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FishOn

New to fight - Spouse w/SCLC

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Good morning and happy Thanksgiving weekend.  Newbie here, as I just found the site.  Wife dx with SCLC in June 2019.  Although it was a larger (lemon size) tumor in the left lung, there was no initial sign of spread and she successfully went through chemo, radiation and PCI, we just received a call last night that her latest chest CT showed growth on left Adrenal growing.  This kind of shook us as we were led to believe we were looking at a Limited, Curative SCLC which was backed up with no MET on any CT or PET to this point.

 

She's scheduled for an abdominal CT with contrast next week, and an Onc apptmt that should tell us more.    Not sure what we're looking at from here.. if surgery to remove Adrenal is an option??  She's not been put on any immunotherapy up to this point, and we really want the Oncologists to treat this as aggressive as the cancer seems to be.   We apparently did not realize, (maybe in denial) how SCLC can spread.  Any insight on what we should expect?  We're very nervous that the doctors are going to be chasing this cancer throughout her body...   Thinking ya beat one, only for it to pop up in another spot.  Anything I should ask for from the doctors?  My head is kind of spinning, trying to think through this, so just going to end my first post right here.  Thanks.

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Fishon,

Welcome here. Very sorry to learn of your wife’s recurrence. Frequent recurrence is what makes lung cancer so difficult to arrest. I’ve had 4 recurrences after no evidence of disease (NED) yielding treatments. 

I encourage you to consult with a radiation oncologist to learn if precision radiation (stereotactic body radiation therapy or SBRT) can fry that adrenal tumor. Note SBRT can be given in combination treatment with chemo and at this juncture, I’d advise the more treatment methods, the better outcome. 

Stay the course. 

Tom

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Thanks Tom, I'll inquire about the SBRT.  How is the radiation delivered?  Is it a course or one or two precise treatments? I'll do some research as well, but appreciate the info.  She's kinda down on Radiation therapies, after the PCI took the remainder of her hair, and gave her a rash a few weeks back.  But it always seems less invasive than a surgery.  Wondering if Immunotherapy is something we have to ask for or would be offered now that there's been recurrence?  

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Fishon,

My SBRT was a 15-minute treatment given in 3 successive days. There were no side effects, unlike my experience with the 30 days of conventional radiation. 

SBRT is often an alternative for surgery. you may find a combination of conventional chemo with immunotherapy is the next line of treatment. If it were me, I’d have that along with SBRT. 

Stay the course. 

Tom

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Hi Fishon (I like your screen name),

I understand your shock and some confusion after finding that your wife's lung cancer has possibly spread.  I was in a similar situation with my mom a few years ago.  Her lung cancer is different (non-small cell), but I too was in shock when, 1 year after surgery and the end of her follow-up treatment, her lung cancer was back.  Recurrences are all too common in lung cancer - that's the bad news.  But the good news is that regular, follow-up screening most often catches the recurrence early enough to treat it.   Your analogy of "chasing around lung cancer" is a great way to describe treatment for what is now considered, for many, a chronic condition rather than a death sentence.  With advancements in lung cancer treatment, doctor's can throw many different things at the cancer in the hopes to eradicate it or slow it down.

You mentioned immunotherapy.  Yes, some SCLC patients benefit from immunotherapy.  When it is prescribed and why, I am not sure.  But research is showing that some kinds of immunotherapy help slow SCLC and/or eradicate it.  My mom was on immunotherapy for nearly 1 year for her recurrence (again, she has NSCLC) and she is nearing her 2 year mark of NED (I don't want to jinx it, her next scan results are on December 12th).  I am a big supporter of immunotherapy when it is appropriate.  If I were you, I would definitely bring it up and ask your wife's docs if it is an option.  Your wife's treatment options may not be simple or obvious as her initial option of surgery, so don't forget that you can always look for a second opinion if you are concerned about the options given to her.

Hope this helps a bit.

Take Care,

Steff

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Thanks Steff, 

I sincerely appreciate the responses, and liked how you compared lung cancer as a chronic condition (for many), rather than a death sentence.  

I feel like I'm trying to help my wife frame the way-ahead, without even knowing what that is...  even being so blessed with her initial limited diagnosis, she's tired from the 5-6 months of treatments she's just completed, and just now felt like she was healing up... only to receive the call.

In any event, we're trying to stay positive and I'm thankful for others opinions on these things, as they're still very foreign. 

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