Dr. Vivek Mehta, radiation oncologist, reviews the basic principles and treatment approach for limited stage small cell lung cancer, which combines chest radiation with concurrent chemotherapy.
Radiation to the brain is a component of our treatment of limited stage small cell lung cancer, even with no evidence of cancer there. Dr. Vivek Mehta, radiation oncologist, reviews why we would do such a thing.
Here's the podcast from a webinar I did last month with Dr. Weiss on the subject of whether patients with very limited small cell lung cancer (SCLC) should perhaps undergo surgery as a first intervention. Historically, surgery isn't considered as a typical treatment for patients with SCLC, even if it's very early stage, but some results from retrospective experiences suggest that the patients who undergo surgery in this setting do very well.
I recently had the opportunity to sit down with Dr. Toni Wozniak, Moedical Oncologist and lung cancer expert at the Barbara A. Karmanos Cancer Center at Wayne State University in Detroit, MI. We covered several topics, including SCLC, the subject of this podcast. It is an audio interview but includes a few figures that are synchronized with the audio on the video version, or you can download the pdf of the figures and just follow along with the audio.
One topic that is rarely considered in the management of SCLC is the role of surgery. The main reason is that the vast majority of patients presenting with SCLC either have extensive disease that has spread throughout the body (2/3 of SCLC presentations) or at least already have rather bulky nodal disease that would make then a less-than-ideal candidate for surgery even if they had NSCLC; the other key component of this bias against surgery is the strong tendency for SCLC to have micrometastatic disease even early in the disease process.
There's been several discussions about the potential value of maintenance therapy after the initial chemotherapy for SCLC; I've discussed this subject in a prior post, in which I focused on chemo -- while the results haven't been strong enough to lead to a change in standard practice, at least one trial showed a strong trend in the right direction.
Dr. Laskin has appreciated the warm welcome. Not only have you not scared her off, she's written her first post for us.
By the way, it's misleading to have my name and picture and "about the author" next to these posts by our new faculty -- the software upgrade will fix this. Here's her picture, so you can associate a name with a face (I had threatened to use a Wonder Woman picture if she didn't supply one).
We know PET scans can provide additional metabolic information that can be more sensitive and specific for cancer than chest x-rays and even CT scans in the initial staging of lung cancer (see prior post on introduction to PET scans). PET scans are now nearly universally employed in the initial workup, at least of patients who have NSCLC and aren’t already known to have stage IV disease.
Among the key issues in following patients with a history of treated lung cancer is the pattern of recurrence. We need to have a sense of when the risk is highest and where people are more likely to demonstrate new evidence of disease. Fortunately, there are several studies that can help us with these questions.