Symptoms:

• Cough
• Bloody sputum
• Shortness of breath
• Wheezing
• Chest pain
• Loss of appetite
• Weight loss

Additional symptoms that may be associated with this disease:

• Weakness
• Swallowing difficulty
• Nail abnormalities
• Hoarseness or changing voice
• Fever
• Facial swelling

Signs and tests:

The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.

When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.

Small cell lung cancer has usually spread by the time it is diagnosed.

Tests that may be performed include:

• Chest x-ray
• CBC
• Sputum test
• Bone scan
• CT scan
• MRI
• Positron emission tomography (PET) scan
• Thoracentesis

In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

• Bronchoscopy combined with biopsy
• Pleural biopsy
• CT scan directed needle biopsy
• Mediastinoscopy with biopsy
• Open lung biopsy
• Endoscopic esophageal ultrasound (EUS) with biopsy

Usually, if a biopsy reveals cancer, more imaging tests are done to find out the stage of the cancer. (Stage means how big the tumor is and how far it's spread.) However, the traditional staging system, which uses numbers to tell how bad the cancer is, is usually not used for patients with SCLC. Instead, SCLC is grouped as either:

• Limited (cancer is only in the chest)
• Extensive (cancer has spread outside the chest)

Most cases are extensive.