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Small Cell Lung Cancer Chemotherapy Treatments

written by: Finn Orfano • edited by: Diana Cooper • updated: 10/29/2010

This article discusses chemotherapy for small cell lung cancer. The most often used drugs are briefly discussed, with their common side effects.

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    Small Cell Lung Cancer

    Small cell lung cancer constitutes about 10 to 15 percent of lung cancer diagnoses. Its name reflects the type of cancer cells that are involved. These cells are very small and mostly filled with the nucleus. Due to its appearance, it is also sometimes called ‘oat cell’ cancer. The main therapy for this kind of cancer is chemotherapy, because of two reasons:

    • This type of cancer responds very well to chemotherapy.
    • By the time it is diagnosed, it has usually already spread beyond the lungs.

    Several drugs can be used in chemotherapy for small cell lung cancer.

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    EP

    This is a combination of two drugs (Etoposide and Cisplatin) that is often used as chemotherapy. Both are colorless fluids that are introduced into the bloodstream through a central line or a short, small tube that is put into a vein. This treatment is implemented in cycles, usually six of them that last about three weeks each. Common side effects include:

    • Increased risk of infection due to the drop in white blood cells.
    • Fatigue as a result of the drop in red blood cells.
    • Easy bruising due to the drop in blood platelets.
    • Nausea.
    • Hair loss.
    • A sore mouth.
    • A drop in blood pressure.
    • Changes in bowel function (diarrhea or constipation).
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    Carboplatin

    This drug has a platinum atom at its centre. This forms DNA cross links that damage the cancer cells. This is administered to the bloodstream of the patient through a central line or cannula (short, small tube). It is usually given as a course of several cycles, and often in combination with other drugs, most notably gemcitabin (this treatment is than referred to as GemCarbo). The exact treatment plan depends on the type of cancer. Common side effects are:

    • Increased risk of infection because of the drop in white blood cells.
    • Fatigue as a result of the drop in red blood cells.
    • Easy bruising due to the drop in blood platelets.
    • Kidney damage.
    • Loss of fertility.
    • Arrestment of the menstrual cycle.
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    CAV(E)

    Another type of chemotherapy for small cell lung cancer is known as CAV (or CAVE), a combination of Cyclophosphamide, Adriamycin (also known as Doxorubicin) and Vincristine, sometimes complemented with Etoposide. With exception of adriamycin, which is red, these are all clear fluids that are intravenously brought into the bloodstream. Depending on the type and severity of the cancer, the treatment consists of 4 to 6 cycles that each last 2 to 3 weeks. Side effects common to this combination of drugs are:

    • Increased risk of infection due to the drop in white blood cells.
    • Fatigue because of the drop in red blood cells.
    • Easy bruising as a result of the drop in blood platelets.
    • Complete hair loss.
    • Mouth ulcers.
    • Sensitivity to sunlight.
    • Severe constipation.
    • Loss of fertility.
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    References

    • American Cancer Society: http://www.cancer.org/Cancer/LungCancer-SmallCell/index
    • Cancer Research UK: http://www.cancerhelp.org.uk/type/lung-cancer/about/types-of-lung-cancer
    • MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000122.htm
    • National Cancer Institute: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/Patient
    • University Medical Center Groningen (the Netherlands): http://umcg.eldoc.ub.rug.nl/root/2006/Thirchfos/
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