How long can you live with lung cancer and how do you die from it? Small cell lung cancer: an overview of a rare disease Small cell lung cancer stage 4 prognosis

In the structure of oncological diseases, lung cancer is one of the most common pathologies. It is based on malignant degeneration of the epithelium of the lung tissue and impaired air exchange. The disease is characterized by high mortality. The main risk group consists of 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 cancer 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 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, which is associated with rapid tumor growth and widespread metastasis.

Small cell lung cancer

Causes of small cell lung cancer

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

smoking;
radon exposure;
pulmonary asbestosis;
viral infection;
dust exposure.

Clinical manifestations of small cell lung cancer

Symptoms of small cell lung cancer:

a cough of a prolonged nature, or a new cough with changes in the patient’s usual cough;
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 and bones (occurs with bone metastases);
epilepsy attacks;
Lung cancer, stage 4 - speech impairment occurs and severe headaches appear.

Grades of small cell lung cancer

Stage 1 - the tumor size is up to 3 cm in diameter, the tumor has 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 spreads to neighboring organs, its size has increased from 6 to 7 cm, and 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:

headaches;
hoarseness or loss of voice altogether;
general malaise;
loss of appetite and sudden weight loss;
back pain, etc.

Diagnosis of small cell lung cancer

Despite all the clinical examinations, history taking and listening to the lungs, quality is also necessary, 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);
thoracentesis (sampling of fluid from the chest cavity around the lungs);
– the most common method for diagnosing malignant neoplasms. It is carried out in the form of removing a particle of a fragment of the affected tissue for further examination under a microscope.

There are several ways to perform a biopsy:

bronchoscopy in combination with biopsy;
carried out using CT;
endoscopic ultrasound with biopsy;
mediastinoscopy in combination with biopsy;
open lung biopsy;
pleural biopsy;
videothoracoscopy.

Treatment of small cell lung cancer

Chemotherapy occupies the most important place in the treatment of small cell. Without appropriate treatment for lung cancer, the patient dies 5-18 weeks after diagnosis. Polychemotherapy helps to increase the mortality rate to 45–70 weeks. 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 6-12 weeks after the start of therapy, and based on these results, the likelihood of cure and the patient’s life expectancy can be assessed. The most favorable prognosis is for those patients who achieve complete remission. This group includes all patients whose life expectancy exceeds 3 years. If the tumor has decreased by 50%, and there is no metastasis, it is possible to talk about partial remission. Life expectancy is correspondingly shorter than in the first group. For tumors that cannot be treated and are actively progressing, the prognosis is poor.

After a statistical study, the effectiveness of chemotherapy was revealed and is about 70%, while in 20% of cases 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.

Treatment methods used:

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

According to clinical trial statistics, combination treatment compared to 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 rate of 50%.

Ineffective ways to increase your forecast:

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

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

Question about radiation therapy: Many studies show its benefits during 1-2 cycles of chemotherapy. The duration of the course of radiation therapy should not exceed 30-40 days.

Maybeapplication of standard radiation courses:

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

Hyperfractionated thoracic radiotherapy is considered preferable and results in a better prognosis.

Older patients (65-70 years old) tolerate treatment much worse; the treatment prognosis is much worse, since they respond rather poorly to radiochemotherapy, which in turn manifests itself in low effectiveness and major complications. Currently, the optimal therapeutic approach for elderly patients with small cell cancer has not been developed.

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

Extensive stage

The tumor spreads beyond the lung in which it originally appeared.

Standard therapy methods:

combination chemotherapy with or without prophylactic cranial irradiation;
+

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

For limited stage, in case of a positive response to chemotherapy, extensive stage small cell lung cancer, prophylactic cranial irradiation is indicated. The risk of metastases in the central nervous system within 1 year is reduced from 40% to 15%. No significant deterioration in health was detected after PCO.

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

Patients diagnosed with an advanced stage have a deteriorating health status, which complicates aggressive therapy. Clinical studies have not revealed an improvement in survival prognosis when reducing drug doses or switching 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. The prognosis of the disease and how long patients live depends directly on the treatment of lung cancer. A lot depends on the stage of the disease and what type it is. 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 affecting other organs. It is more sensitive to chemical and radiation therapy.

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

Informative video

Small cell lung cancer is a malignant tumor. The disease is accompanied by a general clinical severe course and the formation of metastases. They quickly spread throughout the body and cannot be fully treated. 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 research, 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, doctors' prognosis is disappointing.

The disease does not manifest itself until a tumor forms in the lungs. Tumors cause symptoms that make it very difficult to recognize cancer. Patients complain of hoarse breathing, cough, and chest pain. In the final stages, blood clots appear when coughing. In the most severe cases, when metastases have spread to neighboring organs, signs of cancer may include:
- Headache
- Discomfort when swallowing food
- Back pain
- 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 chest area is performed, followed by an examination of the bone tissue.

Types of small cell lung cancer

Cellular lung cancer is divided into two types:
1. Small cell carcioma. Refers to cancer with a poor prognosis. This form is characterized by extensive metastases and rapid and aggressive development. Combined chemotherapy is the only treatment option for small cell carcioma.
2. Combined small cell carcinoma. It is characterized by the presence of symptoms of squamous cell or oat cell carcinoma, as well as signs of adenocarcioma.
Depending on the type of disease, the doctor determines the necessary treatment regimen. In addition, the patient’s life expectancy depends on the form of development.

Classification

Scientists identify five forms, which differ depending on the location of the tumor.
1. Pneumonia-like cancer. Before contacting an oncologist, he is treated with antibiotics. The neoplasm occupies most of the right or left lung and is not distributed in a node.
2. Atypical forms. These include: brain, bone and liver. They create metastases, but not the tumor itself.
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 disruption of the functioning of internal organs. The initial formation cannot 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 because they suspect another disease. An oncologist is usually contacted in later stages, when the cancer has spread to most of the organ.

Stages
1. Stage 1 lung cancer. The neoplasm reaches 3 cm in diameter. It is located in one lobe of the bronchus. No metastases are observed in neighboring lymph nodes.
2. Multicellular lung cancer stage 2. The tumor grows up to 6 cm. It grows into the pleura, causing loss of airiness and blocking the bronchi.
3. Lung cancer stage 3. The neoplasm spreads to neighboring organs and grows up to 7 cm. Metastases penetrate the lymph nodes.
4. Small cell lung cancer stage 4. Cancer cells attack large blood vessels and the heart. Signs of the disease become more pronounced. Patients most often complain of:
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 complicates the treatment process and significantly reduces the patient’s life expectancy.

Forecast

If lung cancer treatment is not started during treatment, the disease is fatal in 100% of cases. The life expectancy of patients directly depends on the degree of spread of the tumor. The method of treatment is also of particular importance. When a patient refuses therapy, the doctors' prognosis is not encouraging. They live with this 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 tumor shrinks during treatment. When remission occurs within 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 need to quit smoking and undergo examination once a year. You also need to regularly ventilate the apartment, carry out wet cleaning and, if possible, avoid contact with asbestos.

A disease characterized by strong tumor growth and an increase in malignant cells in a person’s lungs, as a rule, implies stage 4 lung cancer and the prognosis for it, unfortunately, is unfavorable. With stage 4 cancer, extensive metastases form, which grow beyond the lungs, affect the lymph nodes, and enter the liver, bone tissue, kidneys, and the human brain. As a result, the bronchial walls are affected, the mucous membrane and blood vessels are destroyed, and chest pains appear more and more often. The pain that occurs in such cases is very closely related to damage to the tissues adjacent to the lungs - oddly enough, the lung tissue itself does not have pain receptors.

The picture of the disease is very pronounced: paroxysmal, hysterical cough with the presence of blood in the sputum. Shortness of breath, angina pectoris develops, and heart rhythm is disturbed.

Prognosis for non-small cell cancer

There are several types of lung cancer, these include:

Non-small cell lung cancer is a malignant tumor formed from epithelial tissue. In 90% of affected men and 80% of women, the disease occurs due to smoking. Currently, there are 3 types of non-small cell cancer:
1. Squamous cell carcinoma is the most common and grows in the tissues of the respiratory tract.
2. Adenocarcinoma occurs in glandular tissues. Often found in people who do not smoke cigarettes and women.
3. Large cell carcinoma (undifferentiated carcinoma) is called cancer because cancer cells are clearly visible under a microscope. This disease can affect different parts of the organ. One in ten people gets sick.
Symptoms of the disease:
- cough;
- difficulty breathing, even without exertion;
- sputum mixed with bloody bodies;
- hoarseness;
- chest pain;
- lack of appetite, fatigue, uncontrolled weight loss;
- violation of the swallowing reflex;
- swelling of the facial part of the body.
The prognosis for stage 4 non-small cell lung cancer is disappointing, since usually the disease already affects both lungs and metastasizes to other organs. 60% of cases are detected very late, the life expectancy of patients for 5 years is no more than 17%. Squamous cell lung cancer arises from flat cells of the bronchial epithelium (which are not normally present).

As a rule, smokers and workers in hazardous industries get cancer.

In addition, a number of other reasons influence the occurrence of squamous cell carcinoma:
1. Dust and air pollution in big cities.
2. Work in a radioactive zone.
3. Frequent diseases of pneumonia, bronchitis, tuberculosis.
The disease is most often detected in people 40-50 years of age, and men are more often affected.
1. The reason for this is:
2. Marginal lifestyle.
3. Poor quality food.
4. Lack of vitamins in food.
5. Heredity.
Signs of the disease:
1. Lethargy and lack of interest in life are often mistaken for another disease.
2. Unreasonable, instant weight loss.
3. Constant low temperature.
The prognosis for stage 4 squamous cell lung cancer is unfavorable - it is incurable, since metastases penetrate almost all internal organs and poisoning of the body begins. The organs necessary for human life cannot cope with their functions and the person fades away.

Prognosis for small cell cancer

Small cell lung cancer stage 4 prognosis: life expectancy without therapy ranges from 6 to 18 weeks. This is the aggressor tumor. The outbreak spreads throughout the body at tremendous speed. The characteristic signs of the disease are the same as with other types of cancer, with the addition of speech impairment and headache attacks.

Has two forms:
1. Small cell carcinoma is often an irreversible process that develops at lightning speed and attacks extensively.
2. Combined small cell carcinoma - includes a type of adenocarcinoma with features of squamous and oat cell carcinoma.
5577

Previously, this type of disease was considered a male disease, but with environmental pollution, increased nervous stress, and cases of smoking among women, it spread to the female part of the population. The main risk group is 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, and the timeliness of the therapy started.

There are four degrees of development of the disease:
1. The malignant formation is 3 cm. Metastasis to other areas is not observed.
2. Blastoma from 3 to 6 cm. Infected particles enter the pleura, pinching the bronchi, and there is a possibility of atelectasis.
3. The neoplasm grows up to 7 cm. Malignant cells grow into nearby lymph nodes. It begins to spread to other organs.
4. Harmful cells create formations 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 must be preceded by a timely surgical operation, which will remove the malignant tumor in time, and properly selected drug treatment.

If your body copes with this difficult task without complications, then the possibility of 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 malignant formation is predominantly detected at the 3rd (approximately 65%) or 4th stage based on the totality of all symptoms that have appeared by this time. At this point, the malignant tumor of the lungs progresses and gives complications to other organs, so the life period, 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 shrink, 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 a constant cough with the release of red-brown sputum due to metastases entering the blood vessels. Chest pain, previously attributed to neuralgia, becomes constant and unbearable. The heartbeat is disturbed, the passage of the esophagus becomes difficult, constant shortness of breath torments, and 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 help, life expectancy ranges from several weeks to 4-6 months.

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

Prognosis for stage 4 small cell lung cancer

At the final stage, malignant cells affect the tissue of the liver and kidneys, bones, and penetrate the brain. This causes severe pain that analgesics cannot cope with. Absolute recovery (without relapses) during the described stage occurs very rarely. The lifespan 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 for 4-6 years.

Based on the totality of factors, the prognosis for recurrence at stage 4 is positive. Compared to other types of tumors affected by this form of tumor, life expectancy after surgery is very short.

In oncological practice, such a terrible disease as small cell lung cancer is often encountered. Any form of cancer poses a potential threat to the life of the sick person. The disease is often discovered accidentally during an X-ray examination. What are the causes, symptoms and treatments for this form of lung cancer?

Development of small cell lung cancer

Small cell lung cancer is a tumor characterized by a malignant course. The prognosis is unfavorable. This histological type of cancer is diagnosed less frequently than others (adenocarcinoma, squamous cell and large cell carcinoma). It accounts for up to 20% of all cases of this pathology. The risk group includes actively smoking men.

The peak incidence occurs between 40 and 60 years of age. Females are less susceptible to this disease. Initially, the large bronchi are affected. This form is called central cancer. As the disease progresses, the mediastinal and bronchopulmonary lymph nodes become involved. The peculiarity of this form of the disease is that regional metastases are detected already in the early stages.

Clinical forms and stages

The stage of cancer is of great importance when making a diagnosis. The health prognosis depends on when the patient sought medical help. There are 4 stages of cancer. At stage 1, a neoplasm up to 3 cm in size without metastatic foci is detected. The process involves the pulmonary segment or segmental bronchus. The disease is almost never detected at stage 1. An increase in tumor up to 6 cm with single metastatic foci indicates stage 2 of the disease.

Stage 3 is different in that neighboring bronchi, the main bronchus or an adjacent lobe of the organ are affected. At this stage, the lymph nodes located near the tracheal bifurcation and the tracheobronchial nodes are often affected. If stage 4 is detected, the prognosis for life worsens sharply, since it has distant metastases, which cannot be eliminated even with the help of surgery and radiation therapy. In 6 out of 10 people, cancer is detected at stages 3 and 4.

There are 2 types of small cell cancer: oat cell and pleomorphic. The first develops most often. This form of the disease is characterized by increased production of adrenocorticotropic hormone and the development of Cushing's syndrome. Outwardly, this practically does not appear. In oat cell carcinoma, histological examination of lung tissue reveals spindle cells. They have round kernels. Mixed forms are less commonly diagnosed, when there is a combination of signs of small cell cancer and adenocarcinoma.

Why does a tumor start to grow?

The following are the causes of lung cancer in humans:
- smoking;
- burdened heredity;
- prolonged contact with carcinogens (arsenic, asbestos, chromium, nickel);
- presence of pulmonary tuberculosis;
- nonspecific lung diseases;
- exposure to ionizing radiation;
- bad environment.
Risk factors include advanced age, long smoking history, and living together with smokers. The most important factor is nicotine addiction. Many people start smoking in childhood and adolescence and cannot stop. Smoking leads to addiction. People who smoke are 16 times more likely to get sick.

An aggravating factor is the age at which smoking began. The earlier a person starts smoking, the higher the likelihood of developing small cell lung cancer. This disease often develops in people with occupational hazards. This pathology often develops in welders and people in contact with asbestos and various metals (nickel). The condition of the lungs is influenced by the composition of the surrounding air. Living in polluted areas increases the risk of developing pulmonary pathology.

How to recognize small cell cancer

Symptoms of the disease depend on the stage. Cancer manifests itself with the following symptoms:
- cough;
- change in voice (dysphonia);
- swallowing disorders;
- weight loss;
- general malaise;
- weakness;
- chest pain;
- shortness of breath;
- pain in the bones.
The cough gradually gets worse. It becomes paroxysmal, constant and productive. Blood streaks are found in the sputum. Central small cell carcinoma is characterized by noisy breathing and hemoptysis. In later stages, body temperature rises. The development of obstructive pneumonia is possible.

Dysphagia and hoarseness are observed when the trachea and laryngeal nerve are compressed. Patients have a decreased appetite, as a result of which they quickly lose weight. A common symptom of cancer is superior vena cava syndrome. It is manifested by swelling of the face and neck, shortness of breath, and cough. If other organs are affected, severe headaches, enlarged liver, and development of jaundice may occur. Manifestations of small cell carcinoma include Cushing's syndrome and Lambert-Eaton syndrome.

Examination and treatment plan

Treatment is prescribed by a doctor after detecting a tumor and determining the stage of cancer. The following studies are required:
- X-ray of the chest organs;
- tomography;
- biopsy;
- examination of the bronchi endoscopically;
- general blood and urine analysis;
- pleural puncture;
- sputum analysis for the presence of Mycobacterium tuberculosis.
If necessary, thoracoscopy is organized. The life expectancy of patients depends on the condition of other organs. Surgical treatment is effective at stages 1 and 2. Chemotherapy is required after surgery. Experienced doctors know how long such patients live.

With stages 1 and 2 of cancer and adequate treatment, the five-year survival rate does not exceed 40%.

Video recording of a scientific report on small cell lung cancer:

In stages 3 and 4, chemotherapy is combined with radiation. Cytostatics are used (Methotrexate, Cyclophosphamide, Vincristine, Cisplatin). To protect the brain, irradiation can be performed for preventive purposes. Thus, the main method of fighting cancer is to quit smoking or introduce a government ban on the sale of tobacco products.
We recommend reading