Survivorship for Small Cell Lung Cancer

Survivorship in cancer refers to including no signs of cancer after the cancer treatment. Also, survivorship in cancer involves the conditions of the cancer patients living with, through, and beyond cancer. As per the definition, cancer survivorship begins at diagnosis and continues during cancer treatment and throughout the individual’s life. Therefore, survivorship involves the complexities of having cancer showing primary differentiation as per the individuals. 

The cancer survivors have experienced feelings involving joy, concern, relief, guilt, and fear. Some individuals have revealed their experience of appreciating life more after a cancer diagnosis while gaining more acceptance of themselves. The other individuals show anxiety regarding their health and uncertainties regarding coping with everyday life—the feelings of fear and anxiety that require effective communication with the healthcare team member. 

The survivors sometimes go through stressful conditions while interacting with their healthcare team by visiting them frequently after completing the treatment. The patient’s relationship with the healthcare team of cancer has provided a sense of security during treatment, and individuals often miss the required sources that support them. Some significant challenges, such as late treatment effects, emotional challenges, fear of recurrence, sexual health and fertility concerns, and financial and workplace issues, lead to significant patient problems. The primary coping techniques are needed for mitigating such challenges among the patients, which have been illustrated below:

  • Understanding the challenges that the patient is going through
  • Thinking about the possible solutions
  • Asking for and allowing the support of others
  • Making oneself comfortable with the significant course of action you choose

Many cancer survivors have joined the in-person support group or with an online community of survivors, which helps cancer survivors interact with individuals who have similar experiences. Other choices for the support resources involve:

  • Talking with a friend or member of your health care team.
  • Individual counselling.
  • Asking for assistance at the learning resource centre where treatment is provided to the patient. 

Individuals recovering from small cell lung cancer are motivated to follow the established guidelines for good health involving no smoking habits, good diet, regular physical exercise, and stress management. Carrying out physical activities regularly have been effective in rebuilding strength and energy level. The patients who are recovering and those using oxygen are motivated to walk for 15-30 minutes every day to improve their heart and lung functioning. The healthcare team is responsible for helping the patients follow appropriate exercise plans depending upon the patients’ requirements, physical abilities, and fitness level. 

Long-term survivorship:

The long-term survival of the small cell lung cancer patients is associated with the two-stage capability of achieving complete response (CR) to combination chemotherapy with or without regional radiotherapy. When combined with chemotherapy in the limited stage, the CR rate is 50%-60% but only 15%-25% in the extensive background. The median survival in minor disease is 12-16 months with a 2-3-year survival of 10%-25%. Chemotherapy has shown more efficacy in small cell lung cancer, mainly combining regimens that employ cisplatin and etoposide and radiotherapy, effective in limited disease, particularly when combined with chemotherapy. The dose intensity of chemotherapy had a variable impact on the survival of small cell lung cancer patients. Few trials have evaluated the importance of surgical resection in small cell lung cancer patients. Resection can prolong survival among patients with limited-stage, mainly employed as an adjuvant to chemotherapy or radiotherapy.

References

  1. Sugimura, H., & Yang, P. (2006). Long-term survivorship in lung cancer: a review. Chest, 129(4), 1088-1097.

Muppa, P., Terra, S. B. S. P., Sharma, A., Mansfield, A. S., Aubry, M. C., Bhinge, K., … & Kosari, F. (2019). Immune cell infiltration may be a key determinant of long-term survival in small cell lung cancer. Journal of Thoracic Oncology, 14(7), 1286-1295.