Small Cell Overview
So when we think about lung cancer, we basically put it into two buckets. We have what’s called small cell lung cancer, and then we have what’s called non-small cell lung cancer. And the reason we do this is because small cell lung cancer is actually a lot different than non-small cell lung cancer. Small cell is a very aggressive type of lung cancer. And even the staging we use a little differently than the traditional one through four stages, or at least one through three. With small cell lung cancer, we call it extensive, which means basically it’s left that single lung in which it originated, or we call it limited, where it’s still there. When it’s limited, we hope that we can still cure small cell lung cancer. And usually it’s not surgery, which is the go-to for non-small cell. With small cell cancer, it is very sensitive to chemo and radiation at the same time. So if it is limited to one side of the chest and in that lung, then we do what’s called a platinum drug, and that’s a chemotherapy as well as etoposide in combination with radiation. You usually get this for a period of about six weeks. And the hope for that is cure. With that said, with limited small cell lung cancer, as well as extensive, we are very concerned about metastasis or spread to the brain. That’s why we always get a brain MRI to see if you already have disease there. Sometimes, depending on the circumstance of the small cell cancer, if you do not have disease that we can see, they still may elect to do radiation to the whole brain, just because of how high the occurrence is there. But there are long-term side effects to whole brain radiation, so we try and be very judicial on when that’s indicated. If you’re lucky and you’re able to catch small cell lung cancer almost incidentally, then you do go for surgery if it’s small enough. It’s when did the small cell lung cancer is too large to be able to take out with surgery or a little too advanced, even if it’s still limited or on that one side of the chest, that we do opt for concurrent chemo radiation.