What are treatment options for small cell lung cancer?

Answer

TREATMENT OPTION OVERVIEW How small cell lung cancer is treated There are treatments for all patients with small cell lung cancer. Three kinds of treatment are used: surgery (taking out the cancer) radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)

chemotherapy (using drugs to kill cancer cells)

Additionally, clinical trials are testing the effect of new therapies on the treatment of small cell lung cancer. Surgery may be used if the cancer is found only in one lung and in nearby lymph nodes. Because this type of lung cancer is usually not found in only one lung, surgery alone is not often used. Occasionally, surgery may be used to help determine exactly which type of lung cancer the patient has. If a patient does have surgery, the doctor may take out the cancer in one of the following operations:

Wedge resection removes only a small part of the lung.

Lobectomy removes an entire section (lobe) of the lung.

Pneumonectomy removes the entire lung.

During surgery, the doctor will also take out lymph nodes to see if they contain cancer. Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation therapy for small cell lung cancer usually comes from a machine outside the body (external beam radiation therapy). It may be used to kill cancer cells in the lungs or in other parts of the body where the cancer has spread. Radiation therapy may also be used to prevent the cancer from growing in the brain. This is called prophylactic cranial irradiation (PCI). Because PCI may affect brain function, the doctor will help the patient decide whether to have this kind of radiation therapy. Radiation therapy can be used alone or in addition to surgery and/or chemotherapy.

Chemotherapy is the most common treatment of all stages of small cell lung cancer. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the lungs, including cancer cells that have spread to the brain.

Treatment by stage Treatment of small cell lung cancer depends on the stage of the disease, and the patient's age and overall condition. Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Most patients are not cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of small cell lung cancer. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

LIMITED STAGE SMALL CELL LUNG CANCER Treatment may be one of the following:

1. Chemotherapy and radiation therapy to the chest with or without radiation therapy to the brain to prevent spread of the cancer (prophylactic cranial irradiation). 2. Chemotherapy with or without prophylactic cranial irradiation. 3. Surgery followed by chemotherapy with or without prophylactic cranial irradiation.

Clinical trials are testing new drugs and new ways of giving all of the above treatments.

EXTENSIVE STAGE SMALL CELL LUNG CANCER Treatment may be one of the following:

1. Chemotherapy with or without radiation therapy to the brain to prevent spread of the cancer (prophylactic cranial irradiation). 2. Radiation therapy to places in the body where the cancer has spread, such as the brain, bone, or spine to relieve symptoms.

Clinical trials are testing new drugs and new ways of giving all of the above treatments.

RECURRENT SMALL CELL LUNG CANCER Treatment may be one of the following:

1. Radiation therapy to reduce discomfort. 2. Chemotherapy to reduce discomfort. 3. Laser therapy, radiation therapy, and/or surgical implantation of devices to keep the airways open to relieve discomfort. 4. A clinical trial testing new drugs.

TO LEARN MORE Call For more information, U.S. residents may call the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Publications

The National Cancer Institute (NCI) has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp (Http: //cancer.gov/livehelp/vp/vp_sq.html) service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 5:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Organizations and Web sites

There are many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment. A list of organizations and Web sites that offer information and services for cancer patients and their families is available on cancer.gov (Http: //cancer.gov/support_resources.html).

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