Chemotherapy drugs can treat small cell lung cancer (SCLC), such as cisplatin or etoposide. SCLC is aggressive, but chemotherapy can improve the outlook for many people.
Chemotherapy drugs are medications that can kill or prevent the growth of cancer cells. People may take the drugs orally or intravenously.
Lung cancer causes lung tissue cells to grow uncontrollably. Doctors categorize lung cancer as either SCLC or non-small cell lung cancer. They further divide SCLC as either small cell carcinoma or combined small cell carcinoma, depending on how the cells appear under a microscope.
This article discusses the use of chemotherapy for treating SCLC and its impact on a person’s outlook.
Chemotherapy is one of six standard types of treatments that doctors use for SCLC, which also includes:
- radiation therapy, which uses powerful x-rays to destroy cancer cells
- immunotherapy, which supports the person’s immune system to fight the cancer
- surgery to remove tumors
- laser therapy, which uses a strong beam of light to kill cancer cells
- endoscopic stent placements to keep a person’s lungs open and help with their breathing
The treatment regime depends on the stage of cancer. Doctors determine the stage depending on the initial tumor’s location, growth, and spread to other body parts.
Many cancers have four stages, but doctors assess SCLC as either limited or extensive.
At this stage, chemotherapy aims to prevent the cancer cells from growing, dividing, and spreading throughout a person’s body. Doctors will typically administer chemotherapy across several cycles. They will also frequently use radiation therapy at this stage.
Doctors classify SCLC that spreads to other parts of a person’s body as an extensive stage. Treatment could combine immunotherapy with chemotherapy for extensive stage SCLC.
The combined treatment can last for months. Doctors may suggest continuing with immunotherapy for longer to keep the cancer under control.
Chemotherapy can cure some cases of SCLC, depending on its stage.
According to the National Organization for Rare Disorders (NORD), 20–25% of cases of limited stage SCLC are curable, but the cancer is likely to return. SCLC can return with increased resistance to chemotherapy drugs, which reduces their effectiveness.
There is currently no cure for extensive stage SCLC. However, some people will experience improved outcomes from combining chemotherapy with aatezolizumab, an immunotherapy drug. The treatment can help with symptoms but will not cure extensive stage SCLC.
Doctors typically treat SCLC with a combination of chemotherapy drugs. They will typically combine cisplatin or carboplatin with etoposide or irinotecan.
Doctors sometimes refer to these treatment regimes as platinum-based chemotherapy because cisplatin and carboplatin contain platinum.
Doctors may also use topotecan and lurbinectedin to treat extensive stage SCLC. The treatment can be helpful for people who have already received cisplatin or carboplatin.
Chemotherapy targets a person’s fast-growing cells, which can be cancerous or healthy. These include:
- blood-forming cells in bone marrow
- cells lining the digestive tract
- cells in the reproductive systems
- hair follicle cells
Chemotherapy drugs can cause adverse side effects to people if they damage healthy cells, including:
- extreme tiredness
- nausea and vomiting
- digestive changes
- pain while eating and swallowing
- hair loss
- bruising and bleeding
- nerve problems, such as numbness or tingling
- skin and nail changes
- kidney problems
- urinary difficulties
- weight fluctuations
- mood changes
- inability to concentrate or focus
- libido and sexual problems
- fertility problems
Most side effects are temporary, but some can last months or years. Doctors typically provide additional medications to help people experiencing adverse side effects.
SCLC is a challenging and aggressive disease with a 5-year survival rate of 30–35%. This means that around one in three people are alive 5 years after their SCLC diagnosis.
The outlook after chemotherapy depends on the SCLC stage. Doctors cure around 20–25% of people with limited stage SCLC. While chemotherapy will not cure extensive stage SCLC, it can shrink the tumors and reduce symptoms. It can also slow the disease progression.
As SCLC is difficult to treat, researchers are developing new therapy options all the time. Some people may wish to consider clinical trials for new treatments if they are available in their area. Their doctor should be able to provide further information about both clinical trials and available supportive care.
People with SCLC should have open discussions with their doctors about their condition, treatment options, and outlook.
For example, some people may want to ask:
- Does the cancer affect one or both lungs?
- Has it spread?
- Do I need further tests?
- What are my treatment options?
- Will there be any side effects?
- Are there medications to manage side effects?
- How will the cancer or treatment affect my life?
- How can I find support?
SCLC may respond to chemotherapy depending on how far it has spread. Doctors divide SCLC into limited or extensive stages, which affect how treatable the cancer is. Doctors can cure some cases of limited stage SCLC but not extensive stage SCLC.
Chemotherapy and other treatments can reduce symptoms, improve quality of life, and increase survival time. However, chemotherapy can also have several adverse side effects. Some people may require additional treatments to manage these side effects.