Small Cell Lung Cancer Treatment (PDQ�)
General Information About Small Cell Lung Cancer
Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
There are two types of
There are two types of small cell lung cancer.
These two types include many different types of
Small cell carcinoma (oat cell cancer).
Combined small cell carcinoma.
Smoking tobacco is the major risk factor for developing small cell lung cancer.
Anything that increases your chance of getting a disease is called a
Smoking cigarettes, cigars, or pipes now or in the past.
Being exposed to
Being exposed to
Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath.
These and other
A cough that doesn?t go away.
Shortness of breath.
Chest pain that doesn?t go away.
Swelling of the face and neck.
Loss of appetite.
Weight loss for no known reason.
Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer.
The following tests and procedures may be used:
Chest x-ray: An x-rayof the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Physical examand history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient?s health habits and past illnesses and treatments will also be taken. CT scan(CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dyemay be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. PET scan(positron emission tomography scan): A procedure to find malignant tumorcells in the body. A small amount of radioactive glucose(sugar) is injected into a vein. The PET scannerrotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Sputum cytology: A microscope is used to check for cancer cells in the sputum ( mucuscoughed up from the lungs). Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormalareas. A bronchoscopeis inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Fine-needle aspiration (FNA) biopsyof the lung: The removal of tissue or fluidfrom the lung using a thin needle. A CT scan, ultrasound, or other imaging procedureis used to locate the abnormal tissue or fluid in the lung. A small incisionmay be made in the skin where the biopsyneedle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologistthen views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest. Thoracoscopy: A surgicalprocedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscopeis inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph nodesamples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagusor lung. If certain tissues, organs, or lymph nodes can?t be reached, a thoracotomymay be done. In this procedure, a larger incision is made between the ribs and the chest is opened. Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
Certain factors affect prognosis (chance of recovery) and treatment options.
stageof the cancer (whether it is in the chest cavityonly or has spread to other places in the body).
The patient?s gender and general health.
The blood level of
lactate dehydrogenase(LDH), a substance found in the blood that may indicate cancer when the level is higher than normal.
For most patients with small cell lung cancer, current treatments do not cure the cancer.
If lung cancer is found, participation in one of the many
Stages of Small Cell Lung Cancer
After small cell lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the chest or to other parts of the body.
The process used to find out if
Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitorthe disease over time. Bone marrow aspirationand biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologistviews the bone marrow, blood, and bone under a microscope to look for signs of cancer. MRI(magnetic resonance imaging) of the brain: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). Endoscopic ultrasound(EUS): A procedure in which an endoscopeis inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves ( ultrasound) off internal tissues or organsand make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography. EUS may be used to guide fine-needle aspiration (FNA) biopsyof the lung, lymph nodes, or other areas.
biopsy: The removal of all or part of a lymph node. A pathologistviews the tissue under a microscope to look for cancer cells. Radionuclide bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactivematerial is injectedinto a veinand travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
tissue. Cancer invadesthe surrounding normal tissue.
lymph system. Cancer invades the lymph system and travels through the lymph vesselsto other places in the body.
blood. Cancer invades the veinsand capillariesand travels through the blood to other places in the body.
The following stages are used for small cell lung cancer:
Limited-Stage Small Cell Lung Cancer
Extensive-Stage Small Cell Lung Cancer
Recurrent Small Cell Lung Cancer
Treatment Option Overview
There are different types of treatment for patients with small cell lung cancer.
Different types of treatment are available for patients with
Five types of standard treatment are used:
Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be given
Chemotherapy is a cancer treatment that uses
See Drugs Approved for Small Cell Lung Cancer for more information.
Radiation therapy is a cancer treatment that uses high-energy
Endoscopic stent placement
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI Web site.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from
Follow-up tests may be needed.
Some of the tests that were done to
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has
Treatment Options by Stage
A link to a list of current
Limited-Stage Small Cell Lung Cancer
Combination chemotherapyand radiation therapyto the chest. Radiation therapy to the brain may later be given to patients with complete responses.
Combination chemotherapy for patients with
lungproblems or who are very ill. Radiation therapy to the brain may later be given to patients with complete responses. Surgeryfollowed by chemotherapyor chemotherapy plus radiation therapy to the chest. Radiation therapy to the brain may later be given to patients with complete responses. Clinical trialsof new chemotherapy, surgery, and radiation treatments.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with limited stage small cell lung cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Extensive-Stage Small Cell Lung Cancer
Combination chemotherapy. Radiation therapy to the brain may later be given to patients with
Radiation therapy to the brain,
spine, bone, or other parts of the body where the cancerhas spread, as palliative therapyto relieve symptomsand improve quality of life. Clinical trialsof new chemotherapy treatments.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with extensive stage small cell lung cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment Options for Recurrent Small Cell Lung Cancer
Chemotherapy. Radiation therapyas palliative therapyto relieve symptomsand improve quality of life. Laser therapy, stentplacement to keep airways open, and/or internal radiation therapyas palliative therapy to relieve symptoms and improve quality of life. Clinical trialsof new chemotherapy treatments.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent small cell lung cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
To Learn More About Small Cell Lung Cancer
For more information from the
Lung Cancer Home Page
What You Need to Know About? Lung Cancer
Lung Cancer Prevention Lung Cancer Screening
Drugs Approved for Small Cell Lung Cancer
Smoking Home Page (Includes help with quitting)
Secondhand Smoke and Cancer
What You Need to Know About? Cancer
Understanding Cancer Series: Cancer
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Information For Survivors/Caregivers/Advocates
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Changes to This Summary (09/19/2011)
Editorial changes were made to this summary.
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
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PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).