Small cell lung cancer (SCLC) is rarer than non-small cell lung cancer (NSCLC) but tends to be more difficult to treat. SCLC can be more resistant and aggressive than other cancers, which can increase the risk of relapses.
Survival rates for many types of cancer have improved drastically over the last several decades. Despite this, SCLC survival rates have remained less favorable.
From 2000 to 2016, the 5-year relative survival rate in the United States only improved from
Most cases of SCLC have already spread to distant body parts when they’re diagnosed. This is because SCLC is an aggressive cancer. Even though many people respond to initial treatment, the majority experience relapse.
Researchers are still investigating why SCLC tends to be more resistant to treatment than most other cancers.
This article examines why SCLC is difficult to treat and reviews the most common current treatment options.
What is SCLC?
SCLC accounts for
SCLC is often classified as limited stage if it’s limited to one side of your chest and one radiation field. Extensive-stage SCLC has spread widely throughout your lung, to your other lung, or other parts of your body.
SCLC tends to be difficult to treat due to its high risk of relapse, aggressive course of spread, and limited treatment options.
Resistant to treatment
More than 60% to 70% of people with SCLC have an initial response to chemotherapy. But after this initial response, many people relapse. Relapse often occurs within the first year of treatment.
It’s still not clear why SCLC is more resistant to treatments than many other types of cancer. However, many types of immunotherapy and targeted therapy drugs are currently being evaluated as potential new treatments for SCLC.
Immunotherapy drugs recruit your immune system to destroy cancer cells. Targeted therapy drugs help destroy cancer cells while minimally damaging healthy cells.
Aggressive and quick to spread
SCLC tends to be very aggressive and spreads to other tissues quickly. When someone is diagnosed, the cancer may have already spread to their:
- liver
- brain
- adrenal glands
- bone
- bone marrow
SCLC that has spread to distant parts of your body is called metastatic SCLC.
Learn more about how fast SCLC spreads.
Symptoms often don’t appear until later stages
People with SCLC often don’t develop noticeable symptoms until the cancer reaches distant tissues. Early symptoms such as chest pain or a cough might be attributed to other causes, such as the flu.
In the United States, from 2012 to 2021,
Fewer new treatments in development
Compared to NSCLC, relatively few new drugs have been approved to treat SCLC.
Between 2021 and 2023, the
The following treatments are most commonly used to treat SCLC:
- Surgery: Surgery combined with chemotherapy or chemotherapy and radiation therapy is a treatment option for limited-stage SCLC.
- Chemotherapy: Chemotherapy is one of the main treatments for limited and extensive-stage SCLC. It’s often combined with other treatments, such as radiation therapy or immunotherapy.
- Radiation therapy: Radiation therapy is often combined with chemotherapy to shrink the cancer and to either prevent or treat the spread to other locations, such as your brain.
- Immunotherapy: The immunotherapy drugs Tecentriq (atezolizumab) and Imfinzi (durvalumab) are often used to treat extensive-stage SCLC. Many other immunotherapy drugs are under investigation.
- Laser therapy: Doctors use laser therapy to shrink a tumor if it’s impairing your breathing.
- Endoscopic stent placement: An endoscopic stent placement helps open up your airways if the cancer is impairing your breathing.
Can people survive small cell lung cancer?
The outlook for SCLC tends to be less favorable since most people aren’t diagnosed until the cancer is advanced.
Anyone who has cancer that is caught early might be eligible for surgery combined with treatments like chemotherapy and radiation. These can be curative for some people.
Extensive-stage SCLC is usually not considered curable. Treatment is usually palliative, meaning it aims to reduce symptoms and improve quality of life.
The
Like other cancers, the relative survival rate tends to improve the earlier SCLC is found. Survival rates from 2014 to 2020 were:
| Stage | 5-year relative survival rate |
|---|---|
| Localized | 33.3% |
| Regional | 19.0% |
| Distant | 3.9% |
SCLC tends to be an aggressive cancer that often relapses after someone initially responds to treatment. While the survival rate remains low, researchers are constantly looking into new potential treatment options.
A number of clinical trials are currently investigating the potential benefit of targeted therapies and immunotherapy drugs for treating advanced SCLC. Breakthroughs in these drugs may lead to future improvements in treatment.
If you have been diagnosed with SCLC, consider asking your doctor for information on clinical trials near you.