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Posted

Hi,

My dad just got diagnosed with SCLC last week. They said it was in bewteen the lobes (airway?) and has gotten to his lymph nodes but not sure where else. His only symptom was a cough for a couple of weeks. I was wondering if anyone could help me decipher terminology and what some of the tests are being done for. Our family has no experience with any sort of cancer so I feel sort of ignorant and want to be well informed. Unfortunately, I'm a cognitive neuroscience student which doesn't help my dad too much. He is going to have a bone density scan tomorrow and had another brain MRI today (I suppose to check to see if the cancer has spread beyond the nodes). He will get all his results back on friday and meet with the radiologist. His oncologist said that they weren't sure about Chemo yet. He is going to start radiation treatments soon. I was wondering if they do the radiation treatments first before they do chemo (is this normal)? I was also wondering what the side effects of radiation are? He was concerned about incontinence and nausea? He said that this coming friday they were going to do a "sim". What is this? If anyone can give me any info, tips or anything that they might feel useful, please drop me a line.

Posted

Keo...

You may want to check out the website www.blochcancer.org which has very good information for families and folks who have just learned they have lung cancer. Dick Block is a survivor who runs this site and actually wrote a book which I got for my father-in-law last summer. The book is basically online and available for your perusal there at the site. There is also a database of places you can go for a second opinion which is highly recommended. The places mentioned are supposed to provide these 2nd opinions involving not just an oncologist, but also the radiologist and any others involved in a discussion that INCLUDES the patient. Lately I have been reading about some folks frustrated with oncologist decisions, so you may want to seek that 2nd opinion for your dad. Most insurances cover that especially with something like cancer.

I don't know what the "sim" is. I do know that they will often check the bones as well as the blood counts. My father-in-law actually had the chemo first with his first dianosis but I think a lot of it depends on the situation. With his recurrence, they did radiation first but then could not do the chemo as the cancer had continued to spread too aggressively. The first time he did real well with the chemo, worked full time for most of it. He would drink this protein shake called Reliv to help keep his energy level and nutrients where they needed to be. OH! There is a site that has some info from a dietician who has battled cancer more than once that you may want to check out. She also has a great links page. Here is her site. http://www.cancerrd.com/index.html

I encourage you to be very proactive in your father's care. If someone here doesn't have an answer to help you, call the doctors' offices and ask Qs until you get the understanding you were seeking. Your father and his family have the right to understand and be able to make well informed decisions. Don't feel like you are being too bothersome. They owe you the time to better grasp what is going on. (About halfway through our cancer battle, I had to go in with my in-laws and prod and demand because they were just too polite and rationalized that the doctor was just too busy so they should just do whatever he recommended.) Life is just too short and this beast is too unpredictable to worry that you are annoying anyone with questions. The only bad question is the one you didn't ask when you thought you should have. You may want to go back through some of the older SCLC posts to see if they bring any answers. I learned a lot from Sam's posts. You can also do a search for "side effects with radiation" where you will find others' questions and some very helpful replies.

I will be keeping you, your father, and entire family in my prayers.

Hang in there. Be strong and find power in knowledge and faith as well!

Karen M.

Posted

sim - is probably a simulation. A simulation is done before the actual radiation to make sure everything is setup correctly. Not sure about more of the details.

http://imaginis.com/radiotherapy/radio_plan.asp

Radiation and Chemotherapy combined is usually the best. Radiation is only for local control and chemo is for systemic treatment.

Radiation is believed to sensitize the cancer and make the chemo work better.

I *believe* that the exact sequence radiation first vs chemo first, and all the other combinations have not been figured out as far as being the optimal treatment.

Radiation can cause fibrosis and other problems in the lungs. Look into using supplements. Supplements and cancer treatment are controversial but there is some evidence it may help. Another approach is not to take vitamins/antioxidants during active radiation/chemo, but take them a few days before and on days after - I think this is called a "protected zone"

http://www.lef.org/protocols/prtcl-153a.shtml

http://www.itmonline.org/arts/antioxidants.htm

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