Symptoms
1.Small cell lung cancer may not have any symptoms in early stage!
2.The common symptoms at partial diagnosis are weakness (80%), cough (70%), shortness of breath (60%), weight loss (55%), pain (40-50%), hemoptysis (25%).
I. Symptoms and signs caused by primary tumor
(a) Cough: It is a common early symptom, mostly irritating dry cough. When tumor causes bronchial stenosis, persistent, high-pitched metallic sound cough may appear. The cough is mostly accompanied by a small amount of mucus sputum, which may be combined with pus sputum when secondary infection occurs.
(II) Coughing up blood: mostly blood in sputum or intermittent blood sputum, a few of them have big coughing up blood due to erosion of large blood vessels.
(C) Chest tightness and shortness of breath: the tumor causes narrowing of trachea, or the tumor metastasizes to hilar or mediastinal lymph nodes, and the enlarged lymph nodes compress the main bronchus or tracheal bulge.
Symptoms and signs caused by the expansion of tumor in the chest cavity
(a) Chest pain: The tumor directly invades the pleura, ribs or chest wall, causing chest pain of different degrees. If the tumor invades the pleura, it will produce irregular dull pain or hidden pain. If the tumor compresses the intercostal nerve, the chest pain may involve its distribution area.
(2) Superior vena cava syndrome: It is mostly caused by compression of superior vena cava or less common obstruction of intracavernous tumor embolus, manifesting as facial, neck and upper limb edema, jugular vein anger, anterior thoracic bruising and varicose veins, which may be accompanied by dizziness, headache and headache.
(iii) Difficulty in swallowing: The tumor invades or compresses the esophagus, causing difficulty in swallowing.
(iv) Choking and coughing: tracheoesophageal fistula or laryngeal nerve paralysis causes choking and coughing when drinking water or eating liquid food.
(v) Hoarseness: It occurs when the tumor directly presses or metastasizes to lymph nodes pressing the laryngeal nerve (mostly on the left side).
(vi) Horner syndrome: Lung cancer located in the upper lung tip is called supraglottic sulcus (Pancoast carcinoma), when it compresses the sympathetic nerve stem of cervical 8 and thoracic 1, the typical Horner syndrome appears, with droopy eyelid, narrow pupil, sunken eyeball, no or little sweating on the ipsilateral face and chest wall; invasion of the brachial plexus causes local pain and restriction of shoulder joint movement, called Pancoast syndrome. syndrome.
(7) Pulmonary infection: Inflammation caused by tumor obstruction of airway, which can occur repeatedly in the same area, also called obstructive pneumonia.
Symptoms and signs caused by extra-pulmonary metastasis of tumor
(a) Metastasis to lymph nodes: supraclavicular lymph node metastasis is mostly fixed, hard, gradually increasing, increasing and fusing, mostly without pain.
(ii) Metastasis to pleura: causes chest pain and pleural effusion, which is mostly bloody.
(iii) Metastasis to bone: it mostly passes insidiously, and only 1/3 have local symptoms, such as pain and pathological fracture. When metastases to the spine compress the spinal nerve roots, the pain is persistent and worsens at night. Intraspinal metastases can rapidly develop irreversible paraplegia syndrome within a short period of time.
(iv) Metastasis to the brain: Cranial hypertension may occur due to edema of the intracranial lesion, resulting in headache, nausea, and vomiting. It may also lead to diplopia, ataxia, cranial nerve palsy, weakness of one limb or even hemiparesis due to the occupying effect.
(v) Metastasis to the pericardium: pericardial effusion and even pericardial compression may appear, dyspnea, which is obvious when lying down, jugular venous anger, decreased blood pressure, reduced pulse pressure difference, body circulation stasis, and decreased urine output.
(e) Metastasis to adrenal gland, liver and other parts of the body, causing local peripheral organ dysfunction.
Extra-pulmonary manifestations of tumor and systemic symptoms: Extra-pulmonary manifestations of tumor include non-specific systemic symptoms, such as fatigue, anorexia, weight loss.
It also includes paraneoplastic syndrome, the common ones are as follows.
(i) Carcinoid syndrome: asthma-like dyspnea, paroxysmal tachycardia, watery diarrhea and skin flushing due to excessive secretion of 5-hydroxytryptamine.
(ii) Eaton-Lambert syndrome: i.e., tumor-induced neuromuscular syndrome, including cerebellar cortical degeneration, spinal cord degeneration, peripheral neuropathy, myasthenia gravis, and myopathy.
(iii) Syndrome of inappropriate antiduretic hormone secretion (SIADHS): manifests as dilutional hyponatremia, poor appetite, nausea, vomiting, weakness, drowsiness, and even disorientation.
(iv) Hypertrophic pulmonary osteoarthropathy: mostly invades the distal ends of the long bones of the upper and lower extremities, pestle and mortar fingers, painful finger ends, hypertrophic osteoarthropathy .
(e) Cushing syndrome: the tumor secretes adrenocorticotropic hormone-like substances, fat redistribution, etc.
Disease prognosis
1.The average survival of limited stage is 12-20 months, and the 5-year survival rate is 10-20%;
2. The average survival in the extensive stage is 7-12 months, with a 5-year survival rate of less than 2%.