As of 2019, according to the United States National Cancer Institute, the mortality rate from cancer was 158.3 per 100,000 men and women every year in the United States. In 2018, the estimated national cost for cancer treatment was approximately $150.8 billion, and is projected to increase, especially since the population is aging which can lead to a heightened risk of being diagnosed for cancer. However, treatments for cancer are improving, such as for small cell lung cancer (SCLC), a rare form of cancer.
What is SCLC?
SCLC is one of the two main types of lung cancer – the other type is non-small cell lung cancer (NSCLC). According to the American Cancer Society (ACS), SCLC is responsible for approximately 13% of all patients with lung cancer, but is not as prevalent as NSCLC within those patients. Yet, SCLC is aggressive, more so than NSCLC, which allows the cancerous cells to metastasize, or spread, throughout the body, and is usually detected after it has spread, thus making treatment and recovery more difficult. One reason for delayed diagnosis is due to the fact that SCLC is usually asymptomatic, meaning that those with SCLC often do not display any symptoms.
What are symptoms of SCLC?
When symptoms appear, they may appear as the following (but are not limited to): shortness of breath, facial swelling, and loss of appetite. Chest pain or discomfort, persistent coughing or hoarseness of voice, and wheezing may also occur.
What does diagnosis of SCLC look like?
SCLC is diagnosed as one of two stages: limited stage lung cancer, and extensive stage lung cancer. Limited stage indicates that the cancer is confined to one side of the chest, and is small enough that it may need treatment in only one area. On the other hand, the extensive stage is when the SCLC has spread to the other lung, throughout both lungs, or to other parts of the body such as the lymph nodes.
How is SCLC diagnosed?
SCLC can be diagnosed in multiple ways. For example, a variety of imaging tests may be used to determine possible abnormalities in the lungs. For instance, computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans. In addition, a sample of the patient’s mucus may also be taken to determine if SCLC is present. Furthermore, a biopsy (removal of a small piece of tissue) may be conducted on the chest. Additionally, a technique known as bronchoscopy (which uses a thin, lighted tube to observe the airways directly) may also be used.
What factors influence the risk of getting diagnosed with SCLC?
Those who smoke are at an increased risk for SCLC, while those who do not smoke have rarely been found to develop SCLC. The risk for developing SCLC is proportional to the number of years that a patient has been smoking, as well as the amount of cigarettes they smoke per day. Thus, those who have been smoking for years and consume large amounts of cigarettes daily are at the greatest risk for developing SCLC. A popular misconception is that smoking cigarettes that are “low-tar” would decrease the risk of developing SCLC – this is not true as smoking in general causes damage to the lungs. In addition, being exposed to secondhand smoking regularly may also increase the risk of being diagnosed with lung cancer by approximately 30%, according to the American Lung Association (ALA). Furthermore, environmental factors can also influence the risk of being diagnosed with SCLC, such as, but not limited to: diesel exhaust, inhaling radon, inhaling asbestos, and being exposed to outdoor air pollution.
What are current treatment options?
One treatment option is to use surgery to remove the tumor – however, this is generally only performed when the cancer is small and only present in the lung, and the patient is healthy enough to undergo the procedure. Another treatment option is to use radiation, which kills the cancerous cells. Yet, radiation therapy (also known as chemotherapy) can cause numerous side effects, including but not limited to: fatigue, body pain, and loss of appetite. In addition, patients may also undergo immunotherapy, which supports the human immune system in fighting off the cancer.
What is the focus of current research?
Currently, there are clinical trials being conducted in numerous areas. First, targeted antibodies are being investigated as a possible treatment for SCLC. These antibodies specifically target slowing down or stopping the growth of the cancerous cells through the mitosis process (mitosis is the process by which cells grow and divide, and malfunctions during cancer). Another focus is on immunomodulators, which are a class of drugs that are able to influence how the immune system responds to cancerous cells, such as checkpoint inhibitors (these are present in mitosis, and prevent mitosis from occurring if the cell’s deoxyribonucleic acid (DNA) is damaged, for example). Further, adoptive cell therapy is another form of treatment, where immune cells are removed from the body and fortified against cancer, and then re-inserted into the human body to assist the immune system. In addition, cancer vaccines are also being investigated as possibly assisting the body to recognize cancerous cells and their features, thus allowing for a much quicker and larger response should the person have cancer in the future.
Are diagnosis rates improving?
Yes, diagnosis rates have been falling throughout the years due to a decrease in smoking rates. Tobacco is the leading cause for the diagnosis of SCLC because of the damage that is caused to the lungs.
In conclusion, SCLC is one of the two main types of lung cancer, and is an aggressive form of cancer that can metastasize easily. Although its diagnosis is often more during the advanced stages of the cancer, recovery is possible with multiple treatment options available. Currently, ongoing research is investigating multiple innovative solutions, such as immunotherapy, to not only understand this cancer further, but to also improve the quality of life for SCLC patients.
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