Small Cell Lung Cancer: What to Know
Taking the time to learn about a diagnosis or news of cancer coming back can be helpful as you prepare to talk with your doctor, make decisions with your spouse, partner or parent about next steps, or share your treatment plan with others.
“When the oncologist gave me the results of my biopsy, we didn’t think anything negative of the term when he said ‘It’s really a funny name, what you have. It used to be called oat cell cancer, because when you look at it under a microscope, it looks like oats,’” said Montessa, a special education teacher who has lived with small cell lung cancer (SCLC) since 2006. “My cousin and I started laughing and said, ‘That is a really stupid name,’ until I got home and started my own research to understand the significance of the word, small cell lung cancer.” While many people are familiar with lung cancer, not as many are aware of the unique differences that characterize the two types of this disease: non-small cell and small cell. Compared to non-small cell lung cancer (NSCLC), SCLC is less common.1 Approximately 13% of lung cancers are classified as small cell. Approximately 30,000 to 35,000 new cases are reported every year.2,3 If you or someone you are caring for has recently been diagnosed with SCLC, you likely have questions about what to expect in terms of treatment options and how your diagnosis may impact your everyday life. The following overview of SCLC can be a helpful starting point for having more in-depth conversations with your healthcare provider or care team.
The Importance of Emotional and Social Support
Jody, who cared for her sister Kim during the entire length of her five-year fight with SCLC, said that it’s the support that really can make a major difference during treatment and recovery. “Be there 100%,” said Jody. “No one should go through this alone. Surround them with love, support and family. You’ve got to move forward and make it the best life you can. The support helps anyone with small cell lung cancer do that.” Annette, a mother and grandmother who has been living with SCLC for almost three years, agreed that positive support was an important part of her treatment: “Have people around you that are positive and that can keep you lifted up, helping you through it.” It’s that type of support that Annette wants to pay forward to you as you make your journey.“I want people to learn from me that anything is possible,” she said. “Stay positive, find your faith or your center or your strength and strengthen it even more.”
Early Detection Is Key
The earlier lung cancer is caught, the higher the likelihood that a person’s treatment will work successfully.4 Unfortunately, lung cancer symptoms often do not appear until the disease has already reached an advanced stage. This is why the American Cancer Society recommends yearly lung cancer screenings for people who may be at a higher risk for getting the disease.4
To know if you may be at risk for getting SCLC, ask yourself these questions:5
- Do you smoke tobacco or have you in the past? Lung cancer has a variety of potential causes, but smoking cigarettes, cigars or pipe tobacco is the leading risk factor for SCLC.
a. If you are a smoker, do you take any supplements? Some studies suggest that smokers should avoid taking beta carotene supplements.b. For nonsmokers, are you regularly exposed to secondhand smoke? Breathing in the smoke of others or smoke in the environment can increase your risk of SCLC.
- Is there a chance you’ve had exposure to any inhaled chemicals? If you work with or around inhaled chemicals, such as asbestos, arsenic, and coal or nickel products, you may want to consider getting screened for lung cancer regularly.
- Have you been treated with radiation therapy in the past? People who have been treated with radiation therapy to the chest for other cancers in the past – including breast cancer and Hodgkin disease – are at a higher risk of getting lung cancer.
- Do you have a family history of lung cancer? Siblings and children of people who currently have lung cancer or have had it before may have a slightly higher risk of getting cancer themselves.
If you answered “yes” to any of the above questions, you may want to consider getting screened for lung cancer once each year. Because lung cancer symptoms do not usually appear until the disease is at an advanced stage, annual screening for those at risk can help improve a person’s chances of survival if they are diagnosed in the future.4 If you have concerns due to your personal and family history or other risk factors, don't be afraid to share those concerns with your healthcare team. They will help you figure out a solution.6
Understanding the Stages at Diagnosis for SCLC
If a physical exam, biopsy or another type of test has confirmed SCLC, the next critical step is understanding the size and growth of the tumor(s) and the spread of the disease. This is referred to as “staging.”7 If SCLC is at the limited stage, this means the cancer is confined to one part of the chest and has not yet spread throughout the body. Extensive-stage SCLC means the tumors have spread to other areas of the body, such as the other lung, brain or bone marrow.7 A patient’s disease stage will inform their treatment options, so it’s important to understand whether they are dealing with limited-stage or extensive-stage SCLC.8
Exploring Treatment Options
“I was diagnosed in 2014 and at that time it was just the beginning of treatment for small cell,” said Nina, a seven-year SCLC survivor. “And things have changed so much that you get to see all these new treatments coming out. There's so much happening now for small cell, that it's really an exciting thing.” For patients with limited-stage SCLC, treatment with chemotherapy – alone or combined with radiation – is often the recommended course of action. For patients with extensive-stage SCLC, combination chemotherapy with or without an immunotherapy may be used.8 While many will experience periods of remission, it is important to be aware that the cancer may still return.3 There are also a number of clinical trials underway to explore potential treatment options.9,10 Patients can talk to their healthcare providers to learn more about whether they are eligible to participate. “I wish somebody would've told me then how much research matters and that the envelope could be pushed to where we are today,” Montessa described about what she’s seen in the 14 years since her initial diagnosis. “And as in the next few years, I'm certain that we'll turn on the TV and see all of these advancements for small cell lung cancer research. We're right on the cusp and I've been blessed enough to see all of these advancements for small cell lung cancer since 2006.”
Engaging a Care Team of Specialists
“I tell people when they're beginning this battle to put their army together,” said Annette. With SCLC, patients often need to work with medical oncologists who administer chemotherapy treatments, in addition to radiation oncologists and other specialists.11 Being able to communicate with an extended team is a great way for patients to address their full range of needs and stay informed throughout the treatment journey.
- GO2 Foundation for Lung Cancer. Types of lung cancer. https://go2foundation.org/what-is-lung-cancer/types-of-lung-cancer/. Accessed June 3, 2022.
- American Cancer Society. Key statistics for lung cancer. https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html. Updated January 12, 2021. Accessed June 2, 2022.
- National Organization for Rare Diseases. Small cell lung cancer. https://rarediseases.org/rare-diseases/small-cell-lung-cancer/. Updated 2019. Accessed October 4, 2022.
- American Cancer Society. Can lung cancer be found early? https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/detection.html. February 9, 2021. Accessed June 3, 2022.
- American Cancer Society. Small cell lung cancer causes, risk factors, and prevention. https://www.cancer.org/content/dam/CRC/PDF/Public/8709.00.pdf. Updated May 16, 2016.
Accessed December 5, 2022.
- American Cancer Society. Cancer screening during the COVID-19 pandemic. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-during-covid-19-pandemic.html. Updated July 2, 2020. Accessed June 3, 2022.
- American Cancer Society. Small cell lung cancer stages. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/staging-sclc.html. Updated October 1, 2019.
Accessed December 5, 2022.
- National Cancer Institute. Small cell lung cancer treatment (patient version) https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq. Updated May 7, 2021. Accessed December 1, 2022.
- Lung Cancer Foundation of America. Small cell lung cancer | Hope with Answers. https://lcfamerica.org/ lung-cancer-info/hope-with-answers/small-cell-lung-cancer-video/. Accessed December 5, 2022.
- U.S. National Library of Medicine. https://clinicaltrials.gov/ct2/results?recrs=&cond=Small+Cell+Lung+Cancer&term=&cntry=&state=&city=&dist=. Accessed December 6, 2022.
- LUNGevity. Your medical team. https://lungevity.org/for-patients-caregivers/lung-cancer-101/your-medicalteam. Updated February 16, 2021. Accessed December 5, 2022.