PET scan before treatment/normal waiting times? - 1266228

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anac
PET scan before treatment/normal waiting times? - 1266228

Hello,

My aunt has been diagnosed with neuroendocrine SCLC. Her diagnosis started on Aug/16 with an X/Ray, a chest CT on Aug/22, a VATS on Sept/11 and now the biopsy results. She also has done complete blood work, Her CEA levels were very high (260ngl), and since she had colon cancer 13 years ago, she also had a colonoscopy and endoscopy, which both came clear.

She will only see the oncologist next monday (Oct/8).

I have two questions: Will she need, or is recommended, for her to have a PET scan before starting treatment? (is it a protocol?) This would greatly delay the start of chemo (she is abroad and health insurance there is very bureaucratic).

Also, is this a normal wait time? I am so nervous since every article I read talks about the fast spreading nature of SCLC.

Thank you very much!

JimC
Hi anac,

Hi anac,

Welcome to GRACE. I am sorry to hear of your aunt's diagnosis; I hope that we can help with answers to your questions.

A PET scan is not normal protocol in small cell lung cancer. As Dr. Gadgeel has written:

"The following tests are done in patients who are diagnosed with SCLC or suspected to have SCLC:

Blood work, including a complete blood count, blood chemistries such as sodium level, liver and kidney tests
CT scan of the chest (should include the liver and adrenal glands)
MRI or CT scan of the brain
Bone Scan

Note that PET scans are not an approved test for SCLC, even though it is approved for NSCLC (due to it being better studied in that setting). However, if a PET scan is done, then a bone scan is not needed, but a brain scan is still required, since the brain is not well examined on a routine PET scan.

These studies are routinely performed because the areas in the body to which SCLC most typically spreads include the lymph nodes within the chest (hilar: lymph nodes within the lungs, and mediastinal lymph nodes: lymph nodes in the middle of the chest), the brain, other portions of the lung or the opposite lung, pleura (lining of the lungs), adrenal glands, liver, and bones "

These comments can be found in Dr. Gadgeel's excellent "Introduction to Small Cell Lung Cancer" which you can find here: http://cancergrace.org/lung/2010/08/03/intro-to-sclcref-lib/

The time it takes to diagnose and stage lung cancer can be frustratingly long, but the time frame your aunt has experienced is not greatly out of the norm; hopefully she can begin treatment soon after her appointment.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

anac
HI Jim,

HI Jim,

Thank you so much for your answer. I have read the article, it is indeed excellent. It is so much new information to absorb, and so overwhelming.

Thank you for your comment on the waiting times. It does help to know that we are in an expected timeline.

Thanks again,
Ana