Limited stage SCLC

[Pstar]

Hello…I was diagnosed with LS SCLC in Nov 2021. I have completed chemo and radiation and CT scan has showed that nodules have shrunk. I am now wrestling with whether to do PCI or just be followed with CT scans every three months.

[Tom Galli]

Star,

Welcome.

Yours is a tough decision. First line chemo-radiation had an effect and that is a good thing, but small cell unfortunately has a high recurrence rate. There is not a lot of information on the value of PCI for LS SCLC. Here is a radiation oncology trial that provides some insight. (scrub the linked webinar to 5 minutes to get to the radiation oncologist pitch). But most important, my view, in this information is the written summary of questions and answers following the webinar. Here is the link for Q&A. The answer to the question: when is prophylactic cranial radiation (PCI) used contains the answer you seek.

I hope this helps.

Stay the course.

Tom

[BroFTW]

Hello,

My brother was diagnosed with limited stage sclc, last year in May.

Chemotherapy and cjest radiation shrunk the tumours and currently he is in complete remission.

But, after he finished the chest radiation he was feeling quite well and healthy for about 2 months, after which he had PCI.

He finished the PCI by the end of November. Ever since he is having issues with nausea and weakness. Lately it seems like he is having gum and teeth issues too, he's been visiting the dentist. I don't want to scare you here, there are people on this forum with various experience from PCI.

If you read online you can see that sclc is aggresive and mostly metastizes in the brain.

I don't have any advice on whether to do it or not. My brother got PCI and while he's had the hardest time since he was diagnosed, because of the side effects, I still think that it was the right choice at the moment.

As Tom said, there aren't any clear studies on the benefits of PCI.

In the link, it says that researches are questioning whether MRI every 3 months is a better idea, and it could be. This is not an easy decision you might want to talk with few doctors before deciding.

[Tom Galli]

Bro,

I'm sorry to learn about your brother's difficulty. Nausea, weakness and dizziness all can be side effects of PCI. Gum and teeth issues might result from chemotherapy. During my chemo, I was advised to consult with my dentist 4 times per year. But, medical radiation can sometimes affect the teeth and gums.

Unfortunately, your characterization of SCLC is correct. It is aggressive and does frequently metastasize in the brain. This aggressiveness is itself a complicating problem on predicting short or long term benefit or effects of PCI treatments. Many (with or without PCI) don't live long enough to generate meaningful data on the value of PCI as a treatment method.

With lung cancer, there are no easy decisions. With SCLC, decision difficulty and complexity rise exponentially. Thank you for providing your insight.

Stay the course.

Tom

[Pstar]

Thank you all for your replies…I am also being offered to participate in a clinical study that is weighing whether MRI alone every three months is as effective as PCI with MRI every three months…just don’t know which arm of the study I would be a part of as it is randomized…if I do participate hoping for the MRI arm as the side effects of PCI sound so scary…but then metastases to the brain is so scary too.