Small Cell Lung Cancer Treatment
Small cell lung cancer (SCLC) is an aggressive disease that rapidly spreads throughout the body.
When the cancer is found early on, patients will have the best treatment options and experience the highest rates of success. SCLC responds especially well to chemotherapy, and some patients additionally receive radiation therapy and/or surgery.
The exact course of treatment largely depends on the cancer's stage, which describes how much the cancer has spread. Localized small cell lung cancer responds better to surgery, while patients in later stages of cancer may benefit more from experimental therapies and treatments aimed at alleviating symptoms.
SCLC treatment is most effective when given before the cancer spreads to distant sites like the brain, bones, liver or adrenal glands. The best way to extend life span and receive a better prognosis is to find the cancer early.
Be aware of lung cancer symptoms like chest pain and difficulty breathing, especially if you were exposed to carcinogens like cigarette smoke, radon gas and asbestos. To learn more about asbestos-related small cell lung cancer and life-extending treatments, request a free informational packet.
Treatment Options for Small Cell Lung Cancer
Small cell lung cancer treatment can involve any combination of chemotherapy, radiation therapy and in rare cases, surgery. When distant spread has occurred, small cell lung cancer is typically incurable. However, doctors have found increased success rates by combining chemotherapy with platinum-based drugs like cisplatin and carboplatin. Chemotherapy regimens like this, often called combined-modality therapy, have also shown to improve the long-term survival of patients with limited cancer spread. Unfortunately, about 67 percent of small cell lung cancers are diagnosed after extensive spreading which makes long-term disease-free survival rare.
Chemotherapy
Chemotherapy is typically the main mode of treatment for small cell lung cancer. Because chemotherapy drugs circulate throughout the entire body, they can be effective regardless of the cancer's stage.
These drugs are administered orally or intravenously and attack rapidly dividing cells, including the targeted cancer cells. Chemotherapeutic agents are typically administered once every three or four weeks for a total of four to six months.
Patients with asbestos-related SCLC generally receive a combination of two or three drugs that work together to more effectively attack cancer cells. The most common SCLC chemotherapy regimens are as follows:
- Carboplatin and etoposide
- Carboplatin and irinotecan
- Cisplatin and etoposide
- Cisplatin and irinotecan
- Cyclophosphamide, doxorubicin and vincristine
If the cancer continues or begins to spread during treatment, more chemotherapy may be necessary. Other drugs that may be used alone or in combination with chemotherapy include:
- Docetaxel
- Gemcitabine
- Ifosfamide
- Paclitaxel
- Topotecan
Side effects of chemotherapy can significantly interfere with daily life, and patients are encouraged to consider possible side effects before beginning a chemotherapy regimen. Among the normal side effects: constipation, diarrhea, fatigue, hair loss, mouth sores and nausea.
Additionally, chemotherapy patients have an increased chance of infection and may bruise or bleed easily. Certain drugs — particularly cisplatin, docetaxel and paclitaxel — may lead to nerve damage and cause symptoms in the hands and feet. Patients suffering from nerve damage may experience pain, burning, sensitivity to temperature, tingling and weakness. In most cases, side effects are temporary and will go away after treatment ends.
Radiation Therapy
Radiation therapy uses high-energy rays, typically X-rays, to kill cancer cells and slow tumor growth. For asbestos-related small cell lung cancer patients, radiation therapy is administered once or twice a day, five days a week, for three to seven weeks. In patients with localized tumor growth, the treatment is typically given in combination with chemotherapy as a potentially curative treatment, meaning it aims to kill all cancer cells and extend life span. In these cases, radiotherapy begins with the second cycle of chemotherapy and is administered after the chemotherapy drugs to kill any remaining malignant cells.
In one 2002 study, early stage small cell lung cancer patients treated with a combination of radiation therapy and chemotherapy showed a median survival of 27.2 months. A similar study found that the combination improved survival times by about 5 percent when compared to patients treated with chemotherapy alone.
For patients whose cancer has not spread beyond the lung, radiation therapy can also be given preemptively. Patients may receive radiation therapy to the brain in order to reduce the chance of brain metastasis, which is common in small cell lung cancers. And for patients with more invasive cancer, radiation therapy may be used palliatively to minimize symptoms like bone pain, coughing, difficulty swallowing and shortness of breath.
While radiation therapy is a painless procedure, the treatment may cause temporary side effects. The most common side effects include coughing, difficulty breathing, fatigue, loss of appetite, nausea, shortness of breath and skin problems similar to sunburn at the administration site. These side effects typically disappear after treatment ends.
Learn more about lung cancer chemotherapy
Surgery
Potentially curative surgery is an option when lung cancer is localized. However, small cell lung cancer is usually diagnosed after it has already spread, so fewer than 5 percent of patients are eligible for this form of treatment. Most patients who do undergo surgery additionally receive chemotherapy and radiation therapy in order to kill any cancer cells left behind.
Based on the size and location of the patient's tumor, doctors and surgeons recommend one of four types of surgery. The most localized surgery, wedge resection, removes only the tumor itself and a small margin of healthy lung tissue. Segmental resection takes out a slightly larger portion, and lobectomy removes up to half the cancerous lung. The most extensive procedure is pneumonectomy, which involves removing an entire cancerous lung.
A recent study found that adding surgery to a regimen of chemotherapy and radiation therapy can help improve life expectancy in select patients. When treated with this method, 38 percent of early-stage patients and 16 percent of late-stage patients lived five years. The study's researchers concluded that, in some cases, surgery is a viable treatment option when used alongside other therapies.
The most common side effect of small cell lung cancer surgery is pain at the incision site, which can take up to several months to heal entirely. Possible serious complications include infection and pneumonia.
Palliative Small Cell Lung Cancer Treatments
SCLC patients ineligible for potentially curative therapies may choose to undergo strictly palliative treatments. These treatments focus on relieving painful symptoms to improve the quality and length of the patient's life. Two common palliative procedures for SCLC are endoscopic stent placement and laser therapy, also called laser surgery.
During laser therapy, a doctor places a tube into the patient's throat and aims a laser through the tube to reach cancer cells. The laser then destroys tumor cells within the airway to ease breathing. This procedure has a success rate of more than 90 percent, meaning almost all patients experience a reduction in symptoms with few adverse effects.
Much like laser therapy, endoscopic stent placement is commonly given to patients experiencing difficulty breathing. This procedure involves placing a small hollow tube (stent) into the airway to keep it open and clear of tumor obstructions. This procedure immediately eases breathing and improves short-term quality of life. But unlike laser therapy, there are some associated side effects. Frequent complications include bleeding, infection and migration of the stent.
Patients with asbestos-related small cell lung cancer should also consider taking part in a clinical trial, especially if they are in later stages of cancer and are ineligible for potentially curative treatments like surgery. Clinical trials focus on testing promising new treatment methods and drugs. If the treatments are successful, patients may live longer or notice improvements in symptoms. To learn more about clinical trials, visit our Clinical Trials page or find a lung cancer specialist.
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Last Modified Wednesday, March 14th, 2012 | Disclaimer | Privacy Policy |
The information provided by The Mesothelioma Center is not a substitute for professional medical advice, diagnosis or treatment.
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