Small cell lung,with mets to liver, bones,lymph nodes - 1271099

loosescrew
Posts:3

Hello, 2nd time to site. Y'all were everything and more than expected the first time, and it was greatly appreciated. My wife was diagnosed with small cell lung cancer on 6-14 right lung with mets to liver. lymph nodes (5). Admitted to hospital 7/1/15, uncontrolled pain. Biopsy,results arrived while in hospital. MRI/CT/PET scans showed liver ,lymph nodes, and bone mets (cranium,right shoulder,spine,right hip).First round chemo,on 7/20/15 Cisplatin, VP-16. Before,discharge wife had numbness in left jaw. C/T of jaw/chest, showed probable mets to left lung and nerve in jaw. Septic,5 days ICU. Discharged, 2nd round chemo on 8/24.Final round on 9/14, then monthly maintence ( specific drug depending on scan results). I have been told that brain mets are very likely. ESPECIALLY,since the jaw nerve is involved. We are well aware of the prognosis. Just want to get your opinion. Anything, we should or could be doing differently ? We are very confident in our ONC doc, just checking. Thanks, Joe

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JimC
Posts: 2753

Hi,

I'm very sorry to hear of your wife's diagnosis. Everything that has been done so far is pretty standard, and I hope that you will see good results from the next scan. Because of the high risk for SCLC to spread to the brain, PCI (prophylactic cranial irradiation, essentially whole brain radiation performed prior to any evidence of metastasis to the brain) is often recommended after a good response to initial chemotherapy. As Dr. Gadgeel wrote in his post on Treatment of SCLC:

"Because the potential for spread to the brain in small cell lung cancer patients is very high, as noted above, PCI has also been evaluated for patients with ED-SCLC. A recent European study demonstrated that patients with ED-SCLC, no evidence of brain metastases, and who have responded to first line chemotherapy benefit from receiving brain radiation following the completion of front line chemotherapy. The benefit is in the form of extending survival and markedly reducing the chance of the patient developing subsequent brain metastases." - http://cancergrace.org/lung/2010/08/07/treatment-of-small-cell-lung-can…

There is a more recent discussion of which patients benefit most from PCI here.

Best thoughts for good results from treatment.

JimC
Forum moderator