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Home » What are Neuroendocrine Cancers?​ » Small Cell Neuroendocrine Carcinoma

Small Cell Neuroendocrine Carcinoma

Small Cell Neuroendocrine Carcinoma (SCNC) is a rare and aggressive form of cancer that impacts many individuals worldwide, including thousands of Australians. SCNC originates from neuroendocrine cells, specialised cells found in various parts of the body responsible for hormone production. These tumours are known for their rapid growth and metastatic potential, making them a challenge for the medical community.

In Australia, SCNC affects a small but notable portion of cancer patients. While it is considered a rare malignancy, the impact of this aggressive cancer on Australians and their families can be significant. Early detection, accurate diagnosis, and access to advanced treatment options are crucial in addressing the challenges associated with SCNC in Australia, and ongoing research and medical advancements offer hope for improved outcomes and support for those affected by this rare disease.

NeuroEndocrine Cancer Australia is dedicated to the advocacy of patients affected by Small Cell Neuroendocrine Carcinoma, as well as other kinds of neuroendocrine cancer. If you have specific questions related to your condition, you can give our specialised NET cancer nurse a call.

What is Small Cell Neuroendocrine Carcinoma?

Small Cell Neuroendocrine Carcinoma (SCNC) is a rare and highly aggressive form of cancer that falls under the broader category of Neuroendocrine Tumours (NETs). This malignancy originates from neuroendocrine cells, which are specialised cells distributed throughout the body. 

These cells have the unique ability to produce hormones, and NETs can develop in various organs and systems. Small Cell Neuroendocrine Carcinoma is known for its swift progression and metastatic potential, making it a significant concern in the field of oncology.

Small Cell Neuroendocrine Carcinoma in the context of Neuroendocrine Tumours (NETs)

To fully understand Small Cell Neuroendocrine Carcinoma, we should consider its place within the broader context of Neuroendocrine Tumours (NETs). NETs are a diverse group of neoplasms that arise from neuroendocrine cells, which are distributed in different parts of the body. These neuroendocrine cells play a vital role in regulating hormonal balance and have unique characteristics that set NETs apart from other types of cancer.

While NETs, in general, are known for their relatively slow growth, Small Cell Neuroendocrine Carcinoma stands out as an aggressive subtype, primarily due to its rapid proliferation and high propensity for metastasis.

Causes and Risk Factors of Small Cell Neuroendocrine Carcinoma

Understanding the causes and risk factors associated with Small Cell Neuroendocrine Carcinoma is critical for early detection, prevention, and tailored treatment strategies. While the precise origins of SCNC are not fully understood at present, several contributing factors have been identified.

Origins and common factors of Small Cell Neuroendocrine Carcinoma

Small Cell Neuroendocrine Carcinoma can originate in several locations within the body. While lung SCNC is the most commonly observed form, it can also manifest in the gastrointestinal tract and, notably, in gynaecological organs. 

The exact mechanisms that trigger SCNC development are not entirely understood, but it is believed to result from genetic mutations in neuroendocrine cells. These mutations can lead to uncontrolled growth and tumour formation.

Genetic and lifestyle influences

Genetic predisposition can significantly impact an individual’s susceptibility to Small Cell Neuroendocrine Carcinoma, and these genetic factors highlight the importance of genetic counselling and early detection for at-risk individuals. 

Lifestyle choices

Lifestyle choices also play a significant role in influencing the likelihood of SCNC. For example, smoking is a well-established risk factor for lung SCNC. The harmful carcinogens present in tobacco smoke can damage lung tissue, particularly neuroendocrine cells, contributing to tumour development. Reducing or quitting smoking is a crucial preventive measure in lowering the risk of SCNC.

Symptoms of Small Cell Neuroendocrine Carcinoma

Recognising the symptoms of Small Cell Neuroendocrine Carcinoma is pivotal for early diagnosis and prompt intervention. The symptoms associated with SCNC can vary depending on the tumour’s location, size, and stage of development.

Lung Small Cell Neuroendocrine Carcinoma symptoms

In the context of lung Small Cell Neuroendocrine Carcinoma, patients may experience symptoms such as:

  • Persistent cough: A dry or productive cough that persists and may be accompanied by blood-tinged sputum.
  • Shortness of breath: Difficulty breathing, particularly during physical activity.
  • Chest pain: Discomfort or pain in the chest region.
  • Wheezing: Audible high-pitched whistling sounds during breathing.
  • Fatigue: Unusual and extreme tiredness.
  • Unintended weight loss: A noticeable drop in body weight without a clear cause.
  • Loss of appetite: A reduced desire to eat.
  • Hoarseness: Changes in voice, including persistent hoarseness.

Gastrointestinal Small Cell Neuroendocrine Carcinoma symptoms

For Small Cell Neuroendocrine Carcinoma located in the gastrointestinal tract, common symptoms may include:

  • Abdominal pain: Ongoing and unexplained discomfort in the abdominal area.
  • Altered bowel habits: Persistent diarrhoea or constipation that extends over a prolonged period.
  • Gastrointestinal bleeding: This can lead to anaemia due to a significant loss of blood.
  • Fatigue: A general sense of weariness and weakness.
  • Unexplained weight loss: A substantial decrease in body weight without a clear cause.

Gynaecological Small Cell Neuroendocrine Carcinoma

In the case of gynaecological Small Cell Neuroendocrine Carcinoma, patients may experience specific symptoms, including:

  • Vaginal bleeding: Irregular or heavy vaginal bleeding, often unrelated to the menstrual cycle.
  • Pelvic pain: Persistent and unexplained pain in the pelvic region.
  • Altered menstrual patterns: Changes in the regular menstrual cycle or its cessation.
  • Discomfort during intercourse: Pain or discomfort experienced during sexual activity.
  • Abdominal discomfort: Ongoing pain or discomfort in the abdominal area.

It must be noted that symptoms can differ from person to person, and not all individuals with Small Cell Neuroendocrine Carcinoma will exhibit the same signs. Early detection and prompt diagnosis are critical for effective management and treatment of this aggressive form of cancer.

Diagnosis process for Small Cell Neuroendocrine Carcinoma

Diagnosing Small Cell Neuroendocrine Carcinoma (SCNC) is a complex process that requires a combination of medical expertise and diagnostic tests to identify the presence of the disease and determine its stage.

Diagnostic tests and tools

To accurately diagnose Small Cell Neuroendocrine Carcinoma, healthcare professionals employ various diagnostic tests and tools, each serving a unique purpose in the diagnostic process.

Imaging Studies

CT Scan (Computed Tomography): CT scans provide detailed cross-sectional images of the body, allowing doctors to visualise the presence, location, and size of tumours. They are particularly useful in detecting lung and abdominal SCNC.

Chest X-Ray (CXR): is an imaging test that uses X-rays to look at the structures and organs in your chest.

Biopsy

A tissue biopsy is often necessary to confirm the presence of Small Cell Neuroendocrine Carcinoma definitively. During a biopsy, a small sample of tissue is collected and examined under a microscope. The biopsy helps determine the type of cancer, its grade, and its specific characteristics, which are essential for tailoring treatment plans.

Blood tests

Certain blood markers can be elevated in SCNC, such as chromogranin A (CgA). These markers can be indicative of the disease’s presence, but they are not specific to SCNC and are often used in conjunction with other diagnostic methods.

Bronchoscopy

Bronchoscopy is a procedure used to examine the airways and lung tissue. It can help detect SCNC in the lungs and obtain tissue samples for biopsy.

Endoscopy

In cases of gastrointestinal SCNC, endoscopy may be performed. This procedure allows for direct visualisation of the gastrointestinal tract and the collection of tissue samples for biopsy.

PET/CT (Positron Emission Tomography/Computed Tomography)

PET/CT scans involve the injection of a radioactive substance that is absorbed more by cancer cells. It can help identify the extent and location of cancer, including any metastases.

  • 18 – FDG PET / CT: utilises a radioisotope tracer that is an analogue to glucose, called fluorodeoxyglucose (FDG). FDG accumulates within malignant cells because of their high rate of glucose metabolism
  • Gallium-68 DOTATATE (or Ga-68 DOTATATE) is a PET radiotracer that is a form of somatostatin-receptor (SSTR) functional imaging. It is most commonly used for evaluating primary and metastatic well-differentiated neuroendocrine tumours

Pathological examination

Pathologists analyse tissue samples from biopsies to assess the extent of malignancy, cell type, and proliferation rate. This information aids in determining the stage of the disease.

Treatment for Small Cell Neuroendocrine Carcinoma

Treatment for Small Cell Neuroendocrine Carcinoma depends on the cancer’s stage, location, and the overall health of the patient. The goal of treatment is to control the disease, alleviate symptoms, and improve the patient’s quality of life.

Surgery

Surgical resection is a primary treatment for localised SCNC. The extent of surgery depends on the tumour’s size and location. In lung SCNC, for instance, a lobectomy or pneumonectomy may be necessary, while in gastrointestinal SCNC, partial or total removal of the affected organ may be performed. Surgery aims to remove as much of the tumour as possible while preserving organ function.

Drug treatments

Small Cell Neuroendocrine Carcinoma often responds well to chemotherapy, which involves the use of powerful medications to target and destroy cancer cells. Chemotherapy may be used as an adjuvant treatment following surgery or as the primary treatment in cases where the disease has spread extensively. Additionally, targeted therapies that focus on specific molecules involved in tumour growth, such as immunotherapy, may be considered in some cases. Immunotherapy is currently only available in clinical trials in Australia.

Radiation therapy

Radiation therapy uses high-energy X-rays or other particles to target and kill cancer cells. It can be used alongside surgery and chemotherapy to enhance treatment effectiveness. For patients with inoperable tumours or those who cannot undergo surgery, radiation therapy can provide a valuable treatment option.

Treatment side effects

The long-term effects of treatment for SCNC can also vary. Some patients may experience treatment-related side effects, such as fatigue, nausea, and immunosuppression (decreased blood counts in particular white blood cells as a result of chemotherapy). Regular follow-up appointments with healthcare providers are essential to monitor the patient’s progress and manage any potential complications.

Exact treatment for SCNC patients will vary greatly from person to person. It’s best to talk to your healthcare team if you have any specific questions about your treatment plan.

Small Cell Neuroendocrine Carcinoma life expectancy

Life expectancy for individuals with Small Cell Neuroendocrine Carcinoma can vary widely depending on several factors, including the stage at which the cancer is diagnosed, the location of the tumour, the effectiveness of treatment, and the overall health of the patient.

The aggressive nature of Small Cell Neuroendocrine Carcinoma means that it often presents at an advanced stage. In such cases, while treatment can effectively control the disease, the likelihood of a complete cure may be lower. Consequently, individuals diagnosed with SCNC must work closely with their healthcare team to determine the most suitable treatment approach.

While survival rates can vary, advancements in cancer research and the development of more targeted therapies offer hope for improved outcomes in the future. Additionally, clinical trials are continuously exploring innovative treatments and diagnostic methods to enhance the prognosis for SCLC patients.

Resources and support for SCNS patients

Receiving a diagnosis of Small Cell Neuroendocrine Carcinoma can be emotionally and physically challenging. Patients and their loved ones may find it helpful to seek support and information from various resources:

Educational materials: NECA produces numerous brochures and educational materials, all available via our website to provide information about SCNC, its treatment, and supportive care. These resources can help individuals make informed decisions about their care.

Cancer support groups: Many cancer support groups, both in-person and online, provide a platform for individuals to connect with others who have experienced similar challenges. Sharing experiences and advice can be comforting and informative.

Mental health services: A cancer diagnosis can take a toll on one’s mental well-being. Professional counselling and support services can assist patients and their families in coping with the emotional aspects of the disease.

NeuroEndocrine Cancer Australia (NECA) is an advocacy organisation dedicated to supporting patients with NETs, including SCNC. We have a dedicated NET cancer nurse helpline available to talk to NET patients, their families, and provide information.

Future research and treatments for SCNC

The future outlook for Small Cell Neuroendocrine Carcinoma is promising, thanks to ongoing research and innovative treatments. Scientists and clinicians are working tirelessly to enhance our understanding of the disease and develop more effective therapeutic approaches.

Here are some of the most exciting:

  • Research advances: Ongoing research is shedding light on the genetic and molecular mechanisms behind SCNC, leading to the development of new targeted therapies.
  • Immunotherapy: this groundbreaking treatment currently in clinical trials, involves harnessing the body’s immune system to recognise and attack cancer cells.
  • Early detection: Researchers are working on developing more sensitive and specific diagnostic tests to facilitate early detection and intervention.
  • Personalised medicine: By tailoring therapies to an individual’s unique genetic and molecular makeup, treatment efficacy may be significantly enhanced.

Small Cell Neuroendocrine Carcinoma, a subset of Neuroendocrine Tumours, is a rare and aggressive cancer that can affect various parts of the body, with lung, gastrointestinal, and gynaecological locations being notable. The diagnosis and treatment of Small Cell Neuroendocrine Carcinoma involve a multi-faceted approach, with various diagnostic tests and treatment options available. Life expectancy for individuals with SCNC can vary, but ongoing research and evolving treatments provide hope for improved outcomes. 

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