I am looking for studies or information on the effects of radiotherapy on HEAVY smokers with SCLC.
My 64 year mother has been diagnosed with Ext SCLC in Dec 2011. She had brain mets which cause seizures. This is how it was discovered. typical. They did radiation to the brain (Dec) which reduced the cancer,and recently, did a "one time" high dose of radiation to brain(Aug). She is currently clear of brain mets. It was also discovered at this time that she suddenly had diabetes. She was sent to a dietician because of the immediate weight loss that also followed during the first months of treatments. Besides the radiation, she went through 6 months of Carbo/Epo (Jan-Jun) before it stalled. She had no problems with the chemo or side effects. After 1st line treatment stalled, they had her take time off. Six weeks(Aug) later showed increase in tumor size in chest. She currently just finished third round of 2nd line Topotecan. The radiologist suggested that when that stalls they may do some chest radiation.....I am a little more than concerned with that idea because she smoke a ridiculous amount of cigarettes and will not stop. I believe she smokes about 4 packs a day. I can not imagine how much damage her lungs have besides the cancer. I guess I am imagining radiotherapy making her already unhealthy lungs worse??
Are the any studies or journals specifically written about heavy smokers during Ex SCLC treatments and how it effects of the treatments?
Reply # - October 20, 2012, 09:57 AM
Reply To: The effects Radiotherapy to the chest and the heavy
Hello, I'm very sorry your mom is going through all this. I was once a smoker and know just how difficult it is to stop smoking. As a matter of fact most experts on smoking cessation will tell you to not attempt to stop during trying times. I see why she can't. My husband stopped just before his surgery that dx his cancer. I simply put all the smoking paraphernalia away during his 9 day stay. Simply put his 9 days in the hospital and subsequent recovering time was his and my final stopping.
Dr. West stated he used to tell smokers they should quit if they could but didn't push them to stop because it wasn't thought to make a much of a difference. That understanding has changed and it does make a difference. Below is a quote from a post and link to the post explaining further.
Dr. Loiselle states in this post on the subject, "The effect of smoking while undergoing radiation treatment was recently examined by physicians at The Mayo Clinic in Scottsdale and a group from Luebeck Germany. Dr. Dirk Rades and colleagues published a 2008 analysis in the International Journal of Radiation Oncology, Biology, Physics, of 181 patients treated with radiation therapy for non-small cell lung cancer, and found that local control of lung cancer at one year was 46% among currently smoking patients versus 71% among patients that were not currently smoking. For the statisticians among you, this was statistically significant when all other factors where taken into account (i.e. multivariate analysis)."
http://cancergrace.org/radiation/2011/11/02/smoking-cessation-and-radia…
Please let us know of other questions you have,
Janine
forum moderator
Reply # - October 20, 2012, 11:31 AM
Reply To: The effects Radiotherapy to the chest and the heavy
I don't think there is a significant amount of work on this issue (there may be almost none or none at all), and much of the question of damage depends on how large the radiation field is. If they need to radiate a lot of the lung tissue, it will be damaged and non-functional. If they need to just radiate a very limited area of functioning lung tissue, it doesn't have nearly as much of an impact.
Of note, there is no clearly proven value for chest radiation for previously treated advanced SCLC. It makes sense to use it for a focal problem caused by bulky tumor, or to relieve pain, but extensive SCLC is a multifocal problem, so it usually doesn't make a lot of sense to focus on treating just a limited area in the chest.
Good luck.
-Dr. West