- SCLC Types
- SCLC Symptoms
- SCLC Causes
- SCLC Prognosis
- SCLC Treatment
- Drug Types
What are medications for small cell lung cancer (SCLC)?
Medications prescribed for small cell lung cancer are primarily chemotherapy drugs which destroy cancer cells. Antiemetic medications to prevent side effects such as nausea, vomiting and diarrhea are routinely administered along with chemotherapy.
Other medications used for SCLC include medications such as painkillers and corticosteroids for symptom relief, and palliative care to enhance quality of life during the terminal stages of the disease.
What is small cell lung cancer?
Small cell lung cancer is an aggressive type of cancer that starts in the lung’s respiratory tubes (bronchi) in the middle of the chest. Cancers are a group of diseases in which abnormal cells evade the body’s regulatory mechanisms to grow uncontrollably.
Cancers arise from genetic mutations which enable cancer cells to grow, divide, migrate and avoid programmed death (apoptosis) that normal cells undergo when damaged or no longer needed.
Lung cancers are of two main types:
- Small cell lung cancer (SCLC): SCLC accounts for approximately 10% to 15% of lung cancers. SCLCs tend to grow and spread (metastasize) rapidly. SCLC responds well to radiation and chemotherapy, but for most people cancer eventually returns.
- Non-small cell lung cancer (NSCLC): Lung cancers other than small cell lung cancer are grouped into non-small cell lung cancers, because their treatments and prognoses are generally similar. Approximately 85% of lung cancers are non-small cell lung cancer. The three types of NSCLC are:
Other types of lung cancers include carcinoid tumors, sarcomas and hamartoma, a benign tumor, but these are rare. This article will emphasize SCLC.
What are the types of small cell lung cancer?
The two types of small cell lung cancer are:
- Small cell carcinoma: Small cell carcinoma is named after the size and shape of the cancer cells. It is also called oat cell carcinoma because the cells look like oats under the microscope.
- Combined small cell carcinoma: Combined small cell carcinoma is small cell carcinoma combined with any of the non-small cell carcinomas.
Symptoms of SCLC
Symptoms of SCLC can develop and worsen in a matter of weeks as the tumor grows rapidly. The symptoms of the primary tumor in SCLC include:
Tumor growth and spread put pressure on the veins, nerves and other organs in the chest region, resulting in symptoms that include:
- Swelling of face and hands
- Hoarseness of voice
- Difficulty swallowing
- Shortness of breath
- Stridor, a sound caused due to the compression of the airways
- Lung infection, inflammation and fever
Symptoms of metastatic SCLC depend on the region of metastasis. The most common sites of metastasis include the brain, liver, adrenal glands, bones and bone marrow. Following are some of the common symptoms from metastasis:
- Vertebral column and spine:
- Bone: Bone pain
- Liver: Jaundice and abdominal pain
Small cell lung cancers are neuroendocrine cancers, which means they develop in specialized cells that have traits of both nerve cells and hormone-producing endocrine cells. Cancer causes these cells to release substances which make the immune system attack healthy nerve cells resulting in certain rare disorders known as paraneoplastic syndromes.
Causes of SCLC
Tobacco smoke, including secondhand, is the predominant cause of SCLC. Approximately 98% of SCLC patients have smoking in their history. Other risk factors include:
- Exposure to radon, an inert gas produced by uranium decay
- Exposure to carcinogenic substances such as asbestos, silica, arsenic and others
- Taking beta carotene supplements and being a heavy smoker
- Air pollution
- Previous radiation therapy to the chest for other cancers
- Family or personal history of lung cancer
What is the survival rate of small cell lung cancer?
Small cell lung cancers are particularly aggressive and incurable in the extensive stage. The general survival rate at five years for localized SCLC (confined to the lung) is 27%. For SCLC that has spread within the chest region, survival rate at five years is 16%. The five-year survival rate is 3% for metastatic SCLC that has spread to distant parts of the body.
What is the best treatment for small cell lung cancer?
A combination of two chemotherapy drugs constitutes the primary treatment for small cell lung cancer. Choice of chemotherapy drugs and additional treatments depend on the cancer stage at the time of diagnosis, and the patient’s age, gender and general health. SCLC in classified into two stages:
- Limited stage: Limited stage SCLC is cancer that is confined to one side of the chest, in one lung and the lymph nodes on the same side. Only about 30% of patients are at this stage at the time of diagnosis. Standard treatment for limited stage SCLC is combination chemotherapy along with radiation therapy.
- Extensive stage: Extensive stage is incurable in SCLC because cancer has metastasized to the other lung, brain, bone, bone marrow or liver tissue. Nearly 70% of patients are at an extensive stage at the time of diagnosis. Combination chemotherapy, with or without immunotherapy, is the primary treatment for extensive stage SCLC, to prolong survival and enhance quality of life.
Treatments for small cell lung cancer include the following:
Systemic treatments with chemotherapy medications are effective for SCLC because they can work on cancer cells all over the body. Other medications prescribed for SCLC boost the immune system, provide relief from symptoms of SCLC, treat side effects of chemotherapy and complications from paraneoplastic syndromes.
Radiation therapy is the use of high energy X-rays to destroy cancer cells. Radiation therapy can only kill cancer cells directly in the path of the radiation beam and can also damage healthy cells, which makes it useful only for limited stage SCLC with localized tumors. Radiation therapy is performed in addition to chemotherapy.
Prophylactic (preventative) cranial irradiation
Prophylactic cranial irradiation describes mild radiation doses to the brain to reduce the risk of SCLC spreading there. This procedure is used only for patients with limited stage SCLC who have achieved remission after chemotherapy along with radiation or surgery.
Laser therapy is the use of laser beams to kill cancer cells.
Surgery plays a minimal role in SCLC treatment. Surgery for SCLC involves surgical removal (resection) of the cancerous portion of the lung and nearby lymph nodes. Surgery, after or before chemotherapy, may be an option for a small number of patients to control relapse in early stage localized tumors. Diagnosis of SCLC at such an early stage occurs in fewer than 5% of SCLC patients.
Clinical trials and palliative care
People who have a relapse of SCLC, or refractory SCLC that does not respond to standard treatment have the option of enrolling in clinical trials for new treatments. People in advanced and terminal stages of SCLC are treated with palliative care to manage pain and other complications from the cancer.
Latest Cancer News
Daily Health News
What are the types of medications for small cell lung cancer?
The goals of medications for SCLC are to induce remission, prevent relapse and complications, and provide palliative care. Medications may be administered through various routes such as oral, injections or intravenous infusions.
The two main types of medications used in treatment of SCLC are:
- Chemotherapy: Chemotherapy medications are toxic compounds which are highly effective in killing cancer cells in SCLC. Combination chemotherapy, typically with two chemotherapy drugs, is the primary treatment for both stages of SCLC. Antiemetics and corticosteroids are administered to treat the side effects of chemotherapy.
- Immunotherapy: Immunotherapy medications are lab-produced protein molecules known as monoclonal antibodies that enhance the immune system’s ability to fight the cancer cells.
Other medications prescribed for SCLC include pain relievers, antibiotics to prevent infections and medications to treat specific cancer symptoms and correct electrolyte imbalance that can occur from paraneoplastic syndromes (a rare and harmful type of immune response to cancer cells).
How do medications work for small cell lung cancer?
Chemotherapy medications work in various ways to prevent cell growth and replication of DNA during cell division. Chemotherapy drugs are toxic to all cells in the phase of growth and division, including healthy ones. Small cell lung cancer is an aggressive cancer in which cancer cells are constantly growing and dividing, and thus are highly responsive to chemotherapy treatment.
A combination of two chemotherapy drugs is the typical treatment regimen for SCLC. Choice of chemotherapy agents depends on the disease stage. Because of SCLC’s metastatic nature, doctors commonly prescribe many chemotherapy drugs with established clinical efficacy off-label, in addition to the chemotherapy medications approved by FDA specifically for SCLC.
- Combination chemotherapy
- Most widely used combination regimens for both stages of SCLC are:
- Cisplatin or carboplatin with etoposide
- Cisplatin or carboplatin with irinotecan
- Most widely used combination regimens for both stages of SCLC are:
Immunotherapy: PD-1/PD-L1 inhibitors
Immunotherapy medications for SCLC are monoclonal antibodies known as PD-1/PD-L1 inhibitors, which work by enhancing the activity of T-cells, a type of immune cell. T-cells induce programmed death in damaged or mutated cells, including cancer cells, but cancer cells develop the ability to evade immune activity.
T-cell activity is inhibited when protein molecules known as PD-1 and PD-L1 on the T-cell surface interact. Cancer cells escape programmed death by secreting PD-L1 or inducing the T-cells in the tumor microenvironment to produce PD-L1. PD-1/PD-L1 inhibitors block the interaction between PD-1 and PD-L1.
PD-1/PD-L1 inhibitors approved by FDA for SCLC are:
- Nivolumab (Opdivo)
- Pembrolizumab (Keytruda)
- Atezolizumab (Tecentriq)
- Durvalumab (Imfinzi)
Antiemetics and corticosteroids
Antiemetics and corticosteroids are always prescribed with chemotherapy medications to prevent nausea, vomiting and other side effects. FDA-approved medications for chemotherapy side effects include:
- Metoclopramide hydrochloride (Reglan)
- Ondansetron hydrochloride (Zofran)
- Granisetron (Sancuso, Sustol)
- Palonosetron hydrochloride (Aloxi)
- Please visit our medication section of each drug within its class for more detailed information.
- If your prescription medication isn’t on this list, remember to look on MedicineNet.com drug information or discuss with your healthcare provider and pharmacist.
- It is important to discuss all the drugs you take with your doctor and understand their effects, possible side effects and interaction with each other.
- Never stop taking your medication and never change your dose or frequency without consulting with your doctor.
Multimedia: Slideshows, Images & Quizzes
Lung Cancer: Early Signs, Symptoms, Stages
Learn about lung cancer early warning signs, symptoms and treatments. What causes stage IV lung cancer? Get more information on...
Lung Cancer Risks: Myths and Facts
Learn about lung cancer myths and facts. Explore how cigar smoke, menthol, and pollution can increase your risk of lung cancer...
Lung Cancer Quiz: Signs and Symptoms
Lung cancer is the number one cause of cancer deaths in both men and women in the U.S. and worldwide. Get the facts about lung...
Picture of Lung Cancer
Cancer of the lung, like all cancers, results from an abnormality in the body's basic unit of life, the cell. See a picture of...
Related Disease Conditions
Is Shingles Contagious?
Shingles is an infection caused by the varicella-zoster virus. Shingles symptoms and signs include skin burning, numbness, and tingling along with a painful red, blistering rash. Shingles is contagious until all of the blisters have crusted over.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due to tobacco smoke. Lung cancers are classified as either small-cell or non-small-cell lung cancers.
Small Cell Lung Cancer vs. Non-Small Cell Lung Cancer
Non-small cell lung cancers (NSCLC) consist of large cell carcinomas, adenocarcinomas, and squamous cell carcinomas. Small cell lung cancer (SCLC) usually starts in the bronchi and typically appears in those who smoke. SCLC and NSCLC are staged in different manners, and SCLC tends to metastasize more quickly than NSCLC. Signs and symptoms of NSCLC and SCLC include shortness of breath, coughing up blood, recurring lung infections, and chest pain. Treatment may involve radiation therapy, chemotherapy, and surgery.
Can Pancoast Lung Cancer Be Cured?
Pancoast tumors are a rare type of lung cancer that forms at the extreme top of either of the lungs. Due to their location at the top of the lung, there’s a high chance that cancer might attack the adjacent tissue and produce typical symptoms.
What Are the Four Types of Lung Cancer?
The four types of lung cancer are classified by what kind of cells the cancer affects and what the tumor cells look like under a microscope. Lung cancers can be small-cell or non-small cell, further classified as squamous cell carcinoma or adenocarcinoma.
What Is the Survival Rate of Non-Small Cell Lung Cancer?
There are two main types of lung cancers, namely, small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC accounts for 85% of all lung cancer cases in the United States. It must be noted that medical science is progressing with leaps and bounds, and treatment for lung cancer must be initiated and maintained despite the stage of diagnosis.
Six Early Signs of Lung Cancer
Lung cancer is the third most common cancer in the United States. It may not show its signs and symptoms in its early stages. Signs and symptoms typically appear in the advanced stage of the disease.
Is There a Screening Test for Lung Cancer?
A screening test is generally performed as a preventative measure to detect a potential health problem or disease in a person who is yet to have signs or symptoms. There is a screening test for lung cancer, however it is only deemed necessary for people at risk for lung cancer.
What Should I Do After an Unwanted Pregnancy?
There are a variety of options that may help you handle your situation. It might help you to visualize each option and decide how you feel about it. Consider reaching out to trained professionals or close friends if you get overwhelmed.
Treatment & Diagnosis
- Lung Cancer FAQs
- Sensitive to Smoke, Lung Cancer Gene
- Lung Cancer and Chemotherapy
- Lung Cancer Signs and Symptoms
- 5 Causes of Lung Cancer in Non-Smokers
- Dana Reeve Dies of Lung Cancer by Dr. Stoppler
- What Is the Survival Rate for Lung Cancer Nodules?
- Why Does Lung Cancer Spread So Fast?
- Can You Get Lung Cancer After Quitting Smoking?
- Stage IV Lung Cancer With ALK (Anaplastic Lymphoma Kinase) Rearrangement
- Lung Cancer - Health Beat Audio Segment
Medications & Supplements
Prevention & Wellness
Latest Cancer News
Daily Health News
Health Solutions From Our Sponsors
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.