Understanding Small Cell Lung Cancer

The following information is From The American Cancer Society. You can find information about all different types of cancer and resources on how to fight it at Cancer.org.

What is small cell lung cancer?

Lung cancer starts when cells of the lung become abnormal and begin to grow out of control. As more cancer cells develop, they can form into a tumor and spread to other areas of the body.


Types of lung cancer

The 2 main types of lung cancer are:

§ Small cell lung cancer (SCLC), which is sometimes called oat cell cancer. About 10% to 15% of lung cancers are SCLC.

§ Non-small cell lung cancer (NSCLC), which makes up about 85% to 90% of lung cancers. The 3 main types of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

Small cell and non-small cell lung cancers are treated differently. The information here focuses on small cell lung cancer.

Small cell lung cancer stages


Understanding SCLC stages

The stage of a cancer describes how far it has spread. The stage is one of the most important factors in deciding how to treat the cancer and determining how successful treatment might be.


Limited versus extensive stage

For treatment purposes, most doctors use a 2-stage system that divides SCLC into limited stage and extensive stage. This helps determine if a person might benefit from more aggressive treatments such as chemotherapy combined with radiation therapy to try to cure the cancer (for limited stage cancer), or whether chemotherapy alone is likely to be a better option (for extensive stage cancer).

Limited stage

This means that the cancer is only on one side of the chest and can be treated with a single radiation field. This generally includes cancers that are only in one lung (unless tumors are widespread throughout the lung), and that might have also reached the lymph nodes on the same side of the chest.

Lymph nodes above the collarbone (called supraclavicular nodes) can be affected in limited stage as long as they are on the same side of the chest as the cancer. Some doctors also include lymph nodes at the center of the chest (mediastinal lymph nodes) even when they are closer to the other side of the chest.

What is important is that the cancer is confined to an area that is small enough to be treated with radiation therapy in one “port.” Only about 1 out of 3 people with SCLC have limited stage cancer when it is first found.

Extensive stage

This describes cancers that have spread widely throughout the lung, to the other lung, to lymph nodes on the other side of the chest, or to other parts of the body (including the bone marrow). Many doctors consider SCLC that has spread to the fluid around the lung to be extensive stage as well. About 2 out of 3 people with SCLC have extensive disease when their cancer is first found.


There are methods of classifying the stages of the cancer, but i can't remember the specifics of my Mother's and frankly, they are really confusing. If you want to read more about it, you can go here: http://www.cancer.org/cancer/lungcancer-smallcell/detailedguide/small-cell-lung-cancer-staging and read the full article.

Survival rates for small cell lung cancer, by stage

The numbers below are relative survival rates calculated from the National Cancer Institute’s SEER database, based on people who were diagnosed with SCLC between 1988 and 2001.

These survival rates are based on the TNM staging system in use at the time, which has since been modified slightly for the latest version. Because of this, the survival numbers may be slightly different for the latest staging system.

§ The 5-year relative survival rate for people with stage I SCLC is about 31%.

§ For stage II SCLC, the 5-year relative survival rate is about 19%.

§ The 5-year relative survival rate for stage III SCLC is about 8%.

§ SCLC that has spread to other parts of the body is often hard to treat. Stage IV SCLC has a relative 5-year survival rate of about 2%. Still, there are often treatment options available for people with this stage of cancer.

Remember, these survival rates are only estimates – they can’t predict what will happen to any individual person. We understand that these statistics can be confusing and may lead you to have more questions. Talk to your doctor to better understand your situation.



Last Medical Review: 02/22/2016

Last Revised: 02/26/2016



Chemotherapy for small cell lung cancer

Chemotherapy (chemo) is treatment with anti-cancer drugs injected into a vein or taken by mouth. These drugs enter the bloodstream and go throughout the body, making this treatment useful for cancer anywhere in the body.


When might chemotherapy be used?

Chemo is typically part of the treatment for small cell lung cancer (SCLC). This is because SCLC has usually already spread by the time it is found (even if the spread can’t be seen on imaging tests), so other treatments such as surgery or radiation therapy would not reach all areas of cancer.

§ For people with limited stage SCLC, chemo is often given along with radiation therapy. This is known aschemoradiation.

§ For people with extensive stage SCLC, chemo alone is usually the main treatment (although sometimes radiation therapy is given as well).

Some patients in poor health might not be able to tolerate intense doses of chemo. But older age by itself is not a reason to not get chemo.


Drugs used to treat SCLC

SCLC is generally treated with combinations of chemotherapy drugs. The combinations most often used are:

§ Cisplatin and etoposide

§ Carboplatin and etoposide (I know Etoposide was the first one my Mom was on. I believe Carbo was the other)

§ Cisplatin and irinotecan

§ Carboplatin and irinotecan

Doctors give chemo in cycles, with a period of treatment (usually 1 to 3 days) followed by a rest period to allow your body time to recover. Each cycle generally lasts about 3 to 4 weeks, and initial treatment is typically 4 to 6 cycles.

If the cancer progresses (get worse) during treatment or returns after treatment is finished, other chemo drugs may be tried. The choice of drugs depends to some extent on how soon the cancer begins to grow again. (The longer it takes for the cancer to return, the more likely it is to respond to further treatment.)

§ If cancer returns more than 6 months after treatment, it might respond again to the same chemo drugs that were given the first time, so these can be tried again.

§ If the cancer comes back sooner, or if it keeps growing during treatment, further treatment with the same drugs isn’t likely to be helpful. If further chemo is given, most doctors prefer treatment with a single, different drug to help limit side effects. Topotecan, which can either be given into a vein (IV) or taken as pills, is the drug most often used, although others might also be tried.

SCLC that progresses or comes back can be hard to treat.


Possible side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs given and how long they are taken. Some of the more common side effects of chemo include:

§ Hair loss

§ Mouth sores

§ Loss of appetite

§ Nausea and vomiting

§ Diarrhea or constipation

§ Increased chance of infections (from having too few white blood cells)

§ Easy bruising or bleeding (from having too few blood platelets)

§ Fatigue (from having too few red blood cells)

These side effects usually go away after treatment. There are often ways to lessen these side effects. For example, drugs can help prevent or reduce nausea and vomiting.

Some drugs can have specific side effects. For example:

§ Drugs such as cisplatin and carboplatin can damage nerve endings. This is called peripheral neuropathy. It can sometimes lead to symptoms (mainly in the hands and feet) such as pain, burning or tingling sensations, sensitivity to cold or heat, or weakness. In most people this goes away or gets better after treatment is stopped, but it may last a long time in some people.

§ Cisplatin can also cause kidney damage. To help prevent this, doctors give lots of IV fluids before and after each dose of the drug is given.

To learn more about chemo, see the Chemotherapy section of the ACS's website.



Last Medical Review: 02/22/2016

Last Revised: 02/26/2016

I Think that's enough for today. I will post more information later.