How Is Small Cell Lung Cancer Treated?

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Treatment of small cell lung cancer depends on how far the cancer has spread within your body. Because small cancer spreads rapidly, most diagnoses discover cancer outside of the lungs. 

Once outside the lungs, surgery is typically not enough to eliminate the cancer. More often, chemotherapy (drugs) are the best method to help slow or control the advance of the disease.

Your physician will choose the best treatment for you based on:

• Your age, overall health, and medical history
• The extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Your lung cancer may be treated with one or more of surgery, chemotherapy, radiation therapy and laser therapy.

• Surgery - Primary surgery is usually not recommended for SCLC. Occasionally, when there is no preoperative diagnosois, pathology from a resected solitary pulmonary nodule may show SCLC. In some patients, after chemotherapy and/or radiation therapy, there may be a need for resection of residual disease for either diagnostic or therapeutic reasons.     
• Radiation therapy - Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. Radiation may also be used with chemotherapy to treat lung cancer. There are two ways to deliver radiation therapy:
  • External radiation (external beam therapy) - a radiation therapist uses a machine that sends high levels of radiation directly to the cancer cells. Special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
  • Internal radiation (brachytherapy, implant radiation) - radiation is given inside the body as close to the cancer as possible. Substances called radioisotopes may be swallowed, injected, or implanted directly into the tumor. Some of the radioactive implants are called “seeds” or “capsules.” The radioisotopes produce radiation.
    

    Internal radiation produces a higher dose of radiation in a shorter time span than external radiation. Some internal radiation treatments stay in the body temporarily. Other internal treatments stay in the body permanently, although the radioactive substance loses its radiation within a short period of time. Internal and external radiation therapies are sometimes used together.

• Chemotherapy - In most cases, chemotherapy drugs work by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Your oncologist will design a treatment plan specifically for you. Chemotherapy for lung cancer may be given before other treatments, after other treatments, or alone.
• Photodynamic therapy (PDT) - A type of laser treatment that involves injecting light-sensitive chemicals into the bloodstream. Cells throughout the body absorb the chemicals. The chemicals stay longer in the cancer cells than in the healthy cells. At the right time, when most of the chemical has left the healthy cells surrounding the tumor, the light of a laser can be focused directly on the tumor. As the cells absorb the light, a chemical reaction destroys the cancer cells. For lung cancer, the light is delivered through a bronchoscope (a small, flexible tube with a light on the end) that is inserted through the mouth or nose.