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Small cell lung cancer

Last reviewed: 5 Oct 2024
Last updated: 01 Oct 2024

Summary

Definition

History and exam

Key diagnostic factors

  • cough
  • dyspnea
  • hemoptysis
  • chest pain
  • weight loss
Full details

Other diagnostic factors

  • age 65 to 74 years
  • male sex
  • fatigue
  • pulmonary exam abnormalities
  • hoarseness
  • confusion
  • personality changes
  • nausea and vomiting
  • headache
  • dysphagia
  • bone pain and/or fractures
  • seizures
  • cervical or supraclavicular adenopathy
  • facial swelling
  • dilated neck or chest/abdominal wall veins
  • finger clubbing
  • hypertrophic osteoarthropathy
Full details

Risk factors

  • cigarette smoking
  • environmental tobacco exposure
  • radon gas exposure
  • asbestos exposure
Full details

Diagnostic tests

1st tests to order

  • chest x-ray
  • CT chest, liver, and adrenal glands
Full details

Tests to consider

  • bronchoscopy
  • biopsy
  • thoracentesis
  • thoracoscopy
  • MRI or CT of brain
  • bone scan
  • mediastinoscopy
  • positron emission tomography (PET)
  • bone marrow aspirate and biopsy
  • CBC
  • LFTs
  • serum sodium
  • renal function
  • lung function tests
Full details

Treatment algorithm

ACUTE

at initial presentation: limited disease

at initial presentation: extensive disease

ONGOING

relapse within 6 months

relapse after 6 months

Contributors

Authors

Catherine B. Meador, MD, PhD

Attending Physician

Center for Thoracic Cancers

Instructor in Medicine

Harvard Medical School

Massachusetts General Hospital

Boston

MA

Disclosures

CBM declares that she has no competing interests.

Acknowledgements

Dr Catherine B. Meador would like to gratefully acknowledge Dr Leena Gandhi, Dr Alvin R. Cabrera, Dr Christopher R. Kelsey, Dr Lawrence B. Marks, and Dr Rebecca Suk Heist, previous contributors to this topic.

Disclosures

LG, ARC, CRK, and LBM declare that they have no competing interests. RSH has received honoraria for consulting from Novartis, Abbvie, Daichii Sankyo, and EMD Serono. RSH's institution (not RSH) has received research funding from Agios, Abbvie, Exelixis, Daichii Sankyo, Novartis, Lilly, Mirati, Corvus, Incyte, and Genentech Roche.

Peer reviewers

Alan Neville, MD

Professor

Assistant Dean

Undergraduate Program

McMaster University

Hamilton

Ontario

Canada

Disclosures

AN declares that he has no competing interests.

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