Guests/Speakers
James Hiter (Host): Patient Advocate, LCFA Speakers Bureau. James is living with lung cancer and is the founder of Streak For a Cure, a nonprofit raising awareness and funding for lung cancer research.
Montessa Lee: Long-term small cell lung cancer survivor, special educator, LCFA Speakers Bureau member, and patient advocate. Diagnosed with SCLC in 2006 at age 28 while completing her master’s degree, Montessa has since earned a doctorate in education and facilitates support groups for SCLC survivors and caregivers.
Small Cell Lung Cancer Subtypes: What Patients Should Ask Now
For nearly two decades, Montessa Lee has waited for small cell lung cancer research advances to catch up with the progress she watched unfold in non-small cell lung cancer. In this Fall 2026 episode of LCFA’s Living With Lung Cancer: Ask Me Anything podcast, host James Hiter talks with Montessa about small cell lung cancer subtypes, quality of life during treatment, and why patients diagnosed today are entering a different world.
Listen now on Podbean | Watch on YouTube
From misdiagnosis to advocacy
In 2006, at just 28 years old, Montessa had chest pain and a cough that would not go away. She was first told it was inflammation around her rib cage, then bronchitis. On her third visit, an X-ray revealed a tumor the size of a cantaloupe.
tumor the size of a cantaloupe.
“I looked at the numbers and I was angered, you know, by the low prognosis rate, by the low funding for research. And I decided to turn that anger into advocacy.” (Montessa Lee)
Small cell lung cancer research is finally accelerating
Montessa points to 2019 as the next major treatment breakthrough after years of little change. Since then, she says, the pace has picked up: new FDA drug approvals, more labs studying SCLC, and multiple ASCO poster sessions devoted to small cell alone.
“20 years ago, this is the hope that I’ve been waiting for, you know?” (Montessa Lee)
Learn the basics: See how small cell lung cancer differs from other lung cancers on LCFA’s Understanding Small Cell Lung Cancer page.
Small cell lung cancer subtypes: different locks, different keys
Researchers now know that SCLC is not one disease. They have identified subtypes, and some treatments may work better for certain subtypes than others. SCLC is not yet treated with targeted therapies the way many non-small cell oncogene groups are, but Montessa believes it is heading there.
“The same keys that open one lock don’t open another lock.” (James Hiter)
Montessa, a special educator, compares it to her classroom: every learner’s profile is unique.
“And we know that the one-size treatment option doesn’t work for everyone.” (Montessa Lee)
She also explains plasticity, the ability of SCLC to change over time. It is one reason the disease has been so hard to treat, and one reason understanding your own cancer matters.
Ask about subtyping: Montessa suggests asking your doctor what subtype you have and whether it could guide your treatment. Explore current options on LCFA’s Understanding Small Cell Lung Cancer page.
Your questions help your care team
James encourages patients, especially those treated in rural settings, not to feel intimidated: your research and questions can help a doctor who cannot be an expert in everything. Montessa recommends bringing a caregiver to appointments to help retain information, and keeping a journal of side effects to share with your care team.
Her starter questions for anyone newly diagnosed with SCLC:
- Is my cancer limited stage or extensive stage?
- What is my treatment plan, and what are my options?
- Are there clinical trials I could join?
- What are the possible side effects of chemotherapy or radiation?
- How long will I be in treatment?
Explore clinical trials: Use LCFA’s Find a Clinical Trial tool to search studies, including SCLC trials.
Start here: Newly diagnosed? Begin with LCFA’s First 7 Days roadmap for the questions to ask and steps to take first.
Living longer, and living better
As survival improves, Montessa urges researchers to measure more than time.
“We’re not just looking at overall survival, but how are you living while you’re surviving?” (Montessa Lee)
Side effects such as loss of taste or fatigue can matter enormously to some patients. Montessa’s own early treatment caused severe ringing in her ears, which led her doctor to switch her from cisplatin to carboplatin and order a hearing test. Chest radiation also means regular mammograms. She still lives with the ringing, and turns on closed captions. James shares that he would tolerate the same to reach milestones like meeting his newborn grandson.
Skip outdated statistics
Survival statistics online often lag years behind today’s treatments.
“Don’t go to AI or Dr. Google because things are rapidly changing.” (Montessa Lee)
Instead, she recommends recent ASCO publications, lcfamerica.org, and established lung cancer organizations, and checking back often.
A different world, and you’re not alone
When Montessa began advocating, she knew of only one other person with SCLC. Today she facilitates survivor and caregiver groups with more than 50 people in the room.
“If there’s any time to be diagnosed, it’s now.” (Montessa Lee)
“You’re not in it alone.” (James Hiter)
Hear more: Find survivor-led conversations on LCFA’s Living With Lung Cancer: Ask Me Anything page, and connect with advocates through the LCFA Speakers Bureau.
Content shared in this episode reflects personal experiences and should not substitute for professional medical guidance. Please consult your healthcare provider for personalized medical advice.
