Chemotherapy

Chemotherapy means using anti-cancer (cytotoxic) drugs to destroy cancer cells. These work, by disrupting the growth of cancer cells. 

    This is the main treatment for small cell lung cancer. Doctors use it because:

• This type of cancer responds very well to chemotherapy;
• Small cell lung cancer tends to have spread beyond the lung when it is diagnosed.

Chemotherapy drugs circulate in the bloodstream around the body. So, they can treat cells that have broken away from the lung tumour and spread to other parts of the body even if they are too small to see on scans. This microscopic spread often happens even in the early stages of small cell lung cancer.

You may have chemotherapy on its own. Or you may have it before or after radiotherapy (or at the same time). If you are going to have surgery for very early small cell lung cancer, your doctor may suggest that you have chemotherapy before or after your operation.

Doctors usually give a combination of chemotherapy drugs, including either cisplatin or carboplatin (Paraplatin).  The combinations include:

• EP – cisplatin and etoposide;
• Carboplatin and etoposide;
• GemCarbo (gemcitabine and carboplatin).

Small cell lung cancer usually responds well to these treatments. For cancer that has come back after treatment, doctors may use one of the treatments above or one of the following chemotherapy combinations:

• CAV (cyclophosphamide, doxorubicin and vincristine);
• CAVE (CAV plus etoposide);
• ACE (doxorubicin, cyclophosphamide and etoposide).

People who have medical conditions that mean they cannot have CAV or ACE chemotherapy may have topotecan chemotherapy capsules. 

Combinations of chemotherapy tend to work better than single drugs. Usually doctors combine cisplatin or carboplatin (Paraplatin) with at least one other drug such as:

• Vinorelbine;
• Gemcitabine;
• Paclitaxel (Taxol);
• Docetaxel (Taxotere);
• Doxorubicin;
• Etoposide;
• Pemetrexed.

 You have most chemotherapy drugs by injection into a vein or through a drip. But some are tablets or capsules that you swallow.