Small Cell Question of Origin

[Jackson]

My Mom was diagnosed with SCLC mets to liver. The tumor on her lung is and always has been very small but there are multiple lesions on her liver. We questioned her onc if this was normal and he said yes. However he has now stated that we cannot be sure the cancer started in her lung, but is definately small cell cancer and would be treated the same. This came about when she was going to do a trial dosage of Topotecan, taking it once a week rather than one week on then two off. She did not qualify for the trial because the cancer may not have started in her lung. My questions are, has anyone heard of small cell liver cancer? I cannot find any information on it. She had stomach discomfort for about two years prior which was diagnosed as acid reflux. Could this have been the cancer? Her onc has said no because of how quickly small cell grows but how can we be sure at this point that it is small cell? Also, she was on the medication Zocor for high cholesterol and was having her liver monitored because of it. She did have high liver enzymes then all of the sudden cancer. We believe the Zocor had something to do with her getting cancer. Could we be right? I know it's alot of questions but I'd appreciate any thoughts anyone has.

[kimblanchard]

I have never heard of small cell cancer originating in the liver but it certainly can start in places other than the lung. It can start in the intestines, prostate gland, cervix, etc. I highly doubt Zocor would have caused this, most of the studies are now suggesting that Zocor has a protective effect against cancer. I agree with your doctor that this cancer almost certainly spread to the liver from somewhere else. How hard to look for where that somewhere else is? Depends on how curious you are to know, I agree that the treatment will be the same no matter where it started.

[Jackson]

Thank you so much for responding. We were under the assumption that it probably had started in her liver since that's where there seems to be the most cancer and that is why we linked it to the Zocor. Her doctor never specifically said he thought it started in the liver though. We meet with him on Wednesday so I will ask him where he thinks it may have started and if we can find out.

[Fay A.]

This information is provided to inform, not to frighten. Please read the information below on Statins.

http://www.captainclark.com/Pages/jamareport.html

http://www.druginfonet.com/pi_mfr/ppi/m ... /zocor.htm

[kimblanchard]

And I'll counter those with these articles:

http://www.asco.org/ac/1,1003,_12-00264 ... 180,00.asp

http://www.asco.org/ac/1,1003,_12-00264 ... 073,00.asp

So hard to know if they are good or bad from a cancer standpoint. From a heart standpoint, no question they are good though.

[Jackson]

Thanks Fay and Doctor Joe for posting the articles. Doctor Joe, if you don't mind one more question. Since my mom's cancer may not have started in the lung, do you think there is a chance it is not small cell at all? Seems quite rare for small cell to not be lung cancer. I can't jelp but wonder if it was a complete misdiagnosis.

[kimblanchard]

Never hurts to have someone else look at the path slides if you are concerned but small cell cancer generally has a very typical appearance and staining pattern under the microscope. The one cancer that can mimic it is carcinoid tumors which most frequently metastasize to the liver. If it hasn't been reviewed elsewhere it would be very reasonable to ask for a review at a referral center.