Diatnosis and treatment of small cell lung cancer

What is it about?

Small cell lung cancers (SCLCs) account for ∼15–20% of all lung cancers. Because SCLC is almost always associated with long-term tobacco smoking, abstinence from smoking and smoking cessation are crucial for primary prevention. Because symptoms are generally unspecific, the disease is often diagnosed late, with 70% of patients already in stage IIIb or IV at the time of diagnosis. Chemotherapy, generally a platinum-based combination, is the mainstay of therapy and is generally combined with radiation in the first-line treatment of tumours up to stage IIIb. Surgery has a place in stage I SCLC, but plays no key role in advanced cancer. In patients who respond to first-line therapy, prophylactic cranial irradiation can prevent brain metastases and improve overall survival. Although the initial response to treatment is usually good, SCLC tends to relapse quickly. Topotecan is the most studied and widely used agent in second-line therapy; however, newer agents, including biological therapies, are under study.

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