Treatment of small cell lung cancer.

Small cell lung cancer is an extremely virulent disease that tends to present at an advanced stage and may secrete multiple hormones and neural markers. In addition to the usual symptoms of advanced lung cancer, it may also present with a paraneoplastic syndrome. Unlike non-small cell lung cancer, small cell lung cancer is nearly always considered a systemic disease at the time of its discovery and, as a result, chemotherapy remains the cornerstone of treatment. Radiation is also used in most cases in which the disease is limited to the chest. Surgery is reserved for the very small subgroup of patients who present with an isolated mass and no evidence of distant or nodal spread. However, for the vast majority of patients who present with advanced disease, death may come as early as several weeks if they are not treated. With appropriate therapy the majority of these patients can expect to achieve remission and a significant prolongation of life. Long-term cures remain rare.