What to know about small-cell lung cancer remission

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According to a 2020 review of people with lung cancer, over 90% that recurred had done so by 5 years after diagnosis. Over 90% of SCLC recurrences happened in 2 years.

According to a 2021 study involving 229 people with SCLC, the majority of people had a relapse of the disease.

Relapse may depend on the staging of the cancer, as the study results suggest it was more common in people with extensive stage (ES) SCLC. The most common site of relapse for SCLC was the thoracic area, the upper torso.

In people with limited stage (LS) SCLC, the risk of thoracic relapse increased over 2 years. However, in people with ES SCLC, the risk peaked at the end of the first year.

Similarly, the risk of SCLC spreading to the brain increased over 2 years in people with LS SCLC but leveled out in the first year in people with ES SCLC.

The study suggests relapse affecting the central nervous system was 22%. However, some people may have had brain metastases, cancer that has spread to the brain, at the time of diagnosis, which may have affected the risk of relapse.

Remission is not the same as a cure. However, if cancer remains in complete remission for at least 5 years, doctors may consider this a cure.

If any cancer cells remain in the body, there is still a chance the cancer may return at some point. Doctors will monitor people in the years following treatment to check for any signs of cancer returning.

A 2020 case study suggests a cure may be possible for advanced SCLC. The study notes that ES SCLC with brain metastasis typically has a poor prognosis and a median survival of 3–4 months.

However, a 71-year-old female with ES SCLC and brain metastasis achieved complete remission following aggressive treatment. Treatment included chemotherapy, radiation therapy, and a craniotomy, a surgery that removes and replaces part of the skull.

The person had a complete response to treatment and remained cancer free with no symptoms 9 years after the first diagnosis.

According to a 2021 article, risk factors for SCLC relapse include:

• ES SCLC
• elevated lactate dehydrogenase (LDH), a type of enzyme in body tissues
• poor performance status, which refers to a person’s level of functioning
• older age

The article’s authors suggest that adding certain immunotherapies to standard platinum and etoposide chemotherapy may result in some improvement in overall survival.

Other factors that may affect survival include:

• hyponatremia, low sodium levels
• a loss of more than 10% of body weight from baseline weight
• SCLC recurrence
• poor performance status

Improving overall health

According to the American Cancer Society (ACS), a person’s overall health can affect their outlook.

To help stay healthy during and after cancer treatments, people can take steps to look after their well-being. The Centers for Disease Control and Prevention (CDC) recommends steps, such as:

• avoiding tobacco products
• maintaining a moderate weight
• eating a healthy, balanced diet
• getting regular physical activity
• developing a healthy sleep schedule
• talking with loved ones or a counselor about thoughts and feelings around a cancer diagnosis and treatment

According to a 2018 review, SCLC recurrence is common. After receiving second-line therapy, the overall response rate is around 51%, and the average progression-free survival is 4.6 months.

For people with SCLC relapse receiving third-line chemotherapy, the overall response rate is 18%, and the median progression-free survival is around 2 months.

According to the ACS, the 5-year relative survival rates for SCLC between 2012–2018 were as follows:

• Cancer that has not spread beyond the lungs: 30%
• Cancer that has spread to nearby organs, tissues, and lymph nodes: 18%
• Cancer that has spread to distant organs and lymph nodes: 3%
• All stages combined: 7%

People will need to speak with a doctor if they experience any signs of lung cancer returning after remission. According to the ACS, symptoms of lung cancer may include:

• wheezing
• a hoarse voice
• a persistent or worsening cough
• coughing up blood
• chest pain which worsens with coughing, laughing, or deep breathing
• shortness of breath
• persistent or recurrent infections, such as bronchitis or pneumonia
• a loss of appetite
• unexplained weight loss
• fatigue and weakness

Symptoms of metastasis

Signs that lung cancer has metastasized, or spread to other areas of the body, may include:

• bone pain, such as in the back or hips
• headaches
• dizziness
• weakness or numbness in an arm or leg
• difficulty balancing
• seizures
• jaundice, which is a yellowing of the eyes and skin
• swollen lymph nodes

People may want to talk with a healthcare team about the available treatment options and whether taking part in a clinical trial is an option to try newer treatments.

Research from 2020 found that within 2 years, over 90% of small cell lung cancer cases had recurred.

If this type of lung cancer returns, it will usually relapse within the first 5 years following treatment. The risk for SCLC recurrence may depend on many factors, including a person’s overall health, age, body weight, and cancer stage.

People with complete remission from SCLC should speak with a healthcare professional if they notice signs that their cancer may have returned.