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SCLC: Case notes - Tumor shrinkage


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I thought I would detail my wife's tumor shrinkage with appropriate dates. Everyone is different but this may be useful to folks that thought, like me, "it was never going to shrink". Her cancer did not go away but it is stable for now.

1/24/20 - hospitalized; 1/25/20 - CT scan (mass 7.0x6.7x4.8cm); 1/29/20 - Dx stage IIIB SCLC; 1/31/20 - Cycle 1 chemo (3 days); 2/4/20 - discharged from hospital

2/13/20 - PET CT scan (mass 6.1x5.5x5.0cm, SUV 17.5)

2/25/20 - Cycle 2 chemo (3 days); week 1 radiation

3/2/20 - week 2 radiation

3/9/20 - week 3 radiation

3/16/20 - Cycle 3 chemo, week 4 radiation; 3/18/20 - hospitalized; 3/19/20 - CT scan (5.3x5.2cm); 3/23/20 - discharged from hospital 

3/24/20 - week 4 radiation

3/30/20 - week 5 radiation

4/6/20 - completed chest radiation (30 days)

4/14/20 - completed chemo (4 cycles)

4/27/20 - hospitalized, CT scan (mass unchanged); 5/1/20 - discharged from hospital

5/12/20 - PET CT scan (mass 4.7x3.7cm, SUV 8.5)

5/15/20 - hospitalized; 5/21/20 - discharged from hospital

6/9/20 - week 1 brain radiation

6/15/20 - week 2 brain radiation 

6/23/20 - complete brain radiation (10 days)

7/4/20 - hospitalized, CT scan (mass 1.8x1.9x2.0cm); 7/9/20 - discharged from hospital

7/16/20 - hospitalized, CT scan (mass unchanged, considered stable); 7/18/20 - discharged from hospital 

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Additional info: Chest radiation started with cycle 2 of chemo instead of with cycle 1. This was because my wife was in the hospital and radiation setup needs to be at the specific location where radiation will be given consistently. Someone writing the NCCN guidelines "back when" must have realized that not everyone has access to a major hospital that performs both chemo and radiation in house. The guidelines indicate that concurrent radiation should begin with either the 1st or 2nd cycle of chemo.

Also, it is not normal to get so many CT scans within the first-line treatment schedule. My wife was in the hospital a lot and almost every time they checked for a blood clot in the lungs (pulmonary embolism) with a CT scan. I suspect this was highly irritating to my wife's oncologist as I was always questioning the shrinkage rate. At 1 point it seemed like he was discouraged by the small amount of shrinkage early on. Obviously, my wife and I picked up on that.

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