Small cell lung cancer (SCLC) constitutes about 10–15 percent of all lung cancer cases. There are two main types of SCLC according to the kind of cells found in the cancer, and the way tthey grow and spread: small cell carcinoma (also called oat cell carcinoma) and combined small cell carcinoma.
The standard types of treatment used in people with SCLC include surgery, chemotherapy, radiation therapy, and palliative therapies that aim to open blocked airways.
Surgery may only be used when the cancer is found in one lung and nearby lymph nodes. It is not frequently used alone, because SCLC is usually found in both lungs. Even if all the cancer is removed during surgery, some patients will need to be given chemotherapy or radiation therapy to kill any remaining cancer cells following surgery.
Chemotherapy is a cancer treatment that aims to stop the growth of cancer cells. Chemotherapy works either by killing the cells directly or by stopping them from dividing. The medicines enter the bloodstream and can reach cancers anywhere in the body. Chemotherapy is typically part of SCLC treatment because this cancer has usually already spread to other tissues and organs at the time of diagnosis. People with earlier, or limited, stage SCLC usually are given chemotherapy in combination with radiation therapy (also called chemoradiation). For people with SCLC at more advanced or extensive stages, chemotherapy alone is usually the main treatment. The combination of chemotherapy medicines usually used in SCLC are:
- Cisplatin and etoposide
- Carboplatin and etoposide
- Cisplatin and irinotecan
- Carboplatin and irinotecan
Chemotherapy treatment is typically given in four to six cycles, with each cycle lasting about three to four weeks to allow time for the body to recover.
Chemotherapy medicines can cause side effects, depending on the type and dosage given. Known side effects include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea or constipation, fatigue, and a drop in white blood cells and platelets.
Radiation therapy uses high-energy X-rays or particles to kill cancer cells and prevent them from growing. SCLC is most often treated by external radiation therapy (when this therapy is given), in which a machine outside the body is used to send radiation toward the cancer. Another type, less common in SCLC, is internal radiation therapy, where a radioactive substance is sealed in needles, seeds, wires or catheters and placed directly on or near the cancer.
Therapies used to open blocked airways
Photodynamic therapy (PDT) is a palliative treatment to help people breathe better. A light-activated drug (photofrin) is injected into a vein and a couple of days later, a special laser light is aimed at the tumor, killing cancer cells, which are then removed in a few days during a bronchoscopy.
Laser therapy is also a type of palliative cancer therapy. It uses a laser beam to kill cancer cells and open up blocked airways.
Finally, an endoscopic stent placement can be used to open an airway that has been blocked by tissue growth. Stent therapy is usually used after other palliative therapies.
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