Small cell lung cancer (SCLC) often spreads to the brain, where it tends to be very aggressive. Although median survival is about 6 months, with advances in treatment, experts think life expectancy will improve.

SCLC makes up about 15% of all lung cancer cases. Although it’s less common than non-small cell lung cancer, it’s typically more aggressive and likely to spread.

For some people with SCLC, little pieces of the primary tumor in the lungs break off, travel through the lymphatic or circulatory system, and spread to other organs, like the liver, bones, or brain. Cancer cells that spread from one part of the body to another are called metastases.

The brain is a common place for SCLC to spread. According to a 2021 research paper, up to 80% of people with SCLC develop brain metastases, and up to 20% of people with SCLC already have brain metastases when they get their diagnosis.

Although developing brain metastases can worsen the outlook for people with SCLC, new treatments like immunotherapy have improved survival rates.

SCLC that spreads to the brain tends to be highly aggressive.

In a study of 489 people with newly diagnosed SCLC brain metastases between 1990 and 2018, the median survival time from diagnosis was 6 months. The average survival time for study participants with neurological symptoms was 5 months. Those with no neurological symptoms had an average survival time of 8 months.

With advances in treatment, experts think life expectancy will improve. There has been at least one published report of someone becoming cancer-free following extensive treatment for SCLC with brain metastases. But currently, this is very rare and shouldn’t be the expectation.

Symptoms of SCLC brain metastases

Brain metastases don’t always cause symptoms. But if symptoms occur, they may include:

  • slurred speech
  • changes in vision
  • numbness, weakness, or tingling
  • headaches
  • decreases in memory and attention
  • nausea and vomiting
  • difficulty speaking
  • personality changes
  • seizures
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According to the National Cancer Institute, the 5-year relative survival rate for SCLC that’s spread to other parts of the body, including the brain, is 3%. This means that when compared with people who don’t have SCLC, 3% of people with SCLC were still alive 5 years after their diagnosis.

Keep in mind that several factors that can influence your survival, including:

  • your age
  • your overall health
  • the size of your tumor(s)
  • specific genetic mutations in the tumor
  • how early a doctor diagnoses the cancer
  • how well the cancer responds to treatment

In recent years, the use of immunotherapy for tumors with certain genetic mutations has improved overall survival.

New and worsened symptoms often suggest the end of life in someone with SCLC brain metastases. These may include:

These symptoms may make it more challenging to eat or drink properly, which could lead to malnutrition, dehydration, and difficulty taking oral medications.

Resources for support

Resources like support groups, palliative care, and hospice care can help improve the quality and quantity of life for someone with SCLC that’s spread to the brain.

Consider reaching out to the following organizations for help accessing this type of care:

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SCLC is more likely than other types of tumors to spread to the brain. Here are answers to some frequently asked questions about SCLC that’s spread to the brain.

What stage is lung cancer that’s spread to the brain?

Doctors usually classify SCLC as either limited or extensive. They consider SCLC that’s spread to other parts of the body, including the brain, to be extensive stage SCLC. Extensive stage SCLC may also be called stage 4 lung cancer.

What are the final stages of brain metastases?

A person in the final stages of brain metastases may experience extreme tiredness, memory loss, and confusion, and they may withdraw from the world or lose consciousness. They may also lose the ability to speak or swallow.

During this time, a palliative care specialist can provide support and comfort for you and your loved ones.

How fast do brain metastases grow?

Brain metastases grow rapidly. One retrospective study reviewing MRI records of 82 people with brain metastases found that over 75% of tumors grew significantly in volume between diagnosis and treatment. About 30% of the brain tumors doubled in size before treatment, including those treated within 6 days of diagnosis.

SCLC is the rarer but more aggressive type of lung cancer. It’s more likely to spread (metastasize), and the brain is a common location for this.

Brain metastases can worsen your outlook with SCLC. Median survival is about 6 months. However, advancements in treatment may improve this statistic.