ON THIS PAGE: You will find a basic drawing of the main body parts affected by this disease. To see other pages, use the menu.

For medical illustrations showing the different stages of small cell lung cancer, please visit the Stages section.

The next section in this guide is Risk Factors and Prevention. It explains what factors may increase the chance of developing this disease. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will find out more about screening for this type of cancer. You will also learn the risks and benefits of screening. To see other pages, use the menu.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goal of cancer screening is to lower the number of people who die from the disease, or eliminate deaths from cancer altogether.

Learn more about the basics of cancer screening.

Screening information for lung cancer

Based on results from the National Lung Screening Trial, several groups, including ASCO, have developed recommendations for lung cancer screening with a test called a low-dose helical or spiral computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors.

CT scanning is not recommended for every person who smokes. The current recommendations are discussed below. Screening for lung cancer is approved by Medicare. It is also important to receive screening at an approved and experienced center.

It’s important to note that lung cancer screening was intended to find NSCLC, and not small cell lung cancer. However, sometimes small cell lung cancer is found on lung cancer screening scans.

ASCO recommends the following lung cancer screening schedules for people who currently smoke or who have quit smoking:

• Yearly screening with a low-dose CT scan is recommended instead of screening with a chest x-ray or no screening for people age 55 to 74 who have smoked for 30 pack years or more who are current smokers or who have quit within the past 15 years.

• CT screening is not recommended for people who have smoked for less than 30 pack years, are younger than 55 or older than 74, have quit smoking more than 15 years ago, or have a serious condition that could affect cancer treatment or shorten a person's life.

The United States Preventive Services Task Force recommends that people age 55 to 80 who have smoked for 30 pack years or more or who have quit within the past 15 years receive screening for lung cancer with low-dose CT scans each year, and screening can stop after a person has not smoked for 15 years or develops a health problem that would shorten their life or prevent them from being able to have surgery for lung cancer. A pack year is equal to smoking 20 cigarettes (1 pack) a day each year.

Learn more about ASCO’s recommendations for lung cancer screening in current or former smokers and information on lung cancer screening from the National Cancer Institute.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. To see other pages, use the menu.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread, but they can never be used alone to diagnose small cell lung cancer. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

• Size, location, and type of cancer suspected

• Your signs and symptoms

• Your age and medical condition

• The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose and stage small cell lung cancer:

• Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. If cancer cells are found, the pathologist will determine if it is small cell lung cancer or NSCLC, based on what it looks like when seen through a microscope.

More procedures that doctors use to collect tissue for the diagnosis and staging of small cell lung cancer are listed below:

• Sputum cytology. If lung cancer is suspected, the doctor may ask a person to cough up some phlegm so it can be looked at under a microscope. A pathologist can find cancer cells mixed in with the mucus. However, sputum cytology usually does not provide enough tissue to completely diagnose lung cancer.

• Bronchoscopy. In a bronchoscopy, the doctor passes a thin, flexible tube with a light on the end into the mouth or nose, down through the main windpipe, and into the breathing passages of the lungs. A surgeon or a pulmonologist may perform this procedure. A pulmonologist is a medical doctor who specializes in the diagnosis and treatment of lung disease. The tube lets the doctor see inside the lungs. Tiny tools inside the tube can take samples of fluid or tissue so the pathologist can examine them. Patients are given mild anesthesia during a bronchoscopy. Anesthesia is medication to block the awareness of pain.

• Needle aspiration/core biopsy. After numbing the skin, a special type of radiologist, called an interventional radiologist, removes a sample of the lung tumor for testing. This can be done with a smaller needle or a larger needle depending on how large of a sample is needed. The doctor uses the needle to remove a sample of tissue for testing. Often, the radiologist uses a chest CT scan or special x-ray machine called a fluoroscope to guide the needle. In general, a core biopsy provides a larger amount of tissue than a needle aspiration. Doctors have learned that more tissue is needed to diagnose small cell lung cancer.

• Thoracentesis. After numbing the skin on the chest, a needle is inserted through the chest wall and into the space between the lung and the wall of the chest where fluid can collect. The fluid is removed and checked for cancer cells by the pathologist.

• Thoracoscopy. Through a small cut in the skin of the chest wall, a surgeon can insert a special instrument and a small video camera to assist in the examination of the inside of the chest. Patients need general anesthesia for this procedure, but recovery time may be shorter with a thoracoscopy because of the smaller incisions that are used. This procedure may be referred to as video-assisted thoracoscopic surgery or VATS.

• Mediastinoscopy. A surgeon examines and takes a sample of the lymph nodes in the center of the chest underneath the breastbone by making a small incision at the top of the breastbone. This procedure also requires general anesthesia and is done in an operating room.

• Thoracotomy. This procedure is performed in an operating room, and the patient receives general anesthesia. A surgeon then makes an incision in the chest, examines the lung directly, and takes tissue samples for testing. A thoracotomy is the procedure surgeons most often use to completely remove a lung tumor.

• Bone marrow aspiration and biopsy. This is a test used occasionally for small cell lung cancer. These 2 procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration removes a sample of fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle. A pathologist then analyzes the sample(s). A common site for a bone marrow aspiration and biopsy is the pelvic bone, which is located in the lower back by the hip. The skin in that area is usually numbed with medication beforehand, and other types of anesthesia may be used. 

Imaging tests

In addition to biopsies and surgical procedures, imaging scans are very important in the care of people with small cell lung cancer. However, no test is perfect, and no scan can diagnose small cell lung cancer. Only a biopsy can do that. Chest x-ray and scan results must be combined with a person’s medical history, a physical examination, blood tests, and information from the biopsy to form a complete story about where the cancer began and whether or where it has spread.

• CT scan. A CT scan produces images that allow doctors to see the size and location of a lung tumor and/or lung cancer metastases. This test creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

• Positron emission tomography (PET) scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.  

• Magnetic resonance imaging (MRI) scan. An MRI also produces images that allow doctors to see the location of a lung tumor and/or lung cancer metastases and measure the tumor’s size. An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow. MRI scanning does not work well to take pictures of parts of the body that are moving, like your lungs, which move with each breath you take. For that reason, MRI is rarely used to look at the lungs. However, it may be helpful to find lung cancer that has spread to the brain.

• Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by cancer, appear dark. PET scans (see above) have been replacing bone scans to find lung cancer that has spread to the bones.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer; this is called staging.

Finding out where the cancer started

Lung cancer starts in the lungs. Many other types of cancer start elsewhere in the body and spread to the lungs when they metastasize. For example, breast cancer that has spread to the lungs is still called breast cancer. Therefore, it is important for doctors to know if the cancer started in the lungs or elsewhere.

To find where the cancer started, your doctor will take into account your symptoms and medical history, physical examination, how the tumor looks on x-rays and scans, and your risk factors for cancer. A pathologist can perform tests on the biopsy sample to help find out where the cancer began. Your doctor may recommend other tests to rule out specific types of cancer. If, after these considerations, the doctor is still not sure where the cancer started, the doctor may give a diagnosis of metastatic cancer “of unknown primary.” Most treatments for metastatic cancer of unknown primary that are first found in the chest are the same as those for metastatic small cell lung cancer.

Coping with a lung cancer diagnosis

For most patients, a diagnosis of small cell lung cancer is extremely stressful. Some patients with small cell lung cancer develop anxiety and, less commonly, depression. Patients and their families should not be afraid to express the way they are feeling to doctors, nurses, and social workers. The health care team is there to help, and many team members have special training and experience that can make things easier for patients and their families.

In addition to emotional support and education, the doctor may prescribe anti-anxiety medication and occasionally, an antidepressant. He or she may refer the patient to a counselor, psychologist, social worker, or psychiatrist. Furthermore, patients and their families should be aware that there are resources available in the community to help people living with small cell lung cancer. Some patients feel comfortable discussing their disease and experiences throughout treatment with their doctor, nurse, family, friends, or other patients through a support group. These patients may also join a support group or advocacy group in order to increase awareness about lung cancer and to help fellow patients who are living with this disease.

A small cell lung cancer diagnosis is serious. However, patients can be hopeful that their doctors can offer them effective treatment. They may also be able to take some comfort knowing that the advances being made in the diagnosis and treatment of lung cancer will provide more and more patients with a chance for cure.

Learn more about the counseling, finding a support group, and being a cancer advocate.

Stopping smoking

Even after small cell lung cancer is diagnosed, it is still beneficial to quit cigarette smoking. People who stop smoking have an easier time with all treatments, feel better, live longer, and have a lower risk of developing a second lung cancer or other health problems. Stopping smoking is never easy and even harder when facing the diagnosis of lung cancer. People who smoke should seek help from family, friends, programs for quitting smoking, and health care professionals. None of the products available to quit smoking interfere with cancer treatment. Learn more about stopping tobacco use after a cancer diagnosis.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will learn about the different ways doctors use to treat people with small cell lung cancer. To see other pages, use the menu.

This section tells you the treatments that are the standard of care for this type of cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn if it is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Treatments for small cell lung cancer may include a combination of different types of treatments, such as chemotherapy, radiation therapy, and/or surgery. Descriptions of the most common treatment options for small cell lung cancer are listed below. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health.

Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs at the same time.

Chemotherapy is the primary treatment for small cell lung cancer because it spreads quickly. The most commonly used chemotherapy regimen is etoposide (Toposar, VePesid, Etopophos) or irinotecan (Camptosar) plus a platinum-based drug such as cisplatin (Platinol) or carboplatin (Paraplatin).

For patients with limited stage small cell lung cancer, chemotherapy plus radiation therapy (see below) to the chest is given daily over several weeks. Patients with extensive stage cancer initially receive chemotherapy for 3 to 4 months.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, loss of appetite, diarrhea, and hair loss. Nausea and vomiting are often avoidable; learn more about preventing nausea and vomiting caused by cancer treatment. These side effects usually go away once treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high energy x-rays or other particles to destroy cancer cells. A radiation oncologist is a doctor who specializes in giving radiation therapy to treat cancer. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. This can vary from just a few days of treatment to several weeks.

For patients with limited stage small cell lung cancer, radiation therapy is combined with chemotherapy (see above). Radiation therapy is best when given during the first or second month of chemotherapy.

In patients whose cancer has shrunk after chemotherapy, radiation therapy to the head lessens the risk that the cancer will spread to the brain. This is called prophylactic cranial irradiation (PCI), and it has been shown to lengthen the lives of these patients.

Patients with small cell lung cancer who receive radiation therapy often experience fatigue and loss of appetite. If radiation therapy is given to the neck or center of the chest, patients may also develop a sore throat and have difficulty swallowing. Patients may also notice skin irritation, similar to sunburn, where the radiation was directed. Most side effects go away soon after treatment is finished.

If the radiation therapy irritates or inflames the lung, patients may develop a cough, fever, or shortness of breath months and sometimes years after the radiation therapy ends. About 15% of patients develop this condition, called radiation pneumonitis. If it is mild, radiation pneumonitis does not need treatment and goes away on its own. If it is severe, a patient may need treatment for radiation pneumonitis with steroid medications, such as prednisone (multiple brand names). Radiation therapy may also cause permanent scarring of the lung tissue near where the original tumor was located. Typically, the scarring does not cause symptoms. However, severe scarring can cause a permanent cough and shortness of breath. For this reason, radiation oncologists carefully plan the treatments using CT scans of the chest to lessen the amount of healthy lung tissue exposed to radiation (see above).

Learn more about the basics of radiation therapy.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. A surgical oncologist is a doctor who specializes in treating cancer using surgery. For lung cancer, a thoracic surgeon is specially trained to perform lung cancer surgery.

Surgery is rarely used for patients with small cell lung cancer and is only considered for patients with very early-stage disease, such as cancer in a small lung nodule. In those situations, chemotherapy, with or without radiation therapy, is given after surgery (see above).

Learn more about the basics of cancer surgery.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in your treatment plan.

The following treatments may be given to help relieve the symptoms of small cell lung cancer:

• A tumor in the chest that is bleeding or blocking the lung passages can be shrunk with radiation therapy.

• During a bronchoscopy (See Diagnosis), lung passages blocked by cancer can be opened to improve breathing.

• A surgeon can use a laser to burn away a tumor or place a stent to prop open an airway.

• Medications are used to treat cancer pain. Most hospitals and cancer centers have pain control specialists who provide pain relief, even for severe cancer pain. Many drugs used to treat cancer pain, especially morphine, can also relieve shortness of breath caused by cancer. Learn more about managing cancer pain.

• Medications can be used to suppress cough, open closed airways, or reduce bronchial secretions.

• Prednisone or methylprednisolone (multiple brand names) can reduce inflammation caused by lung cancer or radiation therapy and improve breathing.

• Extra oxygen from small, portable tanks can help make up for the lung’s reduced ability to extract oxygen from the air.

• Medications are available to strengthen bones, lessen bone pain, and help prevent future bone metastases.

• Appetite stimulants and nutritional supplements can improve appetite and reduce weight loss.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.

Treatment options by stage

For limited stage cancer, treatment may include chemotherapy combined with radiation therapy to try to cure the cancer. For extensive stage, chemotherapy alone is likely a better option. Learn more about recommendations for the treatment of small cell lung cancer.

Metastatic lung cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your treatment plan chosen.

Your treatment plan may include a combination of surgery, chemotherapy, and radiation therapy. Chemotherapy is not as effective as radiation therapy or surgery to treat lung cancer that has spread to the brain. For this reason, lung cancer that has spread to the brain is usually treated with radiation therapy. Most patients with brain metastases from lung cancer receive radiation therapy to the entire brain. This can cause side effects such as hair loss, fatigue, and redness of the scalp.

Palliative care will also be important to help relieve symptoms and side effects. Radiation therapy or surgery may also be used to treat metastases that are causing pain or other symptoms. Bone metastases that weaken major bones can be treated with surgery, and the bones can be reinforced using metal implants.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED. 

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence. 

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When there is a recurrence, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above such as chemotherapy and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

Treatment for recurrent small cell lung cancer may not work well for very long. If treatment does stop working, it’s important to talk with your doctor about the next steps and the goals of further treatment.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and advanced cancer is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu.

Doctors are working to learn more about small cell lung cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

• Personalized therapy. Researchers are looking at specific features of lung tumors that can predict whether a specific treatment may be effective. To collect this information, patients are increasingly being asked to have additional analyses of the tumor samples taken when the disease is first diagnosed. In many patients for whom chemotherapy is recommended, the amount of tumor tissue removed during the biopsy to diagnose their cancer is not enough for these additional studies. These patients may be asked to have another biopsy to help plan treatment and, if part of a clinical trial, to help researchers find better ways to treat lung cancer. Learn more about personalized therapy.

• Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. For example, the PD-1 pathway may be critical in the immune system’s ability to control cancer growth. Blocking this pathway with PD-1 and PD-L1 antibodies has stopped or slowed the growth of lung cancer for some patients. These results are leading to more research on using this pathway to help the immune system control lung cancer growth. Learn more about immunotherapy and lung cancer.

• Better techniques for radiation therapy. Doctors are finding ways to improve the effectiveness of radiation therapy while reducing the side effects. For example, some studies are looking at stereotactic radiation therapy, which is used to focus radiation more directly on the cancer and spare healthy tissue.

• Improved screening. Lung cancer is more successfully treated in its early stages, which has raised interest in screening people for lung cancer before it causes symptoms. Advances in imaging techniques, such as low-dose, helical CT scanning, are currently being researched, and may help find better ways to diagnose lung cancer early. In the future, molecular features in the blood or sputum may suggest lung cancer is present before it can be seen on a CT scan. Genetic testing to learn which people have a higher risk of lung cancer is also being researched.

• Stopping tobacco use. Even with the best methods for the early detection and treatment of lung cancer, the best way to save lives from lung cancer is through programs to encourage people to never begin smoking and, if they have, quit cigarette smoking. For most people, lung cancer is a highly preventable disease. Even for people with lung cancer, stopping smoking lets people live longer, lowers side effects, and lessens the chance of getting a second lung cancer. Quitting smoking is hard at any time, and even more so during cancer treatment. The health care team can help make it easier to quit smoking with nicotine replacement and other techniques. Research continues into new ways to help people stop smoking.

• Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current lung cancer treatments to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding lung cancer, explore these related items that take you outside of this guide:

• To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.

• Learn about the research announced at ASCO’s Annual Meeting related to small cell lung cancer. 

• Listen to a podcast from an ASCO expert discussing highlights from recent scientific meetings.

• Visit the website of the Conquer Cancer Foundation to find out how to help support research for every cancer type. Please note this link takes you to a separate ASCO website. 

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. To see other pages, use the menu.

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. During this period, tell your doctor or nurse about any new problem that lasts for more than 2 weeks. Learn more about the importance of follow-up care.

Watching for recurrence or second cancer

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given.

People who develop lung cancer are at higher risk for developing a second lung cancer. Your doctor will recommend scans to monitor for a recurrence, so any new cancer can be found as early as possible.

Sometimes, the anticipation before screening tests or waiting for results adds stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to handle any stress related to follow-up tests that you experience.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

Common post-treatment problems include pain, fatigue, and shortness of breath. Your doctor, nurse, and social worker can help you develop a plan to manage any problems that persist after treatment. 

Survivors of small cell lung cancer who have smoked cigarettes in the past also have a high risk of heart disease, stroke, emphysema, and chronic bronchitis. Certain cancer treatments can further increase these risks. Even for those who don’t smoke, healthy lifestyle choices after cancer are important for overall well-being.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

• What is the stage of my lung cancer? What does this mean?

• Can you explain my pathology report (laboratory test results) to me?

Questions to ask about choosing a treatment and managing side effects

• What are my treatment options?

• What clinical trials are available for me? Where are they located, and how do I find out more about them?

• Should I see other doctors to assist in my care, such as a radiation oncologist, medical oncologist, and/or pulmonologist? What is the role of each doctor?

• Who will be leading my overall treatment?

• Who else will be part of my health care team, and what does each member do?

• What treatment plan do you recommend? Why?

• Do I need additional scans or biopsies in order to plan my treatment?

• What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

• What are the possible side effects of this treatment, both in the short term and the long term?

• In addition to treating my cancer, what can be done to treat my symptoms?

• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

• Could this treatment affect my sex life? If so, how and for how long?

• Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

• If I’m worried about managing the costs of cancer care, who can help me?

• If I’m participating in a clinical trial, what are the costs I need to pay? What is covered by my health insurance?

• What support services are available to me? To my family?

• Whom should I call for questions or problems?

Questions to ask about having chemotherapy

• What are the names of the drugs, and how will they be given?

• What are the possible side effects of each medication? What side effects or problems should I watch for?

• What can be done to lessen these side effects?

• How often will I need to visit the doctor to receive the therapy, and how long will each visit take?

• Will I be able to go to and return from this treatment on my own, or should I arrange to have assistance?

Questions to ask about radiation therapy

• How will my treatment be planned? What types of scans will be used?

• Where will I receive radiation therapy?

• How often will I receive radiation therapy?

• How much time will each treatment take?

• How much of the healthy lung will be included in the radiation field?

• Is it possible for me to receive chemotherapy with my radiation therapy? If so, what are the added side effects of giving the chemotherapy at the same time, compared with one after another?

• Will I be able to go to and return from this treatment on my own, or should I arrange to have assistance?

Questions to ask about having surgery

• Do I need to have surgery? If so, what type of surgery will I have?

• How long will the operation take?

• How long will I be in the hospital?

• Can you describe what my recovery from surgery will be like?

Questions to ask about clinical trials

• What are my options for standard treatment?

• What other treatments through clinical trials are available to me?

• How will my experience differ if I enroll in this clinical trial, as opposed to standard treatment? For example, are there different risks, extra tests, a different time commitment, schedule, or costs?

• What is the goal of this clinical trial? Is this a phase I, II, or III clinical trial? What does this mean?

• Where will I receive the clinical trial treatment?

Questions to ask about planning follow-up care

• What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

• Is there anything more I can do to reduce the chance that my cancer will return?

• What long-term side effects or late effects are possible based on the cancer treatment I received?

• What follow-up tests will I need and how often will I need them?

• How do I get a treatment summary and survivorship care plan to keep in my personal records?

• Who will be leading my follow-up care?

• What tests will I have during my follow-up visit?

• What survivorship support services are available to me? To my family?

Questions for patients who smoke

• What are the benefits of me quitting smoking?

• How can you help me to quit smoking?

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu to choose another section to continue reading this guide.