GI Symptoms prior to SCLC Diagnosis

Portal Forums Lung/Thoracic Cancer Screening / Prevention GI Symptoms prior to SCLC Diagnosis

This topic contains 5 replies, has 3 voices, and was last updated by catdander forum moderator catdander forum moderator 10 months, 2 weeks ago.

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July 7, 2017 at 12:11 am  #1291017    

rwh37011

Hi,
Most of my story is on free to breathe, but I came on here to ask for a view as there seems to be a few cases like mine. I know how aggressive sclc is, but recently I have heard of a number of people with GI symptoms up to 2 years before diagnosis of sclc with no ct significant findings just 10 months ago. I have been told that sclc hits like an express train and is not subtle. Also, that it would be exceptionally unlikely to have some symptoms from sclc with nothing showing on xray or ct. I don’t know how sclc grows but could we have had symptoms of sclc two years before diagnosis? I thought worth sharing and perhaps getting a professional view. Could we have been having symptoms from the sclc when it was in some precancerous phase?

RW

July 7, 2017 at 8:02 am  #1291019    
JimC Forum Moderator
JimC Forum Moderator

Hi RW,

Welcome to GRACE. Although it’s always tough to say that cancer can’t present in a particular manner, it would be unlikely to have symptoms that long before diagnosis, especially if previous scans were clear. Some patients point to the possibility of paraneoplastic syndrome, in which an SCLC tumor produces symptoms not only prior to diagnosis but prior to metastatic spread of the cancer. But as Dr. Gadgeel has stated:

‚ÄúParaneoplastic syndromes are changes in different body parts that can occur in cancer patients, not related to direct spread of the cancer. Almost 50% of SCLC patients could have one or more paraneoplastic syndromes, with symptoms that often precede the diagnosis of SCLC.‚ÄĚhttp://cancergrace.org/lung/2010/08/03/intro-to-sclcref-lib/

In the absence of a visible SCLC tumor on scans, it is unlikely that SCLC could be the cause of GI symptoms two years prior to diagnosis. As you say, SCLC tends to be aggressive, and if it were present two years ago it would certainly have appeared on a scan 10 months ago, and would likely be extensive stage at that point.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

July 7, 2017 at 11:19 am  #1291023    

rwh37011

Hi Jim,
I had never heard of piraneoplastics syndromes before. Incredible to read that up to 50% of sclc patients could experience them. Any reason why they aren’t used as early warning signs of sclc, feels like heaps more people could get an earlier diagnosis if they were recognized in time.

RW

July 7, 2017 at 12:36 pm  #1291025    
JimC Forum Moderator
JimC Forum Moderator

Hi RW,

The main reason that paraneoplastic syndrome does not tend to be used as an indicator of SCLC is that the symptoms are fairly non-specific and are much more likely to be caused by a number of lesser ailments, so a diagnosis of SCLC would not be high on the list of causes.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

July 9, 2017 at 3:40 am  #1291030    

rwh37011

Hi Jim,

The paraneoplastic syndromes sure do seem a complicated concept. I was doing a bit of reading up on them and they do seem well documented. The recommendation I could find talked about screening for 4 or 5 years for sclc if they are suspected. Surely untreated sclc would be pretty obvious after this time period? Or are there cases where sclc is indeed more subtle than we make out and that there may be a precancerous phase where there are symptoms?

RW

July 10, 2017 at 1:54 pm  #1291037    
catdander forum moderator
catdander forum moderator

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Yearly screenings may be advised depending on circumstances.

Food for thought; GI symptoms are exceedingly common while lung cancer is not. I’d argue that people who haven’t had GI issues prior to a lung cancer diagnosis is less common than those who do, just because most everyone has GI issues at some point. The GI system is extensive with much to go wrong.

I hope all is well,
Janine

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