Symptoms of Small Cell Lung Cancer

man coughing while doctor checks

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Small cell lung cancer symptoms can be similar to symptoms of other forms of lung cancer, but can also be different in several ways. Usually, unlike non-small cell lung cancers, symptoms are present for only a short while before a diagnosis is made.

Symptoms Related to Location of the Tumor

Small cell lung cancers tend to grow near the central airways of the lungs, and as such, create symptoms early on by irritating the airways or obstructing air flow. They also tend to spread (metastasize) early, and it isn’t uncommon for the first symptoms of small cell lung cancer to be related to its effect on other organs, such as the brain. Some common symptoms include:

Symptoms Due to Spread to the Mediastinum

Small cell lung cancers tend to spread to the area between the lungs (the mediastinum) fairly early on in the course of the disease. When cancer spreads to the mediastinum, it can place pressure on structures in this area, such as:

  • The esophagus: causing difficulty swallowing
  • The trachea (windpipe): causing shortness of breath and a whistling sound while breathing in
  • The heart: sometimes causing fluid to build up in the tissues that line the heart (a pericardial effusion)

Symptoms Related to Superior Vena Cava Syndrome

Small cell lung cancer can also result in symptoms referred to as superior vena cava syndrome (SVC syndrome). When a tumor is present in the mediastinum, it can press on the superior vena cava (the large blood vessel in the chest that returns blood to the heart), causing symptoms such as swelling of the face, neck, and upper chest. SVC syndrome is more common with small cell lung cancers than with some other forms of lung cancer and may be the first symptom of the disease.

Paraneoplastic Syndromes

Small cell lung cancer can also result in a broad variety of symptoms due to paraneoplastic syndromes. In some cases, paraneoplastic symptoms may be the first symptom of lung cancer. Some of these include:

  • Muscle weakness in the upper limbs, vision changes, and difficulty swallowing (Lambert-Eaton myasthenic syndrome)
  • Weakness, fatigue, and a low sodium level in the blood (syndrome of inappropriate antidiuretic hormone secretion (SIADH))
  • Loss of coordination and difficulty speaking (paraneoplastic cerebellar degeneration)
  • Weight gain, high blood pressure, mental changes, and skin changes such as stretch marks on the abdomen and a darkening of the skin (Cushing Syndrome)
  • Clubbing (rounding) of the fingernails

Symptoms When Lung Cancer Spreads

Since small cell lung cancer spreads (metastasizes) early in the course of the disease, the first symptoms may be related to effects cancer has on distant organs. Some of these symptoms may include:

  • Symptoms due to brain metastases: Brain metastases can cause symptoms such as headaches, dizziness, weakness of one side of the body, or speech difficulties (learn more about how lung cancer spreads to the brain)
  • Symptoms due to bone metastasis: Bone metastases can cause symptoms such as back pain and/or compression of the spinal cord causing arm or leg pain (learn more about how lung cancer spreads to bone)
  • Symptoms due to spread to the liver: Liver metastases may result in abdominal pain, itching, and yellowing of the skin (learn more about how lung cancer spreads to the liver)

General Symptoms

Small cell lung cancers can also cause general symptoms of cancer, such as fatigue, loss of appetite, and unexplained weight loss. The syndrome of cancer cachexia, consisting of unintentional weight loss along with muscle wasting, is also far too common and can reduce the quality of life as well as survival.

Bottom Line

The symptoms of small cell lung cancer differ from non-small cell lung cancer in that people rarely look back and realize that they have had symptoms for a long time. The diagnosis of small cell is often made shortly after symptoms arise. And also unlike non-small cell lung cancer, the first symptoms may be neurological, such as headaches, seizures, or weakness related to brain metastases.

Paraneoplastic symptoms are also more common with small cell lung cancer (though they may occur with the type of non-small cell lung cancer known as squamous cell carcinoma). These symptoms can vary tremendously and don't necessarily point at the lungs as the source of the problem. 

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Article Sources

  • American Society of Clinical Oncology. Lung Cancer—Small Cell: Symptoms and Signs. Updated 10/16.