Small Cell Lung Cancer (SCLC) is one of the most aggressive cancers and is the most aggressive subtype of lung cancer. It is a high-grade neuroendocrine tumor usually resulting from smoking and has a poor prognosis. Patients with SCLC generally present with respiratory symptoms such as cough, hemoptysis, and shortness of breath; while imaging can reveal a centrally located lung mass with thoracic lymph node involvement. Paraneoplastic syndromes including Cushing’s, SIADH, and auto-antibody derived diseases may also present in these patients. SCLC grows rapidly and metastasizes quickly resulting in most patients having extensive stage cancer at the time of diagnosis. A study on SCLC survival over three decades from 1983-2012 did identify a slight increase in 5-year survival rate with each decade, however, the median survival for each decade remained at about 7 months [5]. This highlights the true complexity of SCLC has and the need for urgent workup when this disease is suspected. Immunotherapy and small molecule inhibitors offer options for treatment, although SCLC mortality and treatment outcomes have remained relatively unchanged over the past few years [6]. SCLC patients who have the metastasis seen in Figure 1 will likely benefit from an urgent referral for diagnosis and an aggressive treatment plan.  Diagnosing, staging, and treatment planning will likely improve the possibility of improved outcomes. Multidisciplinary Teams (MDTs) are composed of various healthcare specialists who regularly discuss specific individual patients and collaborate on best alternatives to diagnose, discuss treatment plans, and provide timely comprehensive care for these patients. Studies on MDTs generally focus on outcomes based on before and after the MDT interventions and there have been limited studies performed on the impact of MDTs on lung cancer specifically [7]. Other cancers such as breast, head and neck, and rectal have been shown to have more positive outcomes when associated with MDT involvement. Benefits include patient satisfaction, reduced cost, improvement in documentation, and reduction in time between first diagnosis and treatment [8-11]. The time reduction from diagnosis to treatment remains an important aspect of MDTs involvement, particularly with SCLC patients. Coordinating tissue acquisition, staging and treatment for SCLC can prove a challenging task.

There has been conflicting data and controversy surrounding the benefit of resource allocation into MDTs, aimed at improving outcomes among patients with SCLC. A study performed by Bydder et al. (2009) evaluated outcomes of inoperable SCLC patients discussed in MDT meetings versus SCLC patients who were not and found that those who were discussed at the meetings had a mean survival of 280 days versus 205 days for the patients who had no MDT [12]. However, a conflicting study reported in 2011 demonstrated that MDT discussions in SCLC patients was associated with better treatment reception which could lead to better quality of life, but the study did not demonstrate increased survival rates [13]. To date, most of the research within this area has indicated benefits of prompt referral to MDTs aimed at improving the time interval from diagnosis to treatment as well as improving quality of life. Future studies are needed to further understand the role MDTs at improving SCLC survival in patients with ES SCLC - as the one presented in this case [14]. It remains paramount to ascertain best approaches to establish care for SCLC patients, given prognosis.