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PCI QUESTIONS


Bev'sSister

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I am just curious to know if PCI is given only when the Dr. thinks a cure could happen. My sister is supposed to start in April with 10 PCI's. Is this the normal amount. By that, I mean is 10 on the low side or high side or is that the usual amount?

Is this the right thing to do?

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I can't tell you whether it is the right thing to do. There are survivors of sclc who never had PCI, and other choose to have it as a preventative.

Here are some recent discussions from Dr.Jack West at onctalk.com about standard treatments for sclc as well as PCI. I hope this helps.

I really think whether or not to do PCI is a personal choice.

http://onctalk.com/2006/12/01/current-s ... ease-sclc/

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Bobby,

My husband had 17 PCI treatments after remission of the chest tumors. He finished the PCI 11/21/06 and on 12/29/06 was found to have mets to the bones. It will be very interesting to me to see his next PET.

I just sent a (dumb???) question to Dr West on his site. I'm wondering if his being "chemo resistant" that it was just the radiation that killed the tumors. I guess we'll all continue to have questions and wonder why.

I guess this is kind of more than you asked for, sorry. It's just hard to find people to talk with as so few of our loved ones have SCLC.

Laurie

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Bobby,

I don't know exactly what determines whether or not they recommend PCI. In my case we sat down and went over the numbers and the potential problems regarding memory function and recall concerns. It seemed to me that the odds for longer term survival went to those who elected to have PCI. That made the choice easier for me.

My first side effects were the nearly immediate loss of my hair, which I'd held onto through five months of chemo and radiation. Since then I've been experiencing the memory and recall issues which I sort of expected. Being 67 years old I'm never too sure whether my failing memory is normal or has accelerated due to the PCI.

We all have to make our own decisions about this and I relied very heavily on my medical team for advice.

Our prayers and support will be with you and your sister as she deals with this latest decision.

John

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Hi Bobby,

My understanding is that the person is NED when they do PCI, and that it might be done less with extensive than with limited.

Although Bill has yet to start radiation (as you know), our radiation oncologist did mention to us last week that PCI is something we would be discussing after any chest radiation is completed. All of this contingent upon the results of a PET scan in 3 weeks or so.

Sorry I don't have more info.

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We were told that PCI really is for those who are "cureable" and that it is given after all other treatments, and when there appears to be no sign of disease. I wouldn't rule it out in terms of those diagnosed with extensive, because it is still getable.

Best of luck,

Jen

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I just wanted to chime in that while PCI is really considered most standard for LD-SCLC, several of the trials that showed major benefits in reducing risk of brain mets and a modest but real improvement in survival included patients with ED-SCLC. There will be a study of PCI in ED-SCLC presented at our big international oncology meeting in early June, but we don't have the results from that until then. Until then, PCI is certainly a reasonable thing to consider in patients who had at least a good response to treatment, a complete response or a "good partial response" (which I'd consider to be at least a 50% shrinkage, and ideally just with a little residual disease if not complete resolution after treatment.

-Dr. West

-Dr. West

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Thank you all for your replies, and especially yours Dr. West. That was about the best thing someone could say to me today. Never lose faith! Those words made me believe that "Maybe Beverly is right..She is on her way to being cured by faith alone. Well, with a little help from her Doctors. I do believe in miracles and I hope everyone on this board believes too. God bless you all and please continue to pray. Even a little bit improvement in survival is a heck of a lot!

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