small cell lung cancer extensive - 1246703

allyb
Posts:2

My partner has lung cancer which has metastasis to liver and spine. Diagnosed in March 2012 has now completed 6 courses of Cisplatin/Etoposide chemo. He has only had one CT scan after 2nd course of chemo and now has his first appointment with Doctor next week since starting chemo. Could you help by advising what questions we should be asking at this meeting. After his CT scan at his 3rd session of chemo he was told his lung tumour was slightly decreasing but liver tumour slightly increasing by the Nurse. If liver tumour has not decreased is there anything that can be done to help the liver e.g. radiation, abalation or surgery. Is there any maintenance treatment that we should be requesting. When should the next CT scan be taken after completion of chemo. I would just like to get the full facts from the Doctor and just dont know what to ask. My partner is 52 years old and apart from feeling very tired and sick after the chemo he has managed to get out and about and has not been confined to bed. When he was diagnosed he had radation to his spine as it was an emergency and it was mentioned he had degerative disease of spine when he had last CT scan but they would talk about this at a later date. Should we be asking questions about this. He is still able to walk for a few miles at a time.
Thank you

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Reply # - August 13, 2012, 11:52 AM

Dr West
Posts: 4735

allyb,

Here's a link that describes the important highlights of how small cell lung cancer (SCLC) is best managed:

http://cancergrace.org/lung/2010/08/07/treatment-of-small-cell-lung-can…

Essentially, with extensive stage SCLC, it's appropriate to treat for 4-6 cycles of a first line doublet chemo, then to stop chemo and consider prophylactic cranial irradiation (PCI) if the person has had a good response and has a good enough performance status. However, PCI is still far from a mandate -- it's more of an option with a compelling rationale but also some risks to consider in the decision.

There is no established role for maintenance therapy for SCLC, and this is not routinely recommended. It does not offer a survival benefit, based on the results of several trials that have looked at this question.

It is most common to repeat scans on an interval about every 6-12 weeks after chemo has been completed. SCLC can often come back pretty quickly, so sometimes patients will experience new or recurring symptoms in the interval between scans and contact their oncologist, who might well need to move up the timing of a repeat scan and evaluation.

Good luck.

-Dr. West

Reply # - August 13, 2012, 12:15 PM

catdander
Posts:

Hello Ally and welcome to Grace. I'm very sorry about your partner. It's a good sign the he responded after just 2 treatments so I'd not assume he didn't continue to respond to the next 2 or 4. I'm going to refer you to blog/posts by our faculty so you can educate yourself with standards of care for ex sclc and about bone mets (radiation is good to stop fractures and compression). There aren't any lists of questions to use because of the variability of situations. Each is unique. So arming yourself with knowledge (and paper and pen) will be a better way to enter the appointment. After reading up a bit please come back with the questions you have left (or more likely questions you'll then have). The blogs are relatively short and very readable for the lay person.

* http://cancergrace.org/lung/2008/09/05/wird-ed-sclc/

* Scroll down past limited to extensive, http://cancergrace.org/lung/2010/08/03/intro-to-sclcref-lib/
and for additional reading on sclc, http://cancergrace.org/lung/category/lung-cancer/core-concepts/sclc-ext…

* a discussion about local therapy to liver mets, http://cancergrace.org/topic/liver-met-recurrent-adcc

* on bone mets, http://cancergrace.org/lung/2007/02/17/bone-metastases-in-lung-cancer-a…
* http://cancergrace.org/lung/2007/02/21/surgery-for-bone-metastases-when…

I know you didn't ask but, if you're in the US have you made arrangements, made and signed contracts concerning your rights as a partner, as opposed to a spouse. I ask because it was always my mom's concern with my "husband" and me because we never married. So we made contracts and refer to one another as husband and wife. We have had no problems in the hospital or with doctors or staff. In Alabama if you refer to each other as husband and wife, are opposite sex, and have lived together for at least 5 years your as good a married. I'm sorry if I've treaded beyond my bounds.

I hope this is helpful,
Janine

Reply # - August 13, 2012, 02:45 PM

allyb
Posts: 2

Thanks for your reply. I have read the blogs which have given me further information on SCLC and this has given some information that I can ask the Doctor at the next meeting. However it seems it is a matter of praying results from scan are good and cancer stays down as long as possible.

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