Glamorous topics in cancer - 1272374

david
Posts:14

Hi, I have been exploring the site thanks to some links from Janine. Dr Gadgeel posted Introduction to Small Cell and says that almost 50% of SCLC patients could have one or more paraneoplastic syndromes with symptoms that often precede the diagnosis of SCLC.
What length of time are we talking about?
Dr Harman in her post Glamorous Topics in Cancer says that SCLC can secrete intestinal hormones that cause diarrhea. Would this be considered paraneoplastic?

This site is mine of information, it's wonderful that it is available to everyone. I was going to post the links to the topics but I haven't worked out how to do this yet. I hope that you don't mind.

Happy New Year

David.

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Reply # - December 31, 2015, 10:43 AM

JimC
Posts: 2753

Hi David,

[Regarding the content of the first paragraph of this post, please see my correction in my post later in this thread].

Since the paraneoplastic symptoms are associated with the spread of SCLC to other parts of the body, I think Dr. Gadgeel's statement refers to spread that has occurred before diagnosis that has caused symptoms prior to diagnosis. As he states, most SCLC patients have symptoms prior to diagnosis, but SCLC tends to move quickly, so if it had spread enough to cause you symptoms a year ago it is extremely likely that you would be in much worse shape now.

If you're beating yourself up that you or your doctor's didn't find your SCLC sooner, please try not to do so. You had some pretty non-specific symptoms that would not suggest SCLC (and are likely unrelated to it). SCLC can manifest itself and spread fairly quickly, which is why many patients unfortunately are diagnosed with extensive stage disease.

Not a problem that you didn't post links, but if you want to in the future just copy the web address at the top of your browser and paste it into your post.

JimC
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Reply # - January 1, 2016, 05:49 AM

david
Posts: 14

Happy New Year JimC,

Thanks for your reply I was wondering if you could clarify something for me as I must be reading something wrong! Basically are the symptoms related to the spread.

In Dr Gadgeel's post

http://cancergrace.org/lung/2010/08/03/intro-to-sclcref-lib/

the bit I was reading talked about the symptoms not being related to the spread of the cancer:

"Paraneoplastic 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."

When I read you response I thought that it said the symptoms were related to the spread:

"Since the paraneoplastic symptoms are associated with the spread of SCLC to other parts of the body"

I am probably beating myself up and still looking in the rear view mirror, but I think if this could have been identified earlier then I should really share the information. It might just help someone experiencing something similar to get an earlier diagnosis.

I hope you all have good fortune in 2016.

David

Reply # - January 1, 2016, 08:38 AM

JimC
Posts: 2753

Hi David,

Happy New Year to you too!

Yes, I am sorry that I misspoke in my response. Paraneoplastic syndromes don't relate to metastatic spread of cancer, but rather to effects the tumor may have on other bodily systems. I am amending my response accordingly.

Since those symptoms do relate to the presence of a tumor, in this case SCLC, it would be unusual for a significant enough tumor to exist and produce only these effects a year before diagnosis, without other symptoms more indicative of SCLC appearing a while before diagnosis.

I appreciate your sentiment that it might help other patients get diagnosed sooner if these symptoms could be identified as paraneoplastic effects of a malignant tumor, but I'm not certain that's feasible when the symptoms you experienced are very much more likely to have other explanations. For instance many patients seek medical advice as a result of bone/joint pain, but usually the first suspicion is not bone metastases from cancer. When more likely causes are ruled out or scan results lead in that direction, attention may then be turned to less common causes.

JimC
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Reply # - January 1, 2016, 09:17 AM

david
Posts: 14

JimC,

Thank you for this update, I now understand! And I eventually get it that if I was experiencing these paraneoplastic symptoms a year ago that would mean there was a tumor present at that time and if that was the case and it was the sclc then the progression would have been much quicker than what I have witnessed. This really helps me as I can start focussing on what's ahead and not behind me.

Best wishes

David.

Reply # - January 1, 2016, 05:59 PM

catdander
Posts:

In the spirit of "cancer can and does anything" I wanted to say that yes it's not impossible to have sclc that has been growing for a year excreting toxins that cause problems. But very rare enough to be the last thing a doctor would look for and still unlikely in your case.

David, I'm hoping your new year finds limited stage and cure for this cancer.

Janine

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