Small cell lung cancer (SCLC) has a couple of characteristics that drive relatively poor prognosis statistics. The disease tends to develop rapidly and will metastasize to distant parts of the body much earlier than other forms of cancer. The “oat cell” multiplies rapidly and when it travels to another part of the body any malignancy which develops there will also be a small cell cancer. Thus treatment for the disease remains the same as for the primary tumor in the lung.
SCLC Staging and Treatment
Lung cancer in general does not demonstrate symptoms early in disease development; many patients are diagnosed as the result of a chest X-ray taken during a routine physical checkup. That is also true for SCLC; as a result about two thirds of all diagnosed patients have an advanced form of the disease by the time they learn that they’ve developed it. “Extensive” SCLC is the term for a stage four case of the disease; a patient who has been diagnosed with small cell lung cancer while the tumor is confined to one lung and possibly some nearby lymph nodes has an early form of the disease called “limited” small cell lung cancer.
The positive aspect to this is the fact that SCLC is dramatically responsive to both chemotherapy and radiation. Each form of treatment kills oat cells rapidly. One of the factors that defines limited SCLC is the ability to treat the disease with a single field of radiation exposure. However it is not uncommon for patients with an extensive form of the disease to have all malignancy eradicated during the initial treatment. Unfortunately small cell lung cancer has a very high rate of relapse, often occurring within months. The disease is not nearly as responsive to chemotherapy the second time around.
Limited Small Cell Lung Cancer Prognosis
Very few SCLC cases are diagnosed early enough that surgical intervention is a reasonable option. Usually the metastases precludes surgery as an effective option; however those few cases that are diagnosed early enough may be treated with surgical removal of the tumor or as much of it as possible. However in virtually all cases of SCLC chemotherapy and radiation are the two treatment modalities utilized.
Recently developed radiation techniques have contributed to improved survival rates for limited SCLC patients but the prognosis is still not very strong. Generally the most aggressive treatment is a combination of thoracic radiation treatment and chemotherapy. For patients that receive this treatment the median survival time on an average is 20 months. Some 45% of limited SCLC patients are alive after two years. About 14% make it to five years’ survival after initial treatment begins.
Extensive Small Cell Lung Cancer Prognosis
The advanced form of SCLC is generally assumed to be incurable. At this stage patients have developed small cell malignancies in multiple locations distant from the principal tumor, requiring multiple radiation sites which in turn reduces the number of radiation exposures feasible for each tumor. Chemotherapy remains a viable option, but as with limited SCLC is less effective when the disease comes out of remission. The survival rate after diagnosis is 6-12 months. The two-year survival rate with extensive SCLC is about 6%; the five year survival rate is about 2%.