LUNG CANCER
Small Cell Carcinomas
Small cell carcinomas have a tendency to spread early and are very sensitive to chemotherapy and radiation therapy. For these reasons, surgery is not routinely used in their treatment. Early (“limited”) stage patients are those who have no evidence on x-rays, bone scans, and CT scans of any spread outside of the chest. Treatment usually consists of multiple cycles of chemotherapy in conjunction with radiation therapy to the chest (to include the primary tumor as well as potential lymph node drainage pathways). Radiation treatments are usually given once or twice per day, five days a week, for approximately 4 to 6 weeks. On occasion, preventive (elective or “prophylactic”) radiation therapy to the brain will also be recommended, since small cell carcinomas often spread to this area and chemotherapy may not infiltrate the brain as well as other sites. In general, to prevent growth of any small, undetectable cancer sites in the brain, a lower dose of radiation is given than would be used to treat actual known sites of metastatic disease. Radiation therapy can also be given to sites of distant spread (metastases) to alleviate pain or tumor impingement on vital structures, such as the spinal cord. In general, small cell lung cancer can be cured in approximately 20% – 50% of patients who have disease confined to the chest, using multimodality (chemotherapy and radiotherapy) treatment.
