Early stage symptoms of SCLC include a cough that doesn’t get better or worsens over time, coughing up blood, and difficulty breathing. Talk with a doctor if you experience any of these symptoms.

Small cell lung cancer (SCLC) is the rarer of the two main types of lung cancer, with non-small cell lung cancer (NSCLC) being the more common type. SCLC is also the more aggressive cancer and classifies into two types, depending on the characteristics of the tumors.

While smoking is the leading cause of all types of lung cancer, the strongest link is between smoking and SCLC, according to the National Library of Medicine. As smoking rates have declined since the late 1980s, so have the incidence rates for SCLC.

This article discusses the common risk factors for SCLC and the early and late-stage symptoms.

Common risk factors for small cell lung cancer

Most cases of lung cancer are due to smoking, and the link is strongest between smoking and SCLC. But, there are a few other risk factors to know:

smoking cigarettes, pipes, or cigars at any point in your life. But the younger you start smoking, the higher your risk for lung cancer. Your risk also depends on how many years you’ve smoked and how often.
exposure to second-hand smoke
exposure to other chemicals and minerals, such as asbestos, arsenic, chromium, beryllium, nickel, soot, or tar at your place of work
exposure to radiation
living in an area with high levels of air pollution
family history of lung cancer
having human immunodeficiency virus (HIV)
taking beta carotene supplements while also being a heavy smoker
older age
smoking in addition to having other risk factors

What are the early (stage 1) symptoms of small cell lung cancer?

SCLC typically classifies into two stages: limited stage and extensive stage.

Limited stage means the cancer is located only in one lung, and potentially the lymph nodes on the same side of the chest.
Extensive stage means the cancer has spread to the other lung, the lymph nodes on the other side of the chest, distant organs, and in some cases, the fluid around the lung.

According to a 2021 study, only about one third of people diagnosed with SCLC are in the earlier stage of disease — typically with a centrally located tumor in one lung and lymph node involvement. Most people who receive a diagnosis already have lung cancer that has metastasized.

That said, early symptoms of SCLC are usually respiratory, including:

a cough that doesn’t get better or gets worse
difficulty breathing
wheezing
blood in your sputum (coughed up from the lungs)
chest pain or discomfort

What are the later stage symptoms of small cell lung cancer?

Symptoms of extensive stage SCLC depend on the type of tumor and where it has metastasized. The most common areas for metastasis include:

your other lung
your other lymph nodes
your brain
your liver
your adrenal glands
your bones

In addition to the early stage respiratory symptoms, symptoms for extensive stage lung cancer include:

fatigue
lack of appetite
neurological symptoms
fluid in your lungs
bone pain if the cancer has metastasized there
weight loss
general weakness

It’s important to note that for most people diagnosed with SCLC, current treatments will not cure the cancer. However, numerous ongoing clinical trials are being conducted across the country for people with both stages of SCLC.

You can find more information about your treatment options on the NCI website.

What’s the outlook for people with small cell lung cancer?

Survival rates for SCLC depend on the stage, the tumor, and which areas of the body it affects.

The Surveillance, Epidemiology, and End Results (SEER) database, by the National Cancer Institute (NCI), provides 5-year relative survival rates for all types of cancer for people living in the United States. SEER groups stages of cancer in the following way:

Localized: This means the cancer has not spread outside one lung.
Regional: This means the cancer has spread outside the lung to nearby areas, such as the lymph nodes.
Distant: This means the cancer has spread to distant organs, such as the other lung, brain, liver, and bone.

Here are the SEER 5-year relative survival rates based on people diagnosed with SCLC between 2012–2018.

Stage	5-year relative survival rate
Localized	30%
Regional	18%
Distant	3%
All stages combined	7%

What is a relative survival rate?

Relative survival rate gives you an idea of how long someone with a specific condition may live after their diagnosis compared with someone without the condition. For example, a 5-year relative survival rate of 30% means someone with that condition is 30% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. Talk with your doctor about your specific situation.

Takeaway

SCLC is the less common of the two main types of lung cancer. Smoking at some point in your life is almost always the cause.

Early symptoms typically include:

a cough that doesn’t get better or worsens over time
coughing up blood from your lungs
chest discomfort
difficulty breathing

Later symptoms include fatigue, weight loss, and overall weakness.

In most cases, SCLC is not curable, but there are a number of clinical trials investigating promising new treatments.

It’s important to remember that survival rates aren’t the whole picture. Treatments are always advancing, and every person’s health and health history is different.

Symptoms of Small Cell Lung Cancer (SCLC)