Ongoing research in small cell lung cancer

There are numerous agencies, organizations and medical facilities conducting research in the area of lung cancer. The basic areas of focus include:

• Prevention. Research is focusing on ways to help people quit smoking with a variety of methods, such as nicotine replacement products and medications. Studies also are examining the role of diet, vitamins and supplements in cancer prevention.
  
  
• Earlier diagnosis. Researchers continue to study various diagnostic methods for earlier detection of lung cancer. A large clinical trial called the National Lung Screening Trial (NLST) is studying whether  the use of spiral CT scans with people at high risk will improve diagnosis. In addition, scientists are searching for improved methods for detecting cancer cells in sputum samples to detect lung cancer at an earlier stage.
  
  
• Chemotherapy. Research is focusing on the development of new chemotherapy drugs and drug combinations that can be effective with less toxic side effects. Studies are also being conducted to evaluate effective pairing of chemotherapy drugs with surgery and radiation therapy.
  
  
• Gene therapy. Scientists have continued to focus on DNA and their changes that result in cancerous cells. They hope to develop ways to alter lung cancer by changing DNA or to use DNA to repair gene mutations.
  
  
• Angiogenesis inhibitors and vaccines. Researchers hope to develop certain drugs that may be useful in stopping lung cancer growth by preventing new blood vessels from forming. Blood vessels are necessary to nourish cancer cells, a process known as angiogenesis. Without the nourishment, the cancer would not be able to grow. Antiangiogenesis drugs may be successful in stopping this nourishment process.Researchers are also examining other targeted therapies that may help prevent the growth and spread of cancer cells.
  
  Vaccines are also being studied in an attempt to make the body’s immune system fight cancer. Some vaccines are currently being used in clinical trials.

In August 2005, The National Cancer Institute (NCI) announced a new initiative to aggressively fight lung cancer. Using an integrated approach, its mission is to eliminate suffering and death due to lung cancer by 2015. The new plan will focus on three critical areas:

• Reducing the risk factors for lung cancer by eliminating the use of tobacco
  
  
• Earlier detection and treatment of lung cancer and pre-cancer
  
  
• Targeting advanced therapies with ongoing research

As part of the plan, an Image Response Assessment Team (IRAT) will be established. The IRAT will focus on the analysis of lung cancer tumor markers and their contribution to lung cancer treatment. Researchers also intend to use advanced imaging strategies to understand lung cancer development and the response to various treatments.

Staging of small cell lung cancer

The staging of cancer is necessary for accurate treatment and prognosis of the condition. Because small cell lung cancer (SCLC) spreads so quickly, it is not staged in the traditional method. Physicians commonly use two categories to stage SCLC, according to the National Cancer Institute:

• Limited-stage SCLC. The cancer is found in one lung, the tissues between the lungs and nearby lymph nodes only. About 30 percent of patients with SCLC will be in the limited stage, according to the NCI, with a  median survival rate of 16 to 24 months. However, surgery may be possible in certain patients, which can improve the prognosis.
  
  
• Extensive-stage SCLC. The cancer has spread outside of the lung in which it began or to distant parts of the body. About two-thirds of the SCLC patients have extensive stage disease when the cancer is first diagnosed. The median prognosis for extensive stage is 6 to 12 months.

Small cell lung cancer is usually not found in early stages because of its aggressiveness. If SCLC is found only in the lung without lymph node involvement, the relative 5-year survival rate is about 21 percent. However, less than 10 percent of SCLC patients are in this category. After SCLC has shown signs of spreading outside of the lung, the 5-year survival rate drops to 11 percent. For patients who have extensive spread of the disease, the 5-year survival rate is only 2 percent.