Small cell lung cancer is the most aggressive of all lung cancers
Once small cell lung cancer has spread, few treatment options are available to patients, says top oncologist
When Ornella Guida first heard the words, “You have cancer all through your body,” she and her husband were overcome with disbelief. “I was just a regular working mom, supporting my kids through university,” says Guida. “We didn’t ask for this to happen to us.”
Guida first suspected something was wrong when she experienced abdominal pain that would come and
go for days at a time. After initially brushing it off as indigestion or discomfort from a new office chair, she checked herself into hospital on the advice of her family doctor. “That day, I hadn’t eaten anything at all and by 3 p.m., I still wasn’t hungry,” she recalls. “I knew something was wrong.”
A battery of tests revealed cancerous tumours throughout Guida’s body that had spread from her lungs. Her oncologist told her there was a 13.2-cm tumour in her liver, causing pain by pressing on her organs.
The diagnosis: small cell lung cancer (SCLC). “He wanted me to start treatment immediately,” says Guida.
Lung cancer is the leading cause of cancer death in Canada, and SCLC, which accounts for about 15 per cent of all lung cancers, is the most aggressive. Dr. Shaqil Kassam, medical oncologist at Southlake Regional Health Centre in Newmarket, Ont., has supported countless patients through a diagnosis of
SCLC. “By the time we catch it,” he says, “it has usually already spread to other organs in the body.”
Although SCLC originates in the lung, it tends to progress very quickly. “Patients are often very sick by the time they are admitted, presenting with symptoms such as weight loss, fatigue, shortness of breath, coughing, and pain,” says Dr. Kassam. “If caught earlier, in Stages 1 to 3, there’s still a chance, albeit small, of longer-term survival. But at Stage 4, it’s invariably incurable with dismal long-term survival rates.”
Only seven per cent of people with SCLC live beyond five years of their diagnosis. However, this survival rate is reduced to between one and eight months for patients whose first treatment fails. For this reason, says Dr. Kassam, it’s especially important patients be aware of available treatment options, as they are limited and need to be initiated as quickly as possible following diagnosis.
Dr. Stephanie Snow is a
THERE ARE AROUND 4,000 CASES OF SMALL CELL LUNG CANCER ACROSS CANADA, EVERY YEAR.
medical oncologist in Halifax and president of Lung Cancer Canada. She sees firsthand the unmet needs patients with SCLC face every day. “This type of cancer is so aggressive it presents a number of challenges for patients,” she says. “Life expectancy is short, and it takes a long time to set up patient support
groups, and travel to access treatment isn’t always possible for very sick patients.”
Dr. Snow explains that the fast-paced nature of SCLC means tolerance to treatment is paramount. “We don’t want the side effects of treatment to be worse than the disease itself,” she explains.
“The goal is to minimize hospital time to increase patients’ quality of life and time with loved ones. Every day counts.”
While there were no advancements in SCLC treatment options for several decades, that is starting to change. “Historically, it was only chemotherapy, and cancer recurrence was common within a few months of treatment,” says Dr. Snow. “But now, we have immunotherapy, which helps the body
fight the cancer itself, as well as newer chemotherapies
that are less toxic and more patient-friendly.” That said, Dr. Snow says once that cancer recurs, the range of treatment options available to patients is relatively narrow.
Guida received several treatments in mid-2020 and early 2021, including chemotherapy, immunotherapy and radiation. The tumour in her liver has shrunk considerably to 3 centimetres. She continues receiving treatment, having regular scans, and her
cancer has been stable for the past several months.
Meanwhile, she draws a great deal of support from her loved ones. “Being home with family has been the best medicine,” Guida shares. “I also bake often and attend a monthly virtual support group. Prayer helps a lot, too.”
Much of her focus is on positive memories. “Every morning, I wake up with optimism,” Guida says. “You’ve got to stay positive and strong, and that’s what I always tell people who are newly diagnosed.”
When fighting an aggressive disease, health-care providers stress the importance of exploring treatment options to maximize quality of life wherever possible.
To learn more about small cell lung cancer and the support available to patients and their caregivers, visit