Lung Cancer: Symptoms, Diagnosis & Treatments
Lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to histologic type. NSCLC is divided into squamous cell cancers, adenocarcinomas and large cell carcinomas. SCLC is known to be the main cause of smoking, and most of them occur at ages 60-70 with long smoking history. Symptoms are similar to common lung cancer symptoms, such as cough, sputum, dyspnea, and hemoptysis, and paraneoplastic syndromes due to hormone-like substances secreted by cancer cells, which are characteristic of neuroendocrine origin, appear. A typical example is hyponatremia caused by SIADH due to excessive secretion of ADH, which may cause symptoms such as loss of consciousness, neuromuscular junction such as Lambert-Eaton syndrome, and electrolyte abnormalities such as Cushing syndrome, hypokalemia, hypochloremic metabolic alkalosis caused by ectopic ACTH secretion Symptoms may appear. SCLC is more prolonged than NSCLC, and it can grow rapidly over several centimeters within a few days, and it is known that the prognosis is very poor because of its rapid rate of metastasis.
Diagnosis is made primarily through bronchoscopy biopsy, and AP-CT, PET-CT, brain MRI, and bone scan are performed for staging. For SCLC, the stage is divided into two stages, limited or extensive stage. If the cancer is confined to one lung or the lymph node metastasis is localized within the mediastinum, it is called the limited stage. If the cancer is metastasized to the other lung or distant metastasis is found, it is set to extensive stage. Unlike NSCLC, SCLC does not perform surgery except for very early lesions among limited stages, and it is based on chemotherapy. In addition, radiation therapy combined with limited stage has proven to improve the survival rate. In limited stage, 20 ~ 30% of cancer patients survive for more than 5 years and are cured. However, overall prognosis is still worse than other lung cancer because of high recurrence rate. In the extensive stage, chemotherapy is performed for palliative purposes and median survival time is about 9-10 months. If chemotherapy response is good in SCLC, local recurrence in the brain occurs well. In order to prevent this, it is known that the use of whole brain radiation therapy, PCI, is effective in reducing the incidence of brain metastases and prolonging the survival time.
Two-thirds of patients with SCLC are diagnosed with extensive-stage metastasis at the time of diagnosis or with distant metastases, often liver, adrenal glands, bone, and brain. Therefore, systematic scanning with PET-CT should be performed, and staging should be performed by combining AP-CT, bone scan, and brain MRI.
SCLC is a cancer characterized by a rapid proliferation rate and is known to have a very good response to chemotherapy. In the limited stage, chemoradiation therapy is used as a primary treatment modality in combination with radiotherapy to improve the survival rate. Chemotherapy for moderate symptom relief and prolonged survival is performed for palliative treatment in extensive stage. A typical regimen for combination therapy is cisplatin plus etoposide.
Diagnosis is made primarily through bronchoscopy biopsy, and AP-CT, PET-CT, brain MRI, and bone scan are performed for staging. For SCLC, the stage is divided into two stages, limited or extensive stage. If the cancer is confined to one lung or the lymph node metastasis is localized within the mediastinum, it is called the limited stage. If the cancer is metastasized to the other lung or distant metastasis is found, it is set to extensive stage. Unlike NSCLC, SCLC does not perform surgery except for very early lesions among limited stages, and it is based on chemotherapy. In addition, radiation therapy combined with limited stage has proven to improve the survival rate. In limited stage, 20 ~ 30% of cancer patients survive for more than 5 years and are cured. However, overall prognosis is still worse than other lung cancer because of high recurrence rate. In the extensive stage, chemotherapy is performed for palliative purposes and median survival time is about 9-10 months. If chemotherapy response is good in SCLC, local recurrence in the brain occurs well. In order to prevent this, it is known that the use of whole brain radiation therapy, PCI, is effective in reducing the incidence of brain metastases and prolonging the survival time.
Two-thirds of patients with SCLC are diagnosed with extensive-stage metastasis at the time of diagnosis or with distant metastases, often liver, adrenal glands, bone, and brain. Therefore, systematic scanning with PET-CT should be performed, and staging should be performed by combining AP-CT, bone scan, and brain MRI.
SCLC is a cancer characterized by a rapid proliferation rate and is known to have a very good response to chemotherapy. In the limited stage, chemoradiation therapy is used as a primary treatment modality in combination with radiotherapy to improve the survival rate. Chemotherapy for moderate symptom relief and prolonged survival is performed for palliative treatment in extensive stage. A typical regimen for combination therapy is cisplatin plus etoposide.
