2007 PATIENT CARE EVALUATION

SMALL CELL CARCINOMA

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer death in the US. The American Cancer Society estimates 213,380 new lung cancer cases and 160,390 death for both men and woman in 2007. Since 1987, more women have died each year of lung cancer than from breast cancer.  Estimated cancer death for women in 2007 is 70,880 vs 40,460 breast cancer death. 

The Cancer Committee decided to review Small Cell Lung Cancer from 1987 – 2006,

 for age, sex, staging, treatment distribution, and survival information. A total of 378 analytic cases were identified for data analysis. The numbers have been stable over the years.

 The majority of the patients were diagnosed and treated at SAH (69.15%)

Gender was evenly distributed 49.47% males (187) and 50.53% (191) females.

 Race distribution accounted for 93% (352) Caucasians and 7% (25) African American (NCDB was 88% White and 7% African American).

 Most of the 378 patients were diagnosed between the ages of 60 and 79.

Over 50% of patients reported a use of tobacco products and 38.6% reported a previous use.  Only 3.7% were non-smokers at the time of diagnosis. 

TNM  Stage -  Small Cell Carcinoma of the lung (SCL) behaves differently from the other types of lung cancer.  In comparison to other types of lung cancer, small cell is a more rapid growing, and spreading form of cancer.  This makes it more likely to metastasize and present in more advanced stages.  Overall, only 9.30% of the cases reviewed by the Cancer Committee presented with localized disease.

With modern chemo/radiation, survival in limited stage disease is 12-18 months median and for advanced stage, 6-9 months.  Our data are comparable with national data.

Treatment options are determined by stage of cancer at the time of presentation.  Because the disease has usually spread by the time it is discovered, chemo/radiation is the most effective treatment.

In conclusion, despite advances in management lung cancer remains the biggest cancer killer and the greatest impact on reducing this may come from prevention (e.g. smoking cessation). The role of screening is under investigation e.g. spiral CT lung scans, but the Mayo trial of 1,520 smokers found nodules in 70% with only 1.4% of these malignant. The incidence, stage and survival of these patients treated at SAH compares favorably with national data, particularly in view of the older age groups. The oncology committee will continue to monitor our experience with this disease and promote appropriate management as described by the NCCN (National Comprehensive Cancer Network) guidelines.