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Small cell lung cancer



Small cell lung cancer is one of the most lethal and, without chemotherapy, fulminant types of cancer. From 15% to 25% of all lung cancers occur because of this cause. This disease can be derived from any cell in the epithelium, for example from the reserve cells. Usually the same treatment as treatment of non small cell lung cancer is used to cure the patients, so it is not viewed in this report.

As it was said earlier 20% of all lung cancers are caused by small cell lung carcinoma (SCLC). 30,000-35,000 cases are recorded each year. It is essential to understand the histologic difference between non-small cell lung cancer and small cell lung cancer. The distinctions between these two groups are not only in treatment but also in prognosis. On the whole the main difference is that SCLC is more aggressive, lethal and spreads all over the body much sooner. Some researches show that 60-70% of cases of small cell lung cancer start to spread on a very early stage of initial diagnosis. At the same time small cell lung cancer seems to be more responsive to chest radiotherapy and chemotherapy. These two types of therapies are the main kind of treatment and usually it is not based upon the surgery.

Main stages of Small cell lung carcinoma (SCLC):

The current classification of subtypes of small cell lung cancer are:

  • small cell carcinoma
  • mixed small cell/large cell carcinoma
  • combined small cell carcinoma (small cell lung cancer combined with neoplastic squamous and/or glandular components

A far as there is a big difference in treatment of non-small cell lung cancer and small cell lung cancer, it is very important to diagnose the correct type. Examination of tissue and pathology always help to distinguish these two deceases.

It goes without saying that the main risk factor of the appearance of small cell lung carcinoma is smoking.

Small cell lung cancer, squamous cell carcinoma, and adenocarcinoma are three main types of lung cancer in smokers. 30% of all cases of lung cancers in mail smokers and 40% of cases of lung cancers in female smokers are caused by adenocarcinoma. In nonsmokers adenocarcinoma is a cause of lung cancer in 60% to 80% of cases. The percentage is mostly the same among long-term quitters. If to talk about squamous cell carcinoma the percentage of cases among long-term quitters decreases. The probability of appearance the small cell lung cancer is reduced in linear proportion to the number of years since quitting.

In the Asian racial group the appearance frequency of adenocarcinoma in nonsmokers is similar to that in smokers. But it is necessary to take into consideration that the rate of lung adenocarcinoma is lower in Western populations than in Asian. In Hong Kong Chinese women is the main target of lung adenocarcinoma. In Koreans the rate of adenocarcinoma in both smokers and nonsmokers increases in both sexes. Adenocarcinoma is more widespread among white and black women than squamous cell carcinoma according to the National Cancer Institute (NCI). In men adenocarcinoma can be found more often than squamous cell carcinoma.

Treatment of SCLS

A major quantity of clinical trials directed to the treatment of non-small cell lung cancer. But it is important to notice that this kind of treatment can be used for small cell cancer, that's why gene therapies like Iressa are expected to be tested on small cell patients together with chemotherapy and radiation.

Chemotherapy options

  • cyclophosphamide + doxorubicin + vincristine
  • cyclophosphamide + doxorubicin + etopiside
  • etopiside + cisplatin or carboplatin
  • ifosfamide + carboplatin + etopiside

Certainly there are other combinations of treatments and drugs that can be used to help patients all over the world.

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