Treatment options vary depending on the type of cancer a patient is diagnosed with. Approaches to treatment for small-cell lung cancer, or SCLC, normally include chemotherapy and radiotherapy, or a combination of the two. The Mayo Clinic states that surgery is only an option in rare cases of this type of cancer, and even then only when the disease is in its earliest stages. SCLC is divided into two stages, limited and extensive. The limited stage usually consists of both chemotherapy and chest radiation therapy. A patient might also be offered brain radiation treatment due to the rate at which lung cancer can metastasize. The extensive stage offers the same combination of treatments with varying doses. Often in the extensive stage, a targeted radiation therapy is recommended to control pain or other symptomatic issues. Treatment is not affected by the causation of the cancer.
Research has linked several causations to lung cancer, predominately, tobacco smoking. However, another link to lung and related cancers, such as mesothelioma, are also the result of exposure to asbestos. A material once used as insulation for chemical plants and similar industries, asbestos, has also been proven as a human carcinogen. Mesothelioma, like lung cancer, has a long latency period. As a result, treatment options are sometimes limited due to the diagnosis not occurring until the cancer has progressed into the later stages.
The stage of the SCLC will determine which course of treatment is best. Some treatments are standard, or the current method in use, while others are clinical trials. Clinical trials research new methods and improve current ones. The National Cancer Institute lists the current standard treatments for SCLC as surgery, chemotherapy, radiation therapy, laser therapy, and endoscopic stent placement:
- Surgery- Surgical procedures are not common for those diagnosed with SCLC. Surgery as a treatment is only an option if the cancer is confined to one lung or nearby lymph nodes; SCLC is generally found in both lungs. Sometimes surgery is utilized to help the doctor determine the exact type of cancer a patient has. Surgery can be defined as either curative or palliative. Curative surgery refers to those procedures where the tumor appears to be confined to one area, is performed in the early stages of cancer, and aims for the complete removal of a cancerous tumor. Curative procedures can remove anywhere from a tumor and the surrounding tissue to an entire lung. The goal in palliative surgery is simply to make the patient more comfortable.
- Laser Surgery- This procedure is an example of a palliative surgery and involves using a laser beam, which is an intense, narrow beam of light, with the intent of kill cancerous cells.
- Chemotherapy- This treatment utilizes strong drugs to slow, stop, or kill cancerous cells. The types of chemotherapy drugs vary and can be given in any number of combinations, as well as being coupled with other procedures such as surgery or radiation therapy. Chemotherapy is what is known as a systemic therapy, in that it treats the entire body. Traveling through the bloodstream, chemotherapy is capable of killing cells that have metastasized from the original tumor. Chemotherapy dosage varies in the amount and length of treatment depending on the patient. Mostly delivered intravenously, chemotherapy can sometimes be taken orally
- Radiation Therapy- Also known as radiotherapy, radiation can be an effective treatment for lung cancer. High-energy rays, stronger than x-rays, are used to kill or shrink cancer cells. It is likely that an external source of energy will be utilized; however, researchers are working to develop radioactive implants or “seeds” into or near the cancer site. Unlike chemotherapy, radiation targets a specific area of the body, with precise periods of time and local, helping to decrease tissue damage to the surrounding areas. The doses given in this form of treatment are usually spaced out over weeks and sometimes months; this is because the amount of radiation necessary cannot be administered all at once. The number of treatments given and exact dosage is dependent on how the patient reacts to radiation and the extent of the tumor. External radiation therapy is used as either the main source of treatment for lung cancer or after surgery in order to treat metastases.
- Endoscopic Stent Placement- This treatment is used to open an airway that has been blocked by abnormal tissue. An endoscope is a thin, tube-like instrument used for viewing internal tissue. The light and lens on an endoscope can be used to place a stent inside a body structure in order to keep it open.
Photodynamic Therapy has been listed as a new treatment for SCLC. Also referred to as PDT, this particular treatment utilizes a special light that when shined on cancerous tissues, activates previously administered drugs. These and other new treatments are constantly being researched and developed with the help of clinical trials. These trials, for some patients, are an optimistic treatment choice. The aim of treatments is to improve patient survival rates. Treatment options are sometimes changed, furthered, or discontinued as the patient’s cancer goes through re-staging.