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Living with cancer· Appointment prep

Appointment sheet: Small-cell lung cancer

One page to bring and write on: your details, the questions for 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

Small-cell lung cancer

Prepared with OnCo (onco.cc/prep/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

34 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 DLL3, B7-H3, SCLC-A/N/P/I subtypes, Stageis the dominant decision, B7-H3), 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
  1. 5.For my situation (limited stage), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Durvalumab, and what side effects should I expect?
  3. 15.For my situation (limited stage), which of the standard options do you recommend and why?
  4. 16.Am I a candidate for Platinum + etoposide (EP / CE), Durvalumab, and what side effects should I expect?
  5. 17.How do the results of ADRIATIC and CONVERT apply to someone like me?
Extensive stage
  1. 7.For my situation (extensive stage), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Atezolizumab, Durvalumab, and what side effects should I expect?
Relapsed
  1. 9.For my situation (relapsed), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Tarlatamab, Ifinatamab deruxtecan, and what side effects should I expect?
  3. 11.How do the results of DeLLphi-304 apply to someone like me?
Screening and diagnosis
  1. 12.For my situation (screening and diagnosis), which of the standard options do you recommend and why?
Very limited stage (T1-2 N0, ~5%)
  1. 13.For my situation (very limited stage (t1-2 n0, ~5%)), which of the standard options do you recommend and why?
  2. 14.Am I a candidate for Platinum + etoposide (EP / CE), and what side effects should I expect?
Extensive stage, first line
  1. 18.For my situation (extensive stage, first line), which of the standard options do you recommend and why?
  2. 19.Am I a candidate for Platinum + etoposide (EP / CE), Atezolizumab, Durvalumab or related drugs, and what side effects should I expect?
  3. 20.How do the results of IMpower133 and CASPIAN apply to someone like me?
Relapsed, platinum-sensitive (≥90 days)
  1. 21.For my situation (relapsed, platinum-sensitive (≥90 days)), which of the standard options do you recommend and why?
  2. 22.Am I a candidate for Tarlatamab, Lurbinectedin, Topotecan, and what side effects should I expect?
  3. 23.How do the results of DeLLphi-304 apply to someone like me?
Relapsed, platinum-resistant (<90 days)
  1. 24.For my situation (relapsed, platinum-resistant (<90 days)), which of the standard options do you recommend and why?
  2. 25.Am I a candidate for Tarlatamab, Lurbinectedin, Topotecan or related drugs, and what side effects should I expect?
  3. 26.How do the results of IDeate-Lung02 apply to someone like me?
Brain metastases
  1. 27.For my situation (brain metastases), which of the standard options do you recommend and why?
Transformed SCLC (from EGFR-mutant NSCLC)
  1. 28.For my situation (transformed sclc (from egfr-mutant nsclc)), which of the standard options do you recommend and why?
  2. 29.Am I a candidate for Platinum + etoposide (EP / CE), Osimertinib, and what side effects should I expect?
Any stage
  1. 30.Are there clinical trials I could join, for example of Ifinatamab deruxtecan, Actinium-225 DOTATATE, Tarlatamab, PF-08634404?
  2. 31.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 32.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 33.I read that “Rapid chemoresistance”. How does that affect my plan?
  5. 34.I read that “Brain metastases”. 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).
  • Overall survival (OS): Overall survival (OS) is how long patients live, full stop.
  • 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.
  • Neuroendocrine tumour grade (Ki-67) and WHO classification: How fast the tumour cells are dividing, measured by Ki-67 staining, separates slow-growing neuroendocrine tumours from aggressive neuroendocrine carcinomas and decides the treatment.
  • Progression-free survival (PFS): Progression-free survival (PFS) is how long patients live without their cancer growing.
  • 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.
  • Platinum-sensitive / platinum-resistant: Whether a cancer that responded to platinum chemotherapy came back more than six months later (sensitive, so platinum can be used again) or sooner (resistant, so something else is needed).
  • Differentiation: How closely a cancer cell still resembles the mature, specialised tissue it came from.
  • Bronchoscopy (EBUS, robotic navigation): Passing a camera down the windpipe into the lungs to biopsy tumours and lymph nodes without surgery.
  • 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.

Tests and results to bring

Screening and diagnosis: Low-dose CT screening in heavy smokers finds some SCLC but stage shift is limited; diagnosis by bronchoscopic or CT-guided biopsy; staging with PET/CT and brain MRI.

Biomarker results to ask for: DLL3 (not required for tarlatamab), B7-H3, SCLC-A/N/P/I subtypes (research), Stage (limited vs extensive) is the dominant decision, B7-H3 (I-DXd trials), SSTR2 (RYZ101), Transcription-factor subtype (ASCL1/NEUROD1/POU2F3/YAP1, research), PD-L1 and TMB (not predictive in SCLC), SLFN11 (chemotherapy/PARP sensitivity, research), ctDNA (research).

Scans and tests linked to this cancer: CT (computed tomography), Low-dose CT lung screening, MRI, NHS Targeted Lung Health Check (lung cancer screening programme), PET/CT, Somatostatin receptor PET (68Ga/64Cu-DOTATATE).

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