Small Cell Lung Cancer Treatment Options at Penn


Different treatments are available for those with small cell lung cancer. Some treatments are called standard. This means they are the currently used treatments. Some treatments are being tested in clinical trials. A treatment clinical trial is a study meant to help improve current treatments or obtain information on new treatments.

When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. You may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment, while others are available during or after treatment.

Treatment options vary depending on your situation including the stage of the cancer and other factors that may be present.

Talk with your team about the approach that is best for you.

Diagnosing Small Cell Lung Cancer

Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer. The following tests and procedures may be used:

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
  • Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
  • Penn interventional pulmonologists are using a new minimally invasive technology, called endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), as a less invasive way to stage lung cancer.

Standard treatments for patients with small cell lung cancer offered at Penn

Surgery

Surgery may be used if the cancer is found in one lung and in nearby lymph nodes only. Because this type of lung cancer is usually found in both lungs, surgery alone is not often used. Occasionally, surgery may be used to help determine the patient’s exact type of lung cancer. During surgery, the doctor will also remove lymph nodes to see if they contain cancer.

Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Penn thoracic oncologists have developed new surgical procedures to treat previously inoperable lung cancer.

Our surgeons are expert in evaluating the risks and benefits of minimally invasive procedures versus open procedures, so that you can make the decision that’s best for you.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiation therapy

  • External radiation (or external beam radiation) comes from a machine outside the body. The machine directs high-energy rays at the cancer and some normal surrounding tissue. It is the most often used radiation treatment. The machine used to deliver the high-energy rays is called a linear accelerator.
  • Three-dimensional (3-D) conformal radiation treatment is a type of external beam radiation. It uses computers to allow doctors to more precisely target a tumor with radiation beams (using width, height, and depth).
  • Intensity-modulated radiation treatment (IMRT). IMRT is a type of 3-D conformal radiation treatment that uses radiation beams (usually x-rays) of
    various intensities to give different doses of radiation, at the same time, to small
    areas of tissue. This allows the delivery of higher doses of radiation to the tumor and lower doses to nearby healthy tissue.
  • Internal radiation treatment, or brachytherapy, is given by placing an implant into or near the tumor. The implant is a small container that holds the
    radioactive source or material. Internal radiation treatment allows your doctor to give a higher total dose of radiation to a smaller area and in a shorter time than with external radiation treatment.
  • Photodynamic therapy (PDT) combines a drug called a photosensitizer or photosensitizing agent with a specific type of light to kill cancer cells.
    Photosensitizers are drugs that when exposed to a specific wavelength of light,
    produce a form of oxygen that kills nearby cells. PDT can also work by
    shrinking or destroy tumors by damaging blood vessels in the tumor. This
    prevents the cancer from receiving nutrients. Also, PDT may activate the
    immune system to attack the tumor cells.
  • Stereotactic radiosurgery is a a type of external radiation therapy that uses special equipment to position the patient and precisely give a single large dose of radiation to a tumor. It is used to treat brain tumors and other brain disorders that cannot be treated by regular surgery. It is also being studied in the treatment of other types of cancer. Also called radiation surgery, radiosurgery, and stereotaxic radiosurgery.
  • Proton Therapy is the most precise form of radiation treatment for cancer possible, while minimizing damage to healthy tissue and surrounding organs.

Laser therapy

Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells. Find out when this is avail at Penn.

Endoscopic stent placement

An endoscope is a thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may be used to place a stent in a body structure to keep the structure open. Endoscopic stent placement can be used to open an airway blocked by abnormal tissue.

New types of treatment are being tested in clinical trials at Penn.

The Abramson Cancer Center hosts a wide range of materials and activities that provide education and support to address key areas of concern for cancer patients and their loved ones. We are proud that many of our innovative patient education programs have been recognized by national groups, including the National Cancer Institute's Cancer Patient Education Network.

Our educational materials and support activities help people deal with the physical and emotional consequences of a cancer diagnosis and treatment. They also assist patients and families to resume active lives after treatment.

Our support group meetings provide information on topics of ... read more Support

Different treatments are available for those with small cell lung cancer. Some treatments are called standard. This means they are the currently used treatments. Some treatments are being tested in clinical trials. A treatment clinical trial is a study meant to help improve current treatments or obtain information on new treatments.

When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. You may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment, while others are available during or after treatment.

Treatment options vary depending on your situation including the stage of the cancer and other factors that may... read more Treatment

The Abramson Cancer Center of the University of Pennsylvania is committed to helping each cancer survivor find ways to enjoy life to the fullest. We have a nationally recognized program that focuses on the issues that survivors face, called "Living Well After Cancer™."

The LIVESTRONG™ Survivorship Center of Excellence, The Living Well After Cancer Program (LWAC) at the Abramson Cancer Center, directed by Linda A. Jacobs, PhD, RN, is a clinical, research, and education effort focused on early intervention and prevention of disease as the ultimate goal.

The multidisciplinary LWAC Program currently provides care and research opportunities to cancer survivors treated at Penn, the University of Pennsylvania Cancer Network hospitals, and through the Living Well ... read more Living Well

Survivor Stories

Andrew Vartanian

Immediately after being told by his primary care physician that the Abramson Cancer Center is one of the best cancer institutions in the country, Andrew Vartanian made his first appointment.




Spotlight

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials

Clinical trials are studies to find new ways to prevent, detect and treat cancer. The purpose of each clinical trial is to answer a specific question. Our physicians carefully design these studies to find new ways to improve care and quality of life ... more about clinical trials