Saturday, November 27, 2010

SCLC

(my father-in-law was diagnosed with this disease on Wednesday. He's only been sick for a few weeks but his health is declining quickly. If you are friends with hubs, please don't email or facebook him about this. Thanks.)
"Small Cell Lung Cancer - makes up nearly 20% of all Lung Cancer cases. It is associated with cancer cells smaller in size than most other cancer cells. These cells may be small, but they can rapidly reproduce to form large tumors. Their size and quick rate of reproduction allows them to spread to the lymph nodes and to other organs of the body. This type of Lung Cancer is almost always caused by smoking or second hand smoke. 

"Small cell lung cancer (stages): 
  • Limited stage means that the cancer can only be seen in the lung,  surrounding lymph nodes or in fluid around the lung. 
  • Extensive stage means that the cancer has spread outside of the lungs to another area of the body. Typically, the chest, liver or brain. Because small cell lung cancer is comprised of tiny cells and not a solid tumor, it is usually inoperable, except in rare cases in the early limited stage. (3)

    Regardless of the stage of small cell lung cancer, the prognosis is unsatisfactory even though tremendous strides on treatment and diagnosis over the past 15 years have been made. Because of this, all patients diagnosed with this kind of cancer are eligible to participate in ongoing clinical trials. For more information on clinical trials, you can visit the National Cancer Institute's website ."
(quotes courtesy of The Beverly Fund)


Treatment

Because SCLC spreads quickly throughout the body, treatment must include cancer-killing drugs (chemotherapy) taken by mouth or injected into the body.
  • Chemotherapy may be combined with radiation therapy of the lungs in people who have limited disease.
  • The most commonly used drugs in the U.S. are etoposide with either cisplatin or carboplatin.
Because the disease has usually spread by the time it is diagnosed, very few patients with SCLC are helped by having surgery. Surgery is only considered when there is only one tumor that has not spread. Chemotherapy or radiation will be needed after surgery.
Combination chemotherapy and radiation treatment is given to people with extensive SCLC. However, the treatment only helps relieve symptoms. It does not cure the disease.
Often, SCLC may have already spread to the brain, even when there are no symptoms or other signs of cancer in the brain. As a result, radiation therapy to the brain may be given to some patients with smaller cancers, or to those who had a good response in the first round of chemotherapy. This method is called prophylactic cranial irradiation (PCI).

Outlook (Prognosis)

How well you do depends on how much the lung cancer has spread.
Without treatment, the average survival is 2 -4 months. Treatment can often prolong life to 6 - 12 months in patients with extensive disease. About 10% of patients with limited spread will show no evidence of cancer at 2 years.
This type of cancer is very deadly. Only about 6% of people with this type of cancer are still alive 5 years after diagnosis.
(Treatment and Prognosis information courtesy of the National Institutes of Health)



Supportive Therapy The importance of supportive therapy in the treatment of lung cancer cannot be overemphasized.








Quite clearly, malnutrition results in a bad outcome in patients with lung cancer. Patients must be served a palatable meal and attempts must be made to work with patients to determine food likes and dislikes.
Pain control is of critical importance, and the tools to achieve control are available even for the most advanced cases. These include the use of pain-relieving (analgesic) drugs such as non-steroidal anti-inflammatory agents, mild narcotics, strong narcotics, continuous narcotics and narcotics delivered into the spinal canal (epidural). Pain control can generally be achieved without interfering with mental competence. Nausea can be controlled with a variety of drugs
Physical therapy will help maintain muscle strength to keep life as normal as possible.

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