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Living with cancer· Appointment prep

Appointment sheet: Limited-stage small-cell lung cancer

One page to bring and write on: your details, the questions for Limited-stage small-cell lung cancer plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Limited-stage small-cell lung cancer

Prepared with OnCo (onco.cc/prep/limited-stage-sclc/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

18 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Stage by PET-CT and brain MRI, Response after chemoradiation, Pulmonary function and radiation dose constraints, Neuroendocrine markers on pathology, Transcription factor subtype), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Limited stage, fit
  1. 5.For my situation (limited stage, fit), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Platinum + etoposide (EP / CE), Cisplatin, Carboplatin or related drugs, and what side effects should I expect?
  3. 7.How do the results of CONVERT and ADRIATIC apply to someone like me?
After response: brain
  1. 8.For my situation (after response: brain), which of the standard options do you recommend and why?
Stage I, node-negative, found incidentally
  1. 9.For my situation (stage i, node-negative, found incidentally), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Platinum + etoposide (EP / CE), and what side effects should I expect?
Relapse
  1. 11.For my situation (relapse), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Tarlatamab, Lurbinectedin, Topotecan or related drugs, and what side effects should I expect?
  3. 13.How do the results of DeLLphi-304 apply to someone like me?
Any stage
  1. 14.Are there clinical trials I could join, for example of Study Evaluating Tarlatamab After Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer (LS-SCLC), Tarlatamab, MRI surveillance replaces prophylactic cranial irradiation in SCLC, Subtype-directed therapy for SCLC (ASCL1 / NEUROD1 / POU2F3 / inflamed)?
  2. 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 17.I read that “Whether prophylactic cranial irradiation still helps when MRI surveillance is available is being tested in randomised trials”. How does that affect my plan?
  5. 18.I read that “The best radiotherapy dose and schedule to combine with immunotherapy is unknown”. How does that affect my plan?

The words I may hear

  • Limited-stage vs extensive-stage (small-cell lung cancer): Small-cell lung cancer uses a two-way split instead of the usual four stages: limited (confined to one side of the chest and treatable within one radiation field, about a third of patients) or extensive (everything else).
  • Prophylactic cranial irradiation (PCI): Giving the brain a preventive dose of radiation (25 Gy in 10 sessions) before any metastasis can be seen, mainly in small-cell lung cancer, which spreads to the brain in over half of patients.
  • Lobectomy: Removing one lobe of the lung (the right lung has three, the left two).
  • Radiation pneumonitis and lung fibrosis: Inflammation of the lung one to six months after chest radiotherapy, causing cough, breathlessness and fever; usually settles with steroids but can leave permanent scarring.
  • Consolidation therapy: Treatment given after a good response to kill the cancer cells that are presumably left but cannot be seen, to make the remission last.
  • Histologic transformation: When a lung adenocarcinoma escapes targeted therapy by turning into a different cell type, usually small-cell.
  • Chemoradiation (chemoradiotherapy, CRT): Radiotherapy given at the same time as chemotherapy, which sensitises the cancer to radiation.

Tests and results to bring

Biomarker results to ask for: Stage by PET-CT and brain MRI (limited versus extensive is the main decision), Response after chemoradiation (eligibility for durvalumab), Pulmonary function and radiation dose constraints, Neuroendocrine markers on pathology (synaptophysin, chromogranin, INSM1), Transcription factor subtype (ASCL1, NEUROD1, POU2F3; research).

Scans and tests linked to this cancer: MRI, PET/CT.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call