5 small cell lung cancer questions, answered

Though you may not suspect it from the name, small cell lung cancer is among the most aggressive types of lung cancer.

Most small cell lung cancer patients have a history of smoking, but in some cases, it can occur in non-smokers.

Unfortunately, patients don’t typically get diagnosed with small cell lung cancer until the disease has spread to other parts of the body.

We spoke with small cell lung cancer specialist Lauren Averett Byers, M.D., to learn which symptoms patients should watch for, and what newly diagnosed patients should know.

What are the most common symptoms of small cell lung cancer?

“The key with small cell lung cancer is a sudden onset of symptoms,” Byers says. Typically, within a couple of months or weeks, patients report feeling shortness of breath, a consistent cough or a hoarse voice.

If these symptoms keep you from doing things you normally can do without much effort, like walking up a flight of stairs, Byers says you should tell your doctor.

Small cell lung cancer may also spread quickly to other parts of your body, which could cause other symptoms. “When a newly diagnosed patient is experiencing nausea or vomiting, we would look into whether the cancer has spread to the brain,” Byers says.

Pain in your bones could also be a sign of metastasis, she adds. Be sure to tell your care team if you’re experiencing any of these symptoms.

How is small cell lung cancer diagnosed?

Early detection and diagnosis offer the best chance at successful treatment for small cell lung cancer.  New screening guidelines may help diagnose certain types of lung cancer early, but so far, screening hasn’t been proven effective for small cell lung cancer.

“It’s important to be honest with your doctor about your smoking history and symptoms for your best shot at early detection,” says Byers.

If you’re having small cell lung cancer symptoms, your doctor will likely order a chest X-ray or CT scan to look at your lungs. You’ll then need a biopsy if your doctor sees a mass.

During a lung biopsy, your doctor will get a sample of tissue from inside your lung to have it tested in a lab to check for lung cancer cells. Depending on the type of biopsy your doctor recommends, you may receive local anesthetic or mild sedation to allow them to get the tissue sample with less discomfort for you. “Once you have a lung cancer diagnosis, your care team will determine which type of cancer it is, so we can come up with the best treatment plan for you,” Byers says.

How is small cell lung cancer typically treated?

The type of treatment you receive will depend on how advanced the cancer is.

If the cancer is only on one side of the chest, the standard treatment is a combination of chemotherapy and radiation therapy.

“Most newly diagnosed small cell lung cancer patients are considered extensive stage,” Byers says. This means cancer cells are in both lungs or have spread beyond the chest. For decades, the standard of care for these patients has been a chemotherapy combination. But, thanks to research, there are new options.

“Very recent clinical trials have shown that adding immunotherapy to the standard therapy may extend patients’ lives,” Byers says.

For newly diagnosed patients whose cancer is not very advanced, surgery may also be an option, but Byers says that is very rare. 

Are there any new small cell lung cancer treatment advancements?

The Food and Drug Administration recently approved lurbinected in for patients with small cell lung cancer that came back after chemotherapy. That was the first new non-immunotherapy drug approved for the disease since 1998.

There’s also research into the benefits of radiation for patients with extensive stage disease. “Researchers are investigating whether adding radiation for these patients will enhance their response to standard therapy,” says Byers.

Her lab is also investigating a combination of checkpoint inhibitors and PARP inhibitors, a type of targeted therapy. “Those drugs are commonly used for breast cancer or ovarian cancer, but we’ve found they may also benefit some lung cancer patients,” Byers says.  

Eventually, biomarker testing may lead to more treatment options. “We’re really close to having a biomarker that will help match patients with treatment approaches based on which genes are turned on in their cancer,” Byers says.

What should newly diagnosed small cell lung cancer patients know?

“There is so much progress being made to advance new small cell lung cancer therapies,” Byers says. “That should give patients a lot of hope.”

Treatments are becoming more effective and more personalized based on new and emerging clinical trials.

“Seeking out a clinical trial may be your best option to find the treatment that’s right for you and your specific type of cancer,” Byers says.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.