Deeper Dive: Small Cell Lung Cancer Advances with Dr. Jacob Sands

One of the first things that excited me was the onslaught of immunotherapies, because when I was diagnosed and treated, those had not even been approved for people with small cell.

I have a friend who has small cell lung cancer, started out limited stage, and truly believes that the reason she's chose no evidence of disease is because her immune system was so strong because she never even had, I don't think she had chemotherapy, I think she only had radiation, that she's doing great.

Which leads me to my next question.

Can you explain clearly for people the differences in staging for small cell lung cancer?

Although I don't know the specifics of your friend, if someone's getting radiation overwhelmingly, very commonly, they'd get chemotherapy with that and then immunotherapy after that.

But that's important to our staging discussion too.

So staging is, there is stage one, two, three, four, like other cancers, but we often talk about small cell lung cancer as limited stage and extensive stage.

Now, that being said, the caveat is with stage one, which is generally just a nodule.

no lymph nodes involved, a nodule in the lung that's not a large one.

The treatment of that can be surgery.

And then after surgery, we typically recommend chemotherapy.

In patients who have surgery for a stage one small cell lung cancer, then gets chemotherapy plus immunotherapy.

Everyone in the trial gets chemo plus immuno.

Most people, though, with limited stage don't just have a lung nodule.

They have something more.

And the question becomes, does the disease fit in a radiation field, in one radiation field, safely? And if it does, then that's limited stage, essentially.

Limited stage we can treat with a goal of cure.

Chemo and radiation together, followed by two years of immunotherapy.

And what we've seen is that the immunotherapy increased the long-term disease control, improved the survival.