What is Small Cell Lung Cancer?
Small-cell lung cancer is a malignant tumour of the lung and can be of two types– small cell carcinoma (oat cell cancer) and combined cell carcinoma. If you have been diagnosed with small cell carcinoma, it needs to be staged and graded to determine the best possible treatment options for you. Two broad stages of small cell lung cancer are limited and extensive.
Despite many effective small cell lung cancer treatment options, this cancer has high chances of recurrence. Small cell lung cancer life expectancy varies on multiple factors, and most treatment options aim to improve patients’ health and prolong their lives. Smoking is one of the highest risk factors for small cell lung cancer and affects the prognosis of treatment.
How To Treat Small Cell Lung Cancer?
Your doctor and healthcare team will determine how to treat small cell lung cancer based on your diagnostic test results. The most commonly used treatments for this cancer type are:
Surgery is used in small cell lung cancers when the cancer is found in one lung and may have spread to nearby lymph nodes. The lymph nodes surgically removed may be sent for biopsy to test for malignancy. Since small cell lung cancer usually affects both the lungs, surgery is often followed by radiation or chemotherapy. These treatments kill any remaining cancer cells and prevent the recurrence of cancer.
Chemotherapy uses strong drugs to restrict the growth of cancer cells. It may be given orally or injected into a vein. The type of chemotherapy drug used will depend upon your cancer stage. Ask your doctor about any queries you may have about the side effects of chemotherapy and small cell lung cancer.
- Radiation Therapy
Treatment of some small cell lung cancers requires high-energy radiation to kill the dividing cancer cells. Radiation may be given externally or internally. While in the early stages, external radiation can help in treatment, in advanced stage 4 small cell lung cancer radiation therapy may be used for palliative care and symptomatic relief.
Some drugs are used to train immune system cells to attack cancer cells. This treatment is called immunotherapy. Our immune system has an inherent ability to recognise normal body cells and avoid attacking them. This is done by special proteins on immune cells called ‘checkpoints’. When these proteins are turned on, an immune response is initiated. Many cancer cells use these checkpoints to avoid detection by immune cells. However, drugs used in immunotherapy target these checkpoints and, as a result, are able to treat small cell lung cancer.
Stage-wise Small Cell Lung Cancer Treatment
Your small cell lung cancer treatment depends upon its stage.
- Small Cell Lung Cancer: Limited Stage
Limited stage small cell lung cancer is usually treated by surgery, followed by chemotherapy, radiation therapy, or both. If the tumour is large, only surgery is not possible, even in limited-stage small-cell lung cancer.
Most patients with small cell lung cancer must undergo radiation therapy to prevent the spread of cancer to the brain. Your doctor may recommend clinical trials if they feel you are a candidate for it.
- Small Cell Lung Cancer: Extensive Stage
Due to the metastasis in this stage of small cell lung cancer, surgery and radiation therapy may not be effective. Chemotherapy may be advisable if you are in good overall health, along with immunotherapy. This is the first line of treatment and is aimed to shrink the tumour, relieve symptoms and prolong life. It is important to note that recurrence is high in people with this type of cancer.
If your doctor feels that your cancer may spread to the brain, they may advise radiation therapy to the brain.
Apart from the standard treatment options for small-cell lung cancer, your doctor may recommend you to enrol for a clinical trial. Clinical trials are procedures used to test new drugs and treatments for different diseases like cancer. These controlled research procedures enable access to newer, more effective cancer treatments. However, clinical trials are not for everyone.
Ask your doctor if you would like to participate in a clinical trial for your small cell lung cancer. Each clinical trial has its benefits and risks. It is best to have all the information before signing up for a clinical trial.
Getting a Second Opinion
If you have been diagnosed with small-cell lung cancer, it is natural to have several questions. It is best to have an honest discussion with your doctor and healthcare team to ensure you make informed treatment decisions. Feel free to seek a second opinion on your small cell lung cancer.
Getting a second opinion from another specialist is encouraged in cancer cases because it gives the patient and their family as much information as possible about the diagnosis and treatment plan and helps them make better treatment decisions.
A second opinion also ensures you are more confident and in control of your treatment process. This process can take some time, especially for rare cancers. If you are concerned about any part of your lung cancer treatment journey, you can gett a second opinion anytime during your treatment journey.
Here are some reasons why getting a second opinion is recommended for your small-cell lung cancer:
- To ensure you have explored all the options
- When your cancer is rare
- Advanced stages of lung cancer
- You are not confident about the diagnosis or treatment plan
- You wish to explore other treatment options than those suggested by your doctor
- You want to confirm the diagnosis made by your doctor