Small-Cell Lung Cancer
Small-Cell Lung Cancer Treatment
The most effective treatment for small-cell lung cancer is chemotherapy (using medications to kill cancer cells), either alone or in combination with radiation therapy (using high-dose X-rays or other high-energy rays to kill cancer cells).
Chemotherapy uses powerful drugs to kill cancer cells. These medications may be taken by mouth (orally), but they are usually injected into a vein (IV).
Chemotherapy is a systemic treatment because the drugs enter the bloodstream, travel throughout the body, and kill cancer cells wherever they are. However, some normal cells are also killed. This is responsible for some of the side effects of chemotherapy.
Chemotherapy is usually given at intervals to ensure that the bone marrow has recovered before the next dose of chemotherapy is given.
Extensive research and clinical trials have identified different chemotherapy medications for the treatment of small-cell lung cancer.
An oncologist (cancer specialist) recommends chemotherapy specific to the patient’s condition.
Some drugs are used alone, while some are used in combination with others for greater effectiveness. An oncologist (cancer specialist) recommends chemotherapy specific to the patient’s condition.
Treatment of limited-stage small-cell lung cancer
- Currently, cisplatin, etoposide, vincristine, doxorubicin, and cyclophosphamide are the most commonly used medications for the treatment of persons with small-cell lung cancer.
- Standard treatment of small-cell lung cancer involves combination chemotherapy with a cisplatin-containing regimen. Treatment cycles are repeated every three to four weeks. People receive treatment for four to six cycles.
- Some doctors start radiotherapy to the chest as early as possible, while others may give it with the fourth cycle of chemotherapy.
- Radiation and chemotherapy: Sequential-radiation treatment may be given, followed by chemotherapy.
- However, in comparative studies, the earlier the radiation is started concurrently with chemotherapy (as early as the first cycle of chemotherapy), the better the outcome.
- If the patient has limited disease, and has had a complete remission, of the cancer, radiation therapy may be given to the patient’s brain to reduce the risk of small-cell lung cancer spreading to the brain. This is called prophylactic cranial irradiation (PCI). It is usually given after the patient has completed the full chemotherapy, and radiotherapy (to the thorax). The radiation doses are low, and the treatment duration is short, so the side effects of this therapy are minimal.
Treatment of extensive-stage small-cell lung cancer (small-cell lung cancer that remains incurable with current treatment options)
- Persons with extensive-stage small-cell lung cancer are treated with combination chemotherapy. Currently, the combination of cisplatin or carboplatin and etoposide (PE) is the most widely used regimen.
- Radiation therapy may be used for relief of the following symptoms:
- Bone pain
- Compression of the food pipe (esophagus), windpipe, spinal cord, or superior vena cava caused by tumors
- Obstructive pneumonia caused by the tumor