Treatment options for small cell lung cancer (SCLC)

A team of health professionals decides if you need treatment straight away. They also decide what treatment options you have.

The most common treatments for small cell lung cancer are:

• chemotherapy
• radiotherapy
• surgery
• chemotherapy with radiotherapy (chemoradiotherapy)
• radiotherapy to the brain (prophylactic cranial irradiation – also called PCI)
• chemotherapy with or without immunotherapy

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

Most people are referred to a lung cancer MDT. You might go to a different hospital if there isn't a specialist MDT at your local hospital.

The team usually includes:

• a specialist surgeon
• cancer specialists (oncologists) who specialise in treating cancer with cancer drugs (medical oncologist) and radiotherapy (clinical oncologist)
• a specialist cancer nurse (also called clinical nurse specialist)
• a pathologist (an expert who examines any cancer or tissue the surgeon removes)
• a pharmacist
• a radiologist (who looks at your scans and x-rays)
• a dietician (who offers support and advice about eating and drinking)

Your treatment depends on:

• the type of lung cancer
• where your cancer is
• how far it has grown or spread (the stage)
• your general health and level of fitness

Treatment overview

The main treatments are:

• chemotherapy
• radiotherapy
• surgery
• chemoradiotherapy (chemotherapy with radiotherapy)
• radiotherapy to the brain (prophylactic cranial irradiation – also called PCI)
• chemotherapy with or without immunotherapy

You have one or more of these treatments. This depends on the stage of your cancer and also how well the treatment works.

Treatment for limited disease

Limited disease means your cancer is only in one lung. It might be in lymph nodes nearby. The cancer is in a single area that can be treated with radiotherapy. 

The main treatment for limited disease small cell lung cancer is chemotherapy. You usually then have radiotherapy to the chest.

If you are fit enough, you might have chemoradiotherapy. This means that you have chemotherapy at the same time as radiotherapy.

If your cancer is at a very early stage, you might be able to have surgery to remove the part of the lung containing the cancer. This is called a lobectomy. But surgery isn’t used very often for small cell lung cancer. If you do have surgery, you usually have chemotherapy afterwards and might also have radiotherapy.

After treatment

After you finish treatment, you might have radiotherapy to your head if the cancer in your lung has stopped growing and you are well enough. Radiotherapy to the head is called prophylactic cranial radiotherapy (PCR) and it aims to kill any cancer cells that might have spread to the brain but are too small to see on scans.

Treatment for extensive disease

Extensive disease means your cancer has spread outside your lung, either within your chest or to other parts of your body. Cancer that has spread to other parts of the body is also called metastatic (advanced) cancer.

Treatment aims to control the cancer for as long as possible and help with symptoms.

You usually have chemotherapy with or without immunotherapy. If the chemotherapy works well, you might have radiotherapy to your lungs afterwards.

After treatment

After treatment you might also have radiotherapy to your head if the cancer has stopped growing and you are well enough. Radiotherapy to the head is called prophylactic cranial radiotherapy (PCR). It aims to kill any cancer cells that might have spread to the brain but are too small to see on scans.

Symptom control

To control symptoms, you might also have other treatments such as:

• radiotherapy
• internal radiotherapy (brachytherapy)
• laser treatment
• freezing the tumour (cryotherapy)
• a rigid tube called a stent  to keep the airway open
• light therapy (photodynamic therapy - PDT)

Clinical trials

Doctors are always trying to improve treatments, and reduce side effects. As part of your treatment, your doctor might ask you to take part in a clinical trial. This might be to test a new treatment or to look at different combinations of existing treatments.

Your doctor will discuss your treatment, its benefits and the possible side effects with you.