Lymph nodes act as a filtering system outside the lung, collecting cancer cells that are beginning to migrate out of the lung. Distant: the cancer has spread (or metastasized) to other parts of the body (aka: extensive stage SCLC).At the time of diagnosis, 60–70% of people already have metastases.Small-cell carcinoma is an undifferentiated neoplasm composed of primitive-appearing cells. As the name implies, the cells in small-cell carcinomas are smaller than normal cells, and barely have room for any cytoplasm. Some researchers identify this as a failure in the mechanism that controls the size of the cells. Treatment
Small-cell lung cancer is most commonly treated with a combination of two drugs, which is more effective than one drug alone. Chemotherapy
Cisplatin and etoposide,
Carboplatin and etoposide. Cisplatin-resistance
The drug paclitaxel may be useful in the treatment of cisplatin-resistant cancer. About 68.1% of cisplatin-resistant cells
appear to be sensitive to paclitaxel and 66.7% of paclitaxel-resistant cells to
cisplatin. The mechanism for this activity is unknown. Paclitaxel-based chemotherapy showed modest activity in SCLC patients refractory to both etoposide- and camptothecin-based chemotherapy. The newer agent lurbinectedin is active in relapsed SCLC and was approved for medical use in the United States in June 2020. Immunotherapy
In 2018, the FDA approved two immunotherapies for small cell lung cancer:
1. Nivolumab (Opdivo), and
2. Atezolizumab (Tecentriq)

Funding controversy
Tecentriq treatment costs on average $13,200 per month, depending on the dosage schedule.
Self-abuse may refer to:

Self-harm, the intentional, direct injuring of ones own body without suicidal intentions
Self-destructive behaviour, patterns of behaviour to inflict metaphorical or literal harm on oneself
Self-inflicted wound, harming oneself without psychological problems to take advantage of being injured

See also
Algolagnia, deriving sexual pleasure and stimulation from physical pain
Abuse § Self-abuse
Violence § Self-directed violence