Before initiating treatment of a patient with small cell lung cancer (SCLC), an experienced lungcancer pathologist should review the pathologic material.
The current classification of subtypes of SCLC includes the following:
Small cell carcinoma.
Combined small cell carcinoma (i.e., SCLC combined with neoplastic squamous and/or glandular components).
SCLC arising from neuroendocrine cells forms one extreme of the spectrum of neuroendocrine carcinomas...
"Be honest with your doctor," says Carmen Escalante, MD, Chair of
the Department of general internal medicine at the University of Texas M. D.
Anderson Cancer Center. "Sometimes good communication is the key to
controlling your nausea and feeling good again."
Here are some questions to ask:
Am I likely to have nausea or vomiting because of the medicine
"Your side effects depend on the specific drug you're getting," says
Christy Russell, MD, chair of the American Cancer Society Breast Cancer
Advisory Committee. "Just as some drugs cause hair loss and others don't,
some cause nausea and some don't. Your doctor should tell you exactly what to
Should I begin antinausea medicine before starting
Starting antinausea treatment before chemotherapy can reduce the risk of
"anticipatory" or "conditioned" nausea. This is nausea that's
triggered by things that remind you of treatment, says Karen Syrjala, PhD,
director of Biobehavioral Sciences at the Fred Hutchinson Cancer Research
Center in Seattle. Some people are especially susceptible to anticipatory
nausea, like those who get motion sickness. "People at high risk need to
take medicine before they start treatment," says Syrjala, "instead of
waiting until after the symptoms start."
Do you have any advice about my diet?
No diet has been proven to ease chemotherapy nausea. But see if your doctor
has any advice about what to eat and when you should eat it. Many people find
that bland diets help. Your doctor may also suggest eating smaller, more
Should I consider alternative treatments for nausea?
Some people find that treatments such as deep breathing, hypnosis, and
acupuncture help reduce the nausea from chemotherapy. But always check with
your doctor before taking any herb or supplement. They could potentially
interfere with your treatment.
"You have to be careful with alternative medicines," says Escalante.
"A lot of people don't consider them real drugs, but they are."
What if my antinausea medicines don't work?
Don't despair. "If your medicines aren't working or not working well
enough, talk to your health care provider," says Escalante. "There are
always adjustments that he or she can make." You might try adding another
drug or switching to a new one entirely.
However, if you are vomiting uncontrollably, get help right away.
"Vomiting can be dangerous," says Syrjala. It can leave you seriously
dehydrated leading to kidney problems and interfere with your treatment.
SOURCES: Carmen P. Escalante, MD, chair, department of
general internal medicine; clinical medical director, Ambulatory Treatment
Center, EVP & chief operating officer, the University of Texas M. D.
Anderson Cancer Center, Houston. Christy Russell, MD, chair, American Cancer
Society Breast Cancer Advisory Committee; associate professor of medicine, Keck
School of Medicine, University of Southern California, Los Angeles. Karen
Syrjala, PhD, psychologist, director, biobehavioral sciences, Fred Hutchinson
Cancer Research Center, Seattle.