Palliative care for small cell lung cancer (SCLC): What to know - Medical News Today

When someone has a condition that is difficult or impossible to cure, treatment often focuses on relieving the symptoms and improving the person's quality of life. This vital form of care is called palliative care.

This article looks at how doctors use palliative care to treat small cell lung cancer (SCLC).

Specifically, it defines palliative care and explains how it can help people with this condition. It also discusses who should receive palliative care and what such care involves for people with SCLC.

This article also looks at the differences between palliative care and hospice care and explores whether or not health insurance covers palliative care.

It is possible to define palliative care in several ways. The World Health Organization (WHO) defines palliative care as medical care that is directed toward the needs of people with life threatening conditions and that focuses on identifying and treating physical, psychosocial, or spiritual pain.

There are many advantages to palliative care. For example, one 2016 systematic review reports that there may be an association with improved quality of life and reduced symptoms for those who receive this type of care. However, the study authors note that the quality of the available evidence was limited.

Palliative care does not focus on curing life threatening conditions, but it can co-exist with curative treatment. The American Society of Clinical Oncology recommends that people with advanced cancer receive palliative care alongside their active cancer treatment.

As the name suggests, SCLC is a type of lung cancer that affects smaller lung cells. It is a serious condition that, according to one recent article, is most likely to affect people who:

  • are older
  • are male
  • smoke or used to smoke

The article also states that for around 70% of people with SCLC, their condition is incurable by the time a doctor diagnosis it. Only about 2% of people who receive an SCLC diagnosis survive for longer than 5 years after their diagnosis, even with chemotherapy.

For these reasons, palliative care can be vital for many people with SCLC.

Anyone who is experiencing symptoms of SCLC should be eligible for palliative care. The American Cancer Society (ACS) lists the following as some common lung cancer symptoms:

Receiving palliative care can also help people with SCLC cope with the mental health effects of having a serious and potentially life ending illness.

When a person receives palliative care for SCLC, the specifics of their treatment will depend on their needs.

The ACS provides useful information about some common palliative care options for people with SCLC, which the sections below summarize.

Treating a blocked airway

When a tumor grows into the airways, it can cause health problems such as pneumonia or shortness of breath.

However, doctors have several methods for treating blocked airways, including:

  • Photodynamic therapy (PT): With PT, a person with SCLC takes a medication that accumulates inside their cancer cells. This drug is light-activated, which means that it only starts to kill cancer cells when it has exposure to light. When enough of the drug has accumulated in a tumor, a doctor uses a bronchoscope to shine a laser onto it. This activates the drug, killing the cancer cells.
  • Laser therapy: Doctors can also use lasers directly, without light-activated drugs, in order to burn cancer cells. This is known as laser therapy, and it also involves the use of a bronchoscope.
  • Stent treatment: Stent treatment involves using a bronchoscope to place a tube called a stent into a person's airway. This tube is made of metal or silicone, and it helps keep the airway open.

Treating fluid buildup near the lungs

When fluid builds up in the space beside the lungs, it is known as pleural effusion. By pressing on the lungs, this fluid buildup can make breathing more difficult.

Doctors can treat these buildups in a few different ways, such as by using:

  • Thoracentesis: With this treatment option, a doctor inserts a very fine needle between the ribs of a person's lower back to drain the fluid.
  • Pleurodesis: With pleurodesis, a doctor inserts a substance between the wall of the chest and the linings of the lungs, which causes them to stick together. This prevents further fluid buildup.
  • Catheter placement: This requires a doctor to insert a catheter into a person's body. One end of the catheter will be in contact with the fluid buildup, and the other will be outside of the body. The doctor can attach a special bottle to the outer end of the catheter that allows them to drain the fluid buildup regularly.

Treating fluid buildup near the heart

When lung cancer spreads to areas outside of the heart, it can cause pericardial effusions. These are buildups of fluid in the area around the heart, and they can make the heart function less effectively.

Doctors can treat this either by using pericardiocentesis or by creating a pericardial window.

With pericardiocentesis, a doctor uses a very fine needle to drain the fluid around the heart.

With a pericardial window, a surgeon removes some of the sac around a person's heart, which allows any fluid to drain into their chest or abdomen.

Although palliative care can take many forms, the kinds of palliative care for SCLC covered in this article require specialist training to carry out. Doctors and surgeons usually provide these types of palliative care.

For example, as the ACS explains, laser therapy requires a person to be under general anesthesia.

Specialized palliative care for SCLC often requires a hospital setting. This is because such care is highly complex, must be performed in a safe manner, and requires the use of special equipment.

Although coverage from private health insurance providers can vary, both Medicare and Medicaid should cover at least some of the costs of palliative care for SCLC.

Learn more about Medicare and palliative care here.

Are there other ways to get palliative care for those without insurance?

Besides insurance coverage, there may be other ways for people to receive palliative care for SCLC.

For example, the Cancer Financial Assistance Coalition aims to provide financial support for people with cancer.

Another group that can provide support is the Patient Advocate Foundation. This organization aims to help improve access to healthcare by assisting decision making and providing financial support.

Receiving palliative care can significantly improve quality of life for people with SCLC. It is an extra level of support that doctors can provide alongside medical treatments for SCLC.

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