My brother was newly diagnosed at the end of January, with extensive disease SCLC with mets to liver and many bones. None to brain. He is 52 y.o. and has been generally healthy until diagnosis. He started his 2nd round of chemo today (carboplatin/etoposide), and he was told they will scan after 4 rounds “to give the chemo a chance to work” . I’ can’t find any site that specifically discusses the standard of care regarding scans, but it seems that he has very little time to waste if the first line treatment is not going to work for him! Please let me know if you know of any medical literature that discusses this. He was told he has about six months to live, so is waiting for 4 rounds appropriate, and can an assessment be made earlier to determine efficacy? It seems that what I have read is that people are typically getting scans after 2 rounds!
Welcome to GRACE. I am sorry to hear of your brother’s diagnosis, but I hope that he has a very good response to treatment.
Although I am not aware of a specific standard of care for the initial scan interval, as this is something that varies a bit from one oncologist to another, it is typical to get a scan after the first 2-3 cycles of treatment. As Dr. Gadgeel stated in his post on Treatment of Small Cell Lung Cancer: “Scans to assess the response of the cancer to this treatment are done after every 2-3 rounds (or about 6-9 weeks).”
For lung cancer in general, Dr. West has said “my practice is generally to give an initial two “cycles”, typically about 6-8 weeks, and then repeat scans. However, in patients who are rapidly deteriorating, that provides a very strong hint that the treatment isn’t working, so I move up scans accordingly, sometimes after just 2-4 weeks on a treatment, so we can cut our losses if it isn’t working and consider moving on to the next thing.” – http://cancergrace.org/forums/index.php/topic,1275.msg7021.html#msg7021
With that in mind, if your brother’s symptoms appear to be worsening, you may be able to convince his doctor to move up his initial follow-up scan.
Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
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