest cavity around the lungs);
- the most common method for diagnosing a malignant neoplasm. It is carried out in the form of removal of a particle of a fragment of the affected tissue for further examination under a microscope.

There are several ways to perform a biopsy:

bronchoscopy combined with biopsy;
carried out with the help of CT;
endoscopic ultrasound with biopsy;
mediastinoscopy combined with biopsy;
open lung biopsy;
pleural biopsy;
videothoracoscopy.

Treatment of small cell lung cancer

The most important place in the treatment of small cell is chemotherapy. In the absence of appropriate treatment for lung cancer, the patient dies 5-18 weeks after diagnosis. To increase the mortality rate to 45 - 70 weeks, polychemotherapy helps. It is used both as an independent method of therapy, and in combination with surgery or radiation therapy.

The goal of this treatment is complete remission, which must be confirmed by bronchoscopic methods, biopsy and bronchoalveolar lavage. As a rule, the effectiveness of treatment is assessed after 6-12 weeks, after the start of therapy, also, according to these results, it is possible to assess the likelihood of a cure and the patient's life expectancy. The most favorable prognosis is in those patients who have achieved complete remission. This group includes all patients whose life expectancy exceeds 3 years. If the tumor has decreased by 50%, while there is no metastasis, it is possible to talk about partial remission. Life expectancy is correspondingly less than in the first group. With a tumor that is not amenable to treatment and active progression, the prognosis is unfavorable.

After a statistical study, the effectiveness of chemotherapy was revealed and it is about 70%, while in 20% of cases a complete remission is achieved, which gives survival rates close to those of patients with a localized form.

limited stage

At this stage, the tumor is located within one lung, and nearby lymph nodes may also be involved.

Applied methods of treatment:

combined: chemo+radiotherapy followed by prophylactic cranial irradiation (PKO) in remission;
chemotherapy with or without PCR, for patients who have impaired respiratory function;
surgical resection with adjuvant therapy for stage 1 patients;
combined use of chemotherapy and thoracic radiotherapy is the standard approach for patients with limited stage, small cell LC.

According to the statistics of clinical studies, combination treatment compared with chemotherapy without radiation therapy increases the 3-year survival prognosis by 5%. Drugs used: platinum and etoposide. Prognostic indicators for life expectancy are 20-26 months and a 2-year survival forecast of 50%.

Inefficient ways to increase forecast:

increasing the dose of drugs;
action of additional types of chemotherapy drugs.

The duration of the course of chemotherapy is not defined, but, nevertheless, the duration of the course should not exceed 6 months.

The question of radiotherapy: many studies show its benefits in the period 1-2 cycles of chemotherapy. The duration of the course of radiation therapy should not exceed 30-40 days.

Maybeapplication of standard irradiation courses:

1 time per day for 5 weeks;
2 or more times a day for 3 weeks.

Hyperfractionated thoracic radiotherapy is considered preferable and contributes to a better prognosis.

Patients of older age (65-70 years) tolerate treatment much worse, the prognosis of treatment is much worse, as they respond quite poorly to radiochemotherapy, which in turn manifests itself in low efficiency and large complications. Currently, the optimal therapeutic approach for elderly patients with small cell carcinoma has not been developed.

Patients who have achieved tumor remission are candidates for prophylactic cranial irradiation (PCR). The research results indicate a significant reduction in the risk of brain metastases, which without the use of PKO is 60%. RCC improves the prognosis of 3-year survival from 15% to 21%. Frequently, survivors show impairments in neurophysiological function, but these impairments are not associated with the passage of PCR.

extensive stage

The spread of the tumor occurs outside the lung in which it originally appeared.

Standard methods of therapy:

combined chemotherapy with or without prophylactic cranial irradiation;

Note! The use of higher doses of chemotherapy drugs remains an open question.

For a limited stage, in case of a positive response to chemotherapy, an extensive stage of small cell lung cancer, prophylactic cranial irradiation is indicated. The risk of formation of metastases in the CNS within 1 year is reduced from 40% to 15%. There was no significant deterioration in health after PKO.

Combined radiochemotherapy does not improve the prognosis compared to chemotherapy, but thoracic irradiation is reasonable for palliative therapy of distant metastases.

Patients diagnosed with an advanced stage have a deteriorating state of health that complicates aggressive therapy. Conducted clinical studies have not revealed an improvement in survival prognosis with a decrease in drug doses or with the transition to monotherapy, but, nevertheless, the intensity in this case should be calculated from an individual assessment of the patient's health status.

Disease prognosis

As mentioned earlier, small cell lung cancer is one of the most aggressive forms of all. What prognosis of the disease and how long patients live depends directly on the treatment of oncology in the lungs. A lot depends on the stage of the disease, and what type it belongs to. There are two main types of lung cancer - small cell and non-small cell.

Small cell lung cancer affects smokers, it is less common, but spreads very quickly, forming metastases and capturing other organs. Is more sensitive to chemical and radiation therapy.

Life expectancy in the absence of appropriate treatment is from 6 to 18 weeks, and the survival rate reaches 50%. With appropriate therapy, life expectancy increases from 5 to 6 months. The worst prognosis is in patients with a 5-year illness. Approximately 5-10% of patients remain alive.

Informative video

Respiratory cancer is one of the most common diseases. More often, smoking men over 55 years of age suffer from it, but often the disease occurs in women. In terms of mortality, it occupies one of the first places. The chances of survival increase if there is a general positive attitude, competent therapy, and high body resistance. With a combination of these factors, even if stage 4 lung cancer is diagnosed, death can be avoided.

Causes of the disease

The following factors influence the development of malignant tumors:

Smoking. Tobacco products contain a large amount of carcinogens.
Poor environmental conditions, lack of good nutrition. The percentage of morbidity is especially high among residents of megacities.
The presence of chronic pathologies of an infectious or bacterial nature (bronchitis, tuberculosis).
hereditary predisposition.
Weakening of immunity associated with HIV, chemotherapy.

The risk group includes people working in hazardous industries, where there are chemical fumes hazardous to health.

Under the influence of these factors, pathological DNA changes occur in women and men, as a result of which bronchial epithelial cells begin to mutate, forming a tumor. With a certain degree of organ damage, leading to disability, a person is issued a disability. It is important to know how lung cancer manifests itself in order to consult a doctor at the first sign.

Types and stages of disease development

Histological classification distinguishes between small cell and non-small cell lung cancer. The latter is especially common and accounts for approximately 80% of all cases. These are neoplasms that form from epithelial tissues.

Depending on the clinical features, the classification of lung cancer distinguishes several types of non-small cell forms:

Adenocarcinoma - formed in the peripheral region. The tumor is formed on the basis of mucous and glandular tissue.
Squamous cell carcinoma. The neoplasm in this case consists of flat epithelial cells. Central cancer of the right lung is often diagnosed when large bronchi are affected.
Large-celled - the tumor consists of large cells and spreads very quickly.
Mixed, combining several types.

The mediastinal form of lung cancer, miliary carcinomatosis is rare. In the first case, a tumor is diagnosed in the mediastinal regions. Miliary carcinomatosis is a lesion with metastases in the form of nodes that differ in an average degree of intensity.

There are 4 stages of lung cancer:

A neoplasm on one of the bronchi has a size of no more than 3 cm. In stage 1 lung cancer, metastases are usually absent, the lymph nodes and bronchi are not damaged.
The tumor increases and acquires dimensions from 3 to 6 cm. Lung cancer of the 2nd degree is characterized by the appearance of single metastases.
The tumor becomes more than 6 cm, may occupy an adjacent lobe. Grade 3 lung cancer is produced by metastases detected during diagnosis, which appear in the bifurcation lymph nodes.
The terminal stage - the tumor grows into nearby organs and tissues. At the last stage of the disease, pericarditis and pleurisy are added, which further worsens the patient's condition.

At different stages, treatment has its own characteristics.

Small cell lung cancer develops in a short period of time, passing through only 2 stages:

Limited. Pathological cells are localized in one organ and nearby tissues.
Extensive, when metastases are sent to more distant organs.

The fourth stage is not always treatable, therefore it is considered the most dangerous.

Symptoms and signs of stage 4 cancer before death

The disease is often discovered quite by accident. The first symptoms of lung cancer at an early stage, which are just beginning to appear, usually go unnoticed. Postponing a visit to the doctor about the emerging minor pain leads to the fact that the disease is actively progressing. Usually at an early stage the patient does not focus on them. In the initial stages of the disease, it is often confused with the common cold. The first signs are manifested in the form of a slight malaise, dry cough.

Lung cancer, stage 3, which has gone unnoticed, reveals itself in the next stage with symptoms that are more pronounced. The patient begins to complain of pain in the chest that occurs during breathing, lack of appetite, coughing fits with purulent and bloody sputum.

Typical symptoms of stage 4 lung cancer before death:

Shortness of breath, even at rest, is the first symptom to look out for. Due to the accumulation of exudate, the growth of the tumor, the patient's breathing becomes intermittent.

Difficulty in speech caused by damage to the cervical lymph nodes. As a result of metastasis, paralysis of the vocal cords is formed, the voice becomes hoarse.
Decreased or complete lack of appetite.
Drowsiness. Against the background of dehydration and slow metabolism, fatigue occurs, the patient sleeps a lot.
Apathy. The person loses interest in life.
Disorientation, hallucinations are typical for stage 4 lung cancer symptoms before death. Memory lapses are possible, speech becomes incoherent. The brain suffers from oxygen starvation, which causes lung cancer.
Edema. As a result of kidney failure, they form on the lower extremities. In lung cancer of the 4th degree with metastases, the penetration of the latter into the mediastinum is characteristic, which leads to compression of the veins and the appearance of edema on the face and neck.
Unbearable pain is another dying symptom. Occur as a result of metastases in other organs. Often, pain can only be managed with the help of narcotic drugs.

The spread of metastases leads to the appearance of diseases that are not related to oncology. It can be pyelonephritis, jaundice, arrhythmia, angina pectoris, peristalsis disorders. Metastasis affects the bones, causing their deformation, severe pain. When stage 4 lung cancer in women and men manifests itself with similar symptoms, treatment usually comes down to analgesics, narcotic drugs to alleviate the patient's last days of life.

Symptoms of lung cancer in men and women are the same, without specific manifestations. A timely visit to the doctor will prevent the development of the disease, the result of which can be not only disability, but also death.

The patient's chances of recovery

Even if the first stage of lung cancer and the second are missed, the disease can still be overcome. It is categorically impossible to run it to such a state when there is damage to the brain, bones and those symptoms of the disease, which will inevitably be followed by a fatal outcome. Competent, timely actions help to stop the spread of metastases, and the treatment of stage 4 lung cancer is bearing fruit.

Regardless of whether stage 2 or stage 4 lung cancer is being treated, different types of the disease have their own prognosis for recovery.

They say about a peripheral lesion when a pathogenic focus is formed in the bronchioles, small bronchi. Neoplasm occurs in areas that are not vital. Operative intervention and chemotherapy for lung cancer helps to reverse the pathogenic process.

Central lung disease is a more severe form of the disease. The pathogenic focus is formed where the main blood vessels are concentrated. In the process of growth, the tumor destroys them and moves through the lymphatic system, launching metastases to other organs. The duration of treatment compared to that which is carried out in relation to peripheral neoplasms is much longer. Even if you get a disability, a person can stay alive.

Video

Video - how to reduce cancer in stage 4?

Diagnostic methods

Instrumental and laboratory methods help to diagnose lung cancer in the early stages. Particular attention is paid to tumors radiography, MRI, ultrasound, CT.

An important stage in the diagnosis, which helps to identify pathology, are the following laboratory tests:

A blood test that determines the level of hemoglobin.
Biopsy and histology methods are two procedures during which the taken tissue is examined.

Screening diagnosis of lung cancer is performed using high-frequency equipment. They give a more complete picture of the disease, which increases the chances of recovery.

How is stage 4 lung cancer treated?

With regular examinations, the initial stage of cancer is detected, when metastases have not yet formed. In this case, an operation is performed to remove the affected part of the lung.

When metastases have already spread throughout the body, it is unlikely that a person will be completely cured, even if the primary focus is removed. Therefore, the treatment of stage 4 lung cancer aims to relieve pain and prolong a person's life as much as possible.

Although there is no absolute cure, surgery can improve the patient's condition. It just doesn't always work out. At the last stage of the disease, the tumor becomes too large, so surgery becomes unsafe. If fluid accumulates in the lungs, a drainage tube is placed.

Usually prescribed chemotherapy, hormonal, immunomodulatory drugs. Painkillers for lung cancer help to improve the patient's well-being for a short period of time. A lot of positive reviews have such a method of treating cancer as ASD fraction 2, which, according to a certain scheme, is taken with a small amount of milk or tea. When using ASD medicine with fraction 2 according to a certain scheme, the dosage must be observed. It is prescribed by the attending physician individually. Treatment of ASD 2 fraction gives good results in complex therapy along with other medications.

The third stage and even the fourth is not a sentence. Modern techniques, folk remedies, a diet for lung cancer, combined with the desire of the patient to recover, can work wonders. A new method of treating oncological diseases is being mastered - targeted therapy, which ensures the rapid destruction of pathogenic cells.

Phytotherapy

Treatment with folk remedies also gives results. Celandine is capable of stopping the growth of a malignant tumor. It is used both in complex collections and as an independent tool. To obtain the result, direct contact of the plant with the neoplasm is required.. With lung cancer, this cannot be achieved, so celandine must be given to the patient in the form of a tincture. Its effectiveness is much higher if taken for lung cancer, the symptoms of which have just been discovered.

The tincture is prepared from the juice of the plant. Celandine must be dug up by the roots, washed, dried a little and ground in a meat grinder. Squeeze the juice from the resulting mass and mix it with alcohol. For 1 liter of juice - 250 ml of alcohol. Take celandine in the form of such a tincture before meals four times a day. One dose is a tablespoon.

You can use celandine and as a compress. It helps to relieve pain, especially when metastases have reached the spine. The grass passed through a meat grinder is poured with alcohol. Having moistened a piece of cloth in the resulting product, apply it to the sore spot.

Helps cure lung cancer burdock juice. Traditional medicine also recommends using this plant to alleviate the patient's condition. Of course, the question of whether lung cancer is treated only with folk remedies cannot be answered in the affirmative. This is just an addition to the treatment.

Forecast

A positive result depends on the stage at which treatment is started. The age, lifestyle of the patient, the size of the tumor, and the general condition of the body are also important. You can not ignore the diet recommended for oncology.

According to statistics, 40% of patients have a survival rate of 5 years. This is if treatment is started in a timely manner, disability is issued. With a local form of the disease and the absence of measures to combat carcinoma, patients live no more than 2 years.

It is impossible to answer unambiguously the question of whether stage 3 lung cancer is curable. An essential role belongs to timely diagnosis. The chances of stopping a disease detected at this stage are much greater than when a tumor that affects other organs and lymph nodes is detected. Life expectancy up to 5 years can be saved in 24% of patients with large cell neoplasms. With small cell cancer, the percentage is two times lower.

Many are interested in the question of how long patients with stage 4 lung cancer live. The most progressive form is cellular cancer. Sudden death can occur 3-4 months after the discovery of the disease. However, if the patient is treated, taking into account all the nuances of the pathological process, with stage 4 small cell lung cancer, the prognosis can be quite optimistic.

It is important to comply with all requirements for the care of patients with oncology. Lung cancer of the last stage is not cured, but allows you to live another 5-10 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:

1 stage	the tumor is small, localized in one segment of the organ, no metastasis
Stage 2 SCLC	the prognosis is quite comforting, although the size of the neoplasm is much larger, can reach 6 cm. Single metastases are observed. Their location is regional lymph nodes.
Stage 3 SCLC	the prognosis depends on the characteristics of the particular case. The tumor can exceed 6 cm in size. It spreads to neighboring segments. Metastases are more distant, but are within regional lymph nodes
Stage 4 SCLC	the prognosis is not as encouraging as in previous cases. The neoplasm goes beyond the organ. There is extensive metastasis

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:

laboratory blood tests;
sputum analysis;
chest x-ray;
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.

Given 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 aim 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.

5577

Previously, this type of disease was considered a male disease, but with environmental pollution, increased nervous stress, cases of smoking among women, it has spread to the female part of the population. The main risk group falls on people aged 44-67 years.

Small cell lung cancer: life expectancy

When diagnosed with small cell, it is impossible to say exactly how long patients live. Because this is determined by several factors: the age of the patient, good immunity, the body's susceptibility to drugs, the timeliness of the therapy started.

There are four stages of the development of the disease:

Malignant formation is 3cm. Metastasis to other areas is not observed.
Blastoma from 3 to 6 cm. Infected particles enter the pleura, pinch the bronchi, there is a possibility of atelectasis.
The neoplasm grows up to 7cm. Malignant cells grow into nearby lymph nodes. Spread to other organs begins.
From harmful cells, formations are created that cover the heart, kidneys and liver. Incurable.

In the first stage, characterized by a small tumor in the lung, recovery occurs with a 75-85% probability.

But this should be preceded by a timely surgical operation, which will remove the malignant formation in time, and the right medication.

If your body copes with this difficult task without complications, then the possibility of a relapse after five years will be 6-9%.

At the second stage, where in addition to the tumor there are already small formations in the lymphatic system, the possibility of complete regression is 50-60%.

Due to the likelihood of relapse and weakening of the body, the survival rate for 4-6 years is no more than 25%.

However, this type of malignancy is predominantly detected at the 3rd (approximately 65%) or 4th stage, according to the totality of all the symptoms that have manifested by this time. By this time, a malignant lung tumor progresses and gives complications to other organs, so the period of life, even with treatment, is reduced to 5-7 years.

It is worth noting that if, as a result of therapeutic actions, the tumor begins to decrease, then doctors regard this as a sign that increases the success of recovery. With partial remission, the chances are about 52%, and with complete remission, 75-90%.

The 3rd stage of a cancerous tumor is characterized by the manifestation of a constant cough with the release of red-brown sputum due to metastases in the blood vessels. Become constant and unbearable pain in the chest, previously attributed to neuralgia. The heartbeat is disturbed, the esophagus becomes difficult to pass, constant shortness of breath torments, symptoms appear that characterize the initial damage to other organs.

When diagnosed with a malignant lung tumor in the 3rd phase, the prognosis is disappointing. Without drug assistance, life expectancy ranges from a few weeks to 4-6 months.

However, this type of tumor has an increased sensitivity to radiation and chemotherapy, so the combined treatment of small cell carcinoma with the correct dosage of cytotoxic drugs can increase the lifespan to 5-7 years.

Predictions for stage 4 small cell lung cancer

At the final stage, malignant cells affect the tissue of the liver and kidneys, bones, penetrate into the brain. This causes severe pain that analgesics cannot cope with. Absolute recovery (without relapse) during the described stage is very rare. The life span of cancer patients with malignant tumors that have spread to the heart or liver is no more than 2 months. With a diagnosis of stage 4 sarcoma, the prognosis does not exceed 8-10% of people's life expectancy within 4-6 years.

According to the total set of factors, the prognosis of recurrence at stage 4 is positive. Compared with other types of lesions with this form of tumor, life expectancy after surgery is very short.

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:

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

Neoplasm less than 3 cm in size (measured in the direction of maximum elongation), located in one segment.
Less than 6 cm, not extending beyond one segment of the lung (bronchus), single metastases in nearby lymph nodes
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.
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 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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