SCLC is a distinct type of neuroendocrine cancer, which shows aggressive behavior, rapid growth, and early distant spread.
Lung cancer is classified into two primary types as:
non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
Limited-stage cancer is treated with chemotherapy and radiation, while extensive-stage cancer is incurable, which requires systemic chemotherapy to improve quality of life and prolong survival.
Epidemiology
In US, this type of lung cancer has second place in prevalence for both genders, preceded by prostate cancer in males and breast cancer in females.
Small cell lung cancer rates decreased due to declining smoking prevalence. Lung cancer rates decrease in men and women of all races aged between 30 to 54 years old.
Anatomy
Pathophysiology
SCLC cancer can develop through various routes that hinder conventional DNA mending procedures.
SCLC originates in peri bronchial areas and infiltrates the bronchial submucosa, with widespread metastases occurring early in the disease’s progression.
Etiology
Tobacco chewing, second-hand smoke, and environmental factors increase the risk of lung cancer up to 85% of total cases.
Certain occupational and environmental factors can significantly influence the development of SCLC.
Genetics
Prognostic Factors
SCLC is typically classified into two stages: limited-stage and extensive-stage.
Following are the indicators of poor prognosis:
Relapsed disease
Weight loss of greater than 10% of baseline body weight
Poor performance status
Hyponatremia
Clinical History
Small cell lung cancer is more commonly diagnosed in older individuals.
Physical Examination
Assessment of vital signsÂ
Lung ExaminationÂ
Lymph Node examinationÂ
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Patients experience respiratory symptoms such as a persistent cough, shortness of breath, and chest pain.
SCLC has aggressive behavior and rapid growth. Compared to non-small cell lung cancer (NSCLC), SCLC tends to present at a more advanced stage.
Differential Diagnoses
Non-Small Cell Lung Cancer
Pneumonia
Tuberculosis
Fungal infections
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Chemotherapy is used for SCLC due to its effectiveness in targeting rapidly dividing cancer cells which includes platinum-based agents.
Radiation therapy is used alone for the limited stage of SCLC.
Supportive care and preventive measures should be carried out to improve the overall health and quality of life of patients.
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Education should be given to individuals about cautious with activities that could cause chondronecrosis.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Â
Use of chemotherapy drugs
Atezolizumab: It is an immune checkpoint inhibitor which blocks the PD-L1 protein on cancer cells and allows the immune system to identifycancer cells more effectively.Â
Use of immune inhibitors
Atezolizumab and durvalumab are humanized monoclonal anti-programmed death-ligand 1 (PD-L1) antibodies which have advanced survival rate, when combined with a platinum agent.Â
Use of Angiogenesis Inhibitors
Bevacizumab is an angiogenesis inhibitor that targets vascular endothelial growth factor (VEGF). It may be combined with chemotherapyin the treatment of extensive-stage SCLC.
Use of PARP Inhibitors
Olaparib and veliparib may be used in combination with chemotherapy in patients with SCLC and specific DNA repair gene mutations. Â
Biopsy: It is the initial diagnostic procedure for SCLC, which involves tissue samples from the lung mass or lymph nodes using techniques such as bronchoscopy and CT-guided biopsy. SCLC spreads to the pleura which causes pleural effusion. Procedures like pleurocentesis or thoracentesis can drain fluid for diagnostic purposes and relieve symptoms.Â
use-of-phases-in-managing-small-cell-lung-cancer
In the initial diagnosis phase, the physician assesses symptoms related to lung cancer, including CT scans and PET scans, and biopsy to confirm the diagnosis.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
The long-term management phase is important phase involves continuous monitoring and progress of treatment.Â
for Small Cell Lung Cancer, etoposide is used in combination with other agents as a dose :
35
mg/m^2
Intravenous (IV)
over 30-60 minutes once a day for 1-4 days to 50 mg per m2 IV over 30-60 minutes once a day for 1-5 days every 3-4 weeks
Dose Adjustments
Renal Dose Adjustments
CrCl >50 ml per min: 100% of the normal dose should be administered
CrCl 15-50 ml per min: 75% of the normal dose should be administered
CrCl <15 mL/min: no data available
Liver Dose Adjustments:
no data available
with carboplatin and etoposide combination
Continue the course until disease progression, or unacceptable toxicity occurs
After completion of 4 cycles of carboplatin and etoposide combination, the recommended dosage of atezolizumab is:
840 mg given IV every two weeks or 1200 mg given IV every three weeks, or 1680 mg given IV every four weeks
Continue the course until disease progression, or unacceptable toxicity occurs
Note:
the first infusion is administered for over 60 minutes if well-tolerated, and subsequent infusions administered for around 30 minutes
Indicated for this type of metastatic lung cancer in patients who have taken platinum-based chemotherapy before the disease progression
3.2 mg/m2 intravenously every 21 days
Start over the treatment only if the ANC (absolute neutrophil count) is more than 1500 cells/mm3 & platelet count is more than 100,000/mm3
Continue the disease progression until unacceptable toxicity is acquired
Dose Modifications
Dose reduction
1st dose reduction-2.6 mg/m2
intravenously every 21 days
2nd dose reduction- 2 mg/m2 intravenously every 21 days
If unable to tolerate more than 2 mg/m2 for more than 2 weeks, permanently discontinue the dose
In the case of renal or hepatic impairment, no dose adjustment is required
SCLC is a distinct type of neuroendocrine cancer, which shows aggressive behavior, rapid growth, and early distant spread.
Lung cancer is classified into two primary types as:
non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
Limited-stage cancer is treated with chemotherapy and radiation, while extensive-stage cancer is incurable, which requires systemic chemotherapy to improve quality of life and prolong survival.
In US, this type of lung cancer has second place in prevalence for both genders, preceded by prostate cancer in males and breast cancer in females.
Small cell lung cancer rates decreased due to declining smoking prevalence. Lung cancer rates decrease in men and women of all races aged between 30 to 54 years old.
SCLC cancer can develop through various routes that hinder conventional DNA mending procedures.
SCLC originates in peri bronchial areas and infiltrates the bronchial submucosa, with widespread metastases occurring early in the disease’s progression.
Tobacco chewing, second-hand smoke, and environmental factors increase the risk of lung cancer up to 85% of total cases.
Certain occupational and environmental factors can significantly influence the development of SCLC.
SCLC is typically classified into two stages: limited-stage and extensive-stage.
Following are the indicators of poor prognosis:
Relapsed disease
Weight loss of greater than 10% of baseline body weight
Poor performance status
Hyponatremia
Small cell lung cancer is more commonly diagnosed in older individuals.
Assessment of vital signsÂ
Lung ExaminationÂ
Lymph Node examinationÂ
Patients experience respiratory symptoms such as a persistent cough, shortness of breath, and chest pain.
SCLC has aggressive behavior and rapid growth. Compared to non-small cell lung cancer (NSCLC), SCLC tends to present at a more advanced stage.
Non-Small Cell Lung Cancer
Pneumonia
Tuberculosis
Fungal infections
Chemotherapy is used for SCLC due to its effectiveness in targeting rapidly dividing cancer cells which includes platinum-based agents.
Radiation therapy is used alone for the limited stage of SCLC.
Supportive care and preventive measures should be carried out to improve the overall health and quality of life of patients.
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.
Oncology, Other
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Education should be given to individuals about cautious with activities that could cause chondronecrosis.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Â
Oncology, Medical
Atezolizumab: It is an immune checkpoint inhibitor which blocks the PD-L1 protein on cancer cells and allows the immune system to identifycancer cells more effectively.Â
Oncology, Radiation
Atezolizumab and durvalumab are humanized monoclonal anti-programmed death-ligand 1 (PD-L1) antibodies which have advanced survival rate, when combined with a platinum agent.Â
Oncology, Radiation
Bevacizumab is an angiogenesis inhibitor that targets vascular endothelial growth factor (VEGF). It may be combined with chemotherapyin the treatment of extensive-stage SCLC.
Oncology, Radiation
Olaparib and veliparib may be used in combination with chemotherapy in patients with SCLC and specific DNA repair gene mutations. Â
Oncology, Other
Biopsy: It is the initial diagnostic procedure for SCLC, which involves tissue samples from the lung mass or lymph nodes using techniques such as bronchoscopy and CT-guided biopsy. SCLC spreads to the pleura which causes pleural effusion. Procedures like pleurocentesis or thoracentesis can drain fluid for diagnostic purposes and relieve symptoms.Â
Oncology, Other
In the initial diagnosis phase, the physician assesses symptoms related to lung cancer, including CT scans and PET scans, and biopsy to confirm the diagnosis.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
The long-term management phase is important phase involves continuous monitoring and progress of treatment.Â
SCLC is a distinct type of neuroendocrine cancer, which shows aggressive behavior, rapid growth, and early distant spread.
Lung cancer is classified into two primary types as:
non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
Limited-stage cancer is treated with chemotherapy and radiation, while extensive-stage cancer is incurable, which requires systemic chemotherapy to improve quality of life and prolong survival.
In US, this type of lung cancer has second place in prevalence for both genders, preceded by prostate cancer in males and breast cancer in females.
Small cell lung cancer rates decreased due to declining smoking prevalence. Lung cancer rates decrease in men and women of all races aged between 30 to 54 years old.
SCLC cancer can develop through various routes that hinder conventional DNA mending procedures.
SCLC originates in peri bronchial areas and infiltrates the bronchial submucosa, with widespread metastases occurring early in the disease’s progression.
Tobacco chewing, second-hand smoke, and environmental factors increase the risk of lung cancer up to 85% of total cases.
Certain occupational and environmental factors can significantly influence the development of SCLC.
SCLC is typically classified into two stages: limited-stage and extensive-stage.
Following are the indicators of poor prognosis:
Relapsed disease
Weight loss of greater than 10% of baseline body weight
Poor performance status
Hyponatremia
Small cell lung cancer is more commonly diagnosed in older individuals.
Assessment of vital signsÂ
Lung ExaminationÂ
Lymph Node examinationÂ
Patients experience respiratory symptoms such as a persistent cough, shortness of breath, and chest pain.
SCLC has aggressive behavior and rapid growth. Compared to non-small cell lung cancer (NSCLC), SCLC tends to present at a more advanced stage.
Non-Small Cell Lung Cancer
Pneumonia
Tuberculosis
Fungal infections
Chemotherapy is used for SCLC due to its effectiveness in targeting rapidly dividing cancer cells which includes platinum-based agents.
Radiation therapy is used alone for the limited stage of SCLC.
Supportive care and preventive measures should be carried out to improve the overall health and quality of life of patients.
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.
Oncology, Other
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Education should be given to individuals about cautious with activities that could cause chondronecrosis.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Â
Oncology, Medical
Atezolizumab: It is an immune checkpoint inhibitor which blocks the PD-L1 protein on cancer cells and allows the immune system to identifycancer cells more effectively.Â
Oncology, Radiation
Atezolizumab and durvalumab are humanized monoclonal anti-programmed death-ligand 1 (PD-L1) antibodies which have advanced survival rate, when combined with a platinum agent.Â
Oncology, Radiation
Bevacizumab is an angiogenesis inhibitor that targets vascular endothelial growth factor (VEGF). It may be combined with chemotherapyin the treatment of extensive-stage SCLC.
Oncology, Radiation
Olaparib and veliparib may be used in combination with chemotherapy in patients with SCLC and specific DNA repair gene mutations. Â
Oncology, Other
Biopsy: It is the initial diagnostic procedure for SCLC, which involves tissue samples from the lung mass or lymph nodes using techniques such as bronchoscopy and CT-guided biopsy. SCLC spreads to the pleura which causes pleural effusion. Procedures like pleurocentesis or thoracentesis can drain fluid for diagnostic purposes and relieve symptoms.Â
Oncology, Other
In the initial diagnosis phase, the physician assesses symptoms related to lung cancer, including CT scans and PET scans, and biopsy to confirm the diagnosis.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
The long-term management phase is important phase involves continuous monitoring and progress of treatment.Â
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