SCLC metastasis to brain and spine

[BJakobsson]

Hi everyone,

Great to join this group and see everybody’s inspiring stories. 
My dad was diagnosed with SCLC on Jan 6th 2023. He had a 15cm tumour in his left Lung, at this stage there was no metastasis. After a long month wait with appointments and scans he had his MRI of his brain on the 1st of Feb 2023 and was starting chemo the same day alongside immunotherapy. A small lesion was on his brain and he was subsequently treated for that by targeted radiation and whole brain radiation. He finished his 12 weeks chemo/immunotherapy in April and the scans showed great results with significant reduction of the lung tumour to 5cm and the brain was significantly reduced. It’s now May 20th and he was due to continue immunotherapy and start radiation on his lung late April, but since he last treatment he has slowly declined and not been eating/drinking fluid since about the start of April. He has all up lost 30kg and has gone from a strong man with a lot of strength to not being able to move in the bed. He started to get really week in the legs and can no longer stand up, along with some bladder problems. As a result they scanned his spine due to the symptoms he was experiencing. The scan showed up with multiple lesions all the way down his spine. Waiting to hear from the oncology team as to our best steps moving forward. Does anyone have any advice? They have upped his dexamethasone intake to 8mg to help with the inflammation and hopefully get him eating as he just doesn’t want to eat and drink. 
Any tips to help would be really appreciated, we lost our mum to kidney cancer when we were younger and Dad is our world. 

[Tom Galli]

BJakobsson,

Oh my, your father has a tough row to hoe!

If small cell returns after the first treatment, it returns with a vengeance. The lesions along his spinal cord are troubling and difficult to arrest. Moreover, they are likely causing his difficulty with standing and walking. I'd say trying precision radiation (targeted radiation) to spinal lesions might be a way forward. Have his physicians administered a PET scan? The PET scan (information on a PET scan here) can identify metastatic activity all over his body. I think the results of a PET scan might give you insight into the extent of tumors and perhaps a decision on further treatment or best-supporting care.

I am sorry I don't have a lot of suggestions to offer. Small cell lung cancer is the most difficult of all lung cancers to treat.

Stay the course.

Tom

[BridgetO]

 I agree with Tom that your dad has a tough row to hoe. I don't have suggestions other than to agree with Tom about seeing whether precision radiation is an option. My mom had metastases in her lower spine from breast cancer and localized radiation gave her a year pain free, which was definitely worth it to her.  It sounds like your father's mets are more extensive than my mother's were, but on the other hand  this was over 25 years ago and  radiation is more advanced in approaches than it was then. 

All my best to your father and to you.