There Are Two Main Types Of Small Cell Lung Cancer
These two types include many different types ofcells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:
- Small cell carcinoma .
- Combined small cell carcinoma.
Changes To This Summary
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Added text to state that early phase Ib and II trials showed objective response rates of 10% to 33% with nivolumab or pembrolizumab treatment in patients with disease progression after one or more lines of chemotherapy, resulting in accelerated approval from the U.S. Food and Drug Administration however, both agents were voluntarily withdrawn after subsequent trials failed to confirm benefit.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which iseditorially independent of NCI. The summary reflects an independent review ofthe literature and does not represent a policy statement of NCI or NIH. Moreinformation about summary policies and the role of the PDQ Editorial Boards inmaintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® – NCI’s Comprehensive Cancer Database pages.
Help Getting Through Cancer Treatment
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.
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Nsclc That Has Spread To Only One Other Site
Cancer that is limited in the lungs and has only spread to one other site is not common, but it can sometimes be treated with surgery and/or radiation therapy to treat the area of cancer spread, followed by treatment of the cancer in the lung. For example, a single tumor in the brain may be treated with surgery or stereotactic radiation, or surgery followed by radiation to the whole brain. Treatment for the lung tumor is then based on its T and N stages, and may include surgery, chemo, radiation, or some of these in combination.
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 recurring or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCIs clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
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 recurred . These tests are sometimes called follow-up tests or check-ups.
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What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about this.
For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to tell if the cancer has come back.
For the first year after treatment, your visits may be every 2 to 3 months. You may have CT scans and blood tests. After the first year or so, your visits might be every 6 months, and then at least once a year after 5 years.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
Cancer May Spread From Where It Began To Other Parts Of The Body
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if small cell lung cancer spreads to the brain, the cancer cells in the brain are actually lung cancer cells. The disease is metastatic small cell lung cancer, not brain cancer.
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If Treatment Does Not Work
Recovery from SCLC is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important. People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning. After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
Prognosis And Survival Rates
Prognosis refers to how your doctor believes the disease will continue to develop and how you may be affected by this development. This could mean what symptoms or side-effects you may experience and their severity. Your doctor can also help you with resources and information to potentially improve your prognosis because it doesnt always stay the same. It can differ with each patient and is based on general health and other factors.
A type of cancers survival rate is based on the percentage of people surviving five years after their official diagnosis. The survival rate for NSCLC stage IIIA is about 36 percent, 26 percent for stage IIIB, and one percent for stage IIIC. For extended-small cell lung cancer, the five-year survival rate is at about 16 percent. If tumors have spread to distant parts of the body the survival rate is approximately three percent.
Keep in mind that each years survival rate data does not take into account new technologies and medicines that have been developed in the past five years.
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Patients May Want To Think About Taking Part In A Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
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.
What You Need To Know
- The most common types of lung cancer include lung nodules, non-small cell lung cancer, small cell lung cancer and mesothelioma.
- Rare lung cancers often don’t originate in the lung.
- Rare lung cancers vary according to size, recommended treatment options and rate of metastasis.
The most common types of lung cancer are those found right in the lungs. Other rarer types of cancer may also occur in the lungs and chest wall.
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Treatment Choices For Small Cell Lung Cancer By Stage
For practical reasons, small cell lung cancer is usually staged as either limited or extensive. In most cases, SCLC has already spread by the time it is found, so chemotherapy is usually part of treatment.
If you smoke, one of the most important things you can do to be ready for treatment is to quit. Studies have shown that patients who stop smoking after a diagnosis of lung cancer tend to have better outcomes than those who dont.
Causes And Risk Factors
Anyone can develop lung cancer, but the disease is much more common among smokers. In fact, smoking is the number one risk factor for lung cancer. Researchers estimate that as many as 90% of lung cancers could be prevented if people didnt smoke cigarettes.
While smoking is an important risk factor for both SCLC and NSCLC, it seems to be linked more closely to SCLC. Nearly all cases of SCLC are due to smoking.
Other risk factors for lung cancer include:
- Exposure to substances like radon, asbestos, arsenic, nickel, tar, or other agents
- Older age
- Having a family history of lung cancer
- Exposure to air pollution or secondhand smoke
- Having radiation therapy to the lungs
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Sclc That Progresses Or Recurs After Treatment
If the cancer continues to grow during treatment or comes back, any further treatment will depend on the location and extent of the cancer, what treatments youve had, and on your health and desire for further treatment. Its always important to understand the goal of any further treatment before it starts. You should understand if its to try to cure the cancer, to slow its growth, or to help relieve symptoms. It is also important to understand the benefits and risks.
If a cancer continues to grow during the initial chemotherapy treatment or if a cancer starts to grow after chemo has been stopped for less than 6 months, another type of chemo, such as topotecan may be tried, although it may be less likely to help. For cancers that come back after initial treatment is finished, the choice of chemo drugs depends on how long the cancer was in remission .
What Kind Of Treatment Will I Need
There are many ways to treat small cell lung cancer, but the main types of treatment are radiation, and chemotherapy. In rare cases, surgery may be used. Many times, more than one kind of treatment is used.
The treatment plan thats best for you will depend on:
- The stage of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Your feelings about the treatment and the side effects that may come with it
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The preferred citation for this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
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Recalcitrant Cancer Research Act
In 2013, the US Congress passed the Recalcitrant Cancer Research Act, which mandated increased attention to certain recalcitrant cancers, including small cell lung cancer. That led to the National Cancer Institute supporting small cellspecific research through a consortium.
As a result, new experimental drugs for small cell lung cancer are currently being tested, including Iadademstat and Keytruda .
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Small Cell Lung Cancer
When associated with the lung, it is sometimes called “oat cell carcinoma” due to the flat cell shape and scanty cytoplasm. Caution is required when diagnosing SCLC because small cell mesothelioma an extremely rare subtype of lung cancer can be mistaken for small cell lung cancer.
It is thought to originate from neuroendocrine cells in the bronchus called Feyrter cells .Hence, they express a variety of neuroendocrine markers, and may lead to ectopic production of hormones like ADH and ACTH that may result in paraneoplastic syndromes and Cushing’s syndrome. Approximately half of all individuals diagnosed with Lambert-Eaton myasthenic syndrome will eventually be found to have a small-cell carcinoma of the lung.
Small-cell carcinoma is most often more rapidly and widely metastatic than non-small-cell lung carcinoma . There is usually early involvement of the hilar and mediastinal lymph nodes. The mechanisms of its metastatic progression are not well-understood.
Immunotherapy Through Vaccine Development
The goal of vaccine therapy in NSCLC is to shift the immune balance in favor of activation so that the host may launch a response to tumor-associated antigens . Currently there are two developing strategies to use vaccines in the treatment of NSCLC: tumor vaccines and antigen-specific immunotherapy . Tumor vaccines are developed from autologous or allogenic tumor cells. These vaccines work by exposing the hosts immune system to various tumor-associated antigens . Antigen-specific immunotherapy incorporates specific antitumor immunity against antigens expressed on tumor cells. Since these vaccines target a specific antigen, they may not be able to be used in all patients. Currently there are some ongoing phase III trials involving potential new vaccine therapies in NSCLC .
Table 2
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Diagnosing Squamous Cell Carcinoma
The main way to diagnose squamous cell carcinoma is with a biopsy. This involves having a small piece of tissue removed from the suspicious area and examined in a laboratory.
In the laboratory, a pathologist will examine the tissue under a microscope to determine if it is a skin cancer. He or she will also stage the cancer by the number of abnormal cells, their thickness, and the depth of penetration into the skin. The higher the stage of the tumor, the greater the chance it could spread to other parts of the body.
Squamous cell carcinoma on sun-exposed areas of skin usually does not spread. However, squamous cell carcinoma of the lip, vulva, and penis are more likely to spread. Contact your doctor about any sore in these areas that does not go away after several weeks.
Smoking Is The Major Risk Factor For Small Cell Lung Cancer
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for lung cancer.
Risk factors for lung cancer include the following:
- Smoking cigarettes, pipes, or cigars, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer.
- Being exposed to secondhand smoke.
- Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace.
- Being exposed to radiation from any of the following:
- Radiation therapy to the breast or chest.
- Radon in the home or workplace.
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
When smoking is combined with other risk factors, the risk of lung cancer is increased.
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