Slow growing sclc - 1273958

Hi Erka,

Welcome to GRACE, and thank you for sharing your story. I am not a medical professional, but any scenario in which SCLC is confirmed yet disappears without treatment is very unusual, as lung cancer tends to grow over time. SCLC in particular tends to grow rapidly. On the other hand, cancer is not always known to follow rules, so this type of unusual situation is not unheard of.

Good luck to your mom with her treatment.

JimC
Forum moderator

Wish my Mom's had been slow growing. From beginning to end for her was only 6 weeks and one chemo treatment. Good luck to your Mom. It is very rare I think for it to happen this way, but as Jim said, cancer is not known to always follow rules. Take care, Judy

Hi Erka,

Welcome to Grace. I'm so sorry your mom is going through this. Yes it's very rare to hear a story like this not in my 7 years on Grace however I too am not an oncologist. All chemo works the same way in that it attacks dividing cells. I wouldn't expect your mom's situation to be the usual though including how well she responds to treatment. Hopes for the best are always in order.

All best,
Janine

Hi erka,

It's certainly true that it would be best if these slow growing SCLCs could be detected earlier. Unfortunately, many patients have non-specific symptoms and many also have small lung nodules, the vast majority of whom do not have lung cancer. If surgery/biopsies were performed on all of such patients, there would be a very high percentage of unnecessary procedures, each of which entails risks. It's definitely a catch-22, and there isn't currently an answer to the problem.

JimC
Forum moderator

The thing with many of these symptoms is that they can also be caused by other illnesses. Without a biopsy, there's no other way to diagnose lung cancer. They are now coming up with blood tests, but I don't know how those will work either. But it could be a beginning for situations like yours to avoid invasive surgeries.
Take care, Judy

Erka,

I sort of understand what you're talking about when it comes to extremely unusual situations. My husband's has been one such situation. Really all are different your mom's has a facet of which is usually determined to have an alternative explanation. Don't let that worry you, you have enough on your plate. Doctors will treat the best they can. Another secret about cancer treatment, it's very difficult to ever guess how someone will react to treatment, even the most typical cases.

I will ask an oncologist on our faculty to comment. While they are very busy with their own practices and research endeavors they are tops in explaining in laypersons terms and passionate about educating us so we can be a part of the team.

Following is a link to a post about a theory that may never be able to proven or disproved. I've noted it as an example of how we all too often can't explain cancer. BTW, my husband spontaneously stopped smoking about 3 years prior to diagnosis though he started back a couple of months later, stopping for good prior to surgery. http://cancergrace.org/lung/2009/11/30/can-smoking-cessation-be-a-prese…

All best,
Janine

I have never heard of a small cell lung cancer growing slowly over years, but of course we usually only see them once they become advanced enough to cause symptoms so it is often impossible to know how long they have been there. I personally have never seen a true SCLC case that did not grow aggressively. We do know that a small subset of SCLC patients have tumors discovered at an early stage and can be cured with surgery, which is rare enough that I have always wondered if perhaps there is a group of SCLCs that have a different biology that is less aggressive.

There are also some other possibilities. Neuroendocrine cancer has a spectrum of aggressiveness, and it is possible that some cancers that are called SCLC could truly be lower-grade neuroendocrine tumors (like carcinoid) and were just misclassified.

There are also rare cases of cancers regressing spontaneously, although this isn't common for lung cancer and is classically seen in more immunogenic tumors like melanoma and kidney cancer. However, we know that immune therapies can work in SCLC and so it is conceivable that once in a while the immune system causes the cancer to regress without treatment and keeps it in check for some time. We also know that patients with autoimmune paraneoplastic syndromes may have a better prognosis. Perhaps that is what happened, but I don't think we would ever be able to say for sure.

Janine,

I find the phenomenon of smokers quitting prior to a lung cancer diagnosis, even without symptoms, intriguing because this is precisely what happened to me and its spooky too.

I quit after 34 years of smoking on July 14, 2015. I didn't have a cough or shortness of breath, I was just fed up with smoking -- tired of being an addict and not enjoying it at all.

Then I got a bunch of tests including colonoscopy, mammogram, physical, mole check and various other tests concluding with a chest xray and pulmonary function test in October 2015 because I wanted to be sure I was ok. Well it turns out I was not ok.

Chest xray showed a nodule in the lung, went on to VATS and now chemo (almost done). I want to emphasize that I had absolutely no symptoms driving my quit or getting me to get these tests. My mother had two independent cancers (breast and colon) before she turned 50 so that was in the back of my mind.

One thing that wasn't clear from reading the article, is it really true that the risk of lung cancer goes up for a few years after one quits relative to someone who keeps smoking? Here is a quote from the article:

Although we don’t talk much about it, we’ve known for some time that the risk of lung cancer exceeds that of continuing smokers for a few years after quitting.

Is it possible that quitting triggers lung cancer? I find this hard to believe but with cancer anything is possible and certainly quitting is a big shock to all the tissues in the lung so it is conceivable.

The theory behind this is that it's very rare that people spontaneously stop smoking without planning or having health or traumatic issues for stopping. It's also been noted that some of those people who did spontaneously stop also developed lung cancer. We don't know if there is even a connection but if there is it's not thought that stopping causes the cancer but there may be minute triggers that happen when lung cancer is developing that also trigger some people to just stop.

There's no thought or theory that stopping causes cancer. I remember a discussion on that when this was written. There's plenty of evidence that the longer it's been that one stops the less likely one develops cancer or other respiratory issues. The triggers that cause this spontaneous stopping is thought to be associated with the development of cancer.

I hope that's clear.
All best,
Janine

Hi erka,

I would not really expect a carcinoid tumor to cause siadh, since these tumors do not typically grow rapidly or spread, limiting their effect on most bodily functions unrelated to the site of the tumor. Also, carcinoids typically do not respond to chemo, as stated in this page from the American Cancer Society.

JimC
Forum moderator