Surgery is usually a treatment option in patients with small cell lung cancer. Most often the diagnosis is made at late stages when surgery is no longer possible, even if the disease is diagnosed in earlier stages, surgery may not be considered as a treatment option, because small cell lung cancer tend to spread to distant organs early in the course of the disease. However if the tumor is localized to the periphery of the lung and is small, surgery may be considered after an extensive work-up done to detect metastatic disease yields negative results. This work-up should
include, CT scan of the chest, abdomen, bone scan, MRI of the brain, bone marrow biopsy, and sampling and biopsy of the mediastinal nodes. Patient with small cell lung cancer, who undergoes surgery should receive adjuvant chemotherapy (preventive chemotherapy) because of inherent high risk of distant metastatic disease associated with this disease. Patients with small cell lung cancer who presents with a single small lung lesion may have 70 percent chance of 5-year survival after surgical removal of the tumor and adjuvant chemotherapy.