Hello, I am an oncology nurse and I will attempt to answer your question. The extent of your fathers malignancy is of yet undetermined. It would depend on the type of cancer and the location. Small cell lung cancer or SCLC has the subtypes of pure small cell carcinoma, mixed small/large cell carcinoma, and combined small cell carcinoma (i.e., SCLC combined with neoplastic squamous or glandular components). SCLC is considered a more aggressive type of lung cancer because it usually metastasizes early; however, it is generally very responsive to chemotherapy. Long before, it was referred to as Oat Cell carcinoma. That being said, a CT is only as good as it is intended. A CT shows anatomical landmarks or anatomy but does not any metabolizing activity so a shadow or lesion might not be anything other than scar tissue, polyp, cyst, or pre cancerous cells as well as a malignancy. A PET, on the other hand, will show metabolic activity and can determine if the lesion is a malignancy by the designated SUV score. A PET cannot show anatomical sites so many are done together as a PET-CT where the PET is transposed on top of the CT to show metabolism and anatomy. Given that, I don't think that what is on the liver or kidney could be a malignancy without proof of a PET or biopsy. Given that there is no lymph involvement leads me to believe that your dads disease is confined to the lung, or in situ. In order to determine his prognosis, there are many factors to consider besides that which I have addressed above. What is his age? His co-morbidities? His will to live is a big factor and whether he is invested in the therapy suggested. I think at this juncture it is best to get the results of the head CT and other relevant data and then as it is presented, you will have the opportunity to ask the oncologists the answers you seek. Best of luck to you and your Father, Carm RN.
Lung Cancer Questions
Ton of questions about sm cell ca.
Asked by brimek on Saturday, May 11, 2013
Ton of questions about sm cell ca.
my dad diagnosis w/ ca in nov 12 from scans but no dr would do a biopsy till 5/13. Turns out he has small cell ca. He does not want treatment of any kind. What kind of prognosis does he have. Biopsy said no lymph node involvement but previous scans reveals areas in liver and kidney's. I am scared it may be stage IV. He goes in a few days to have a head CT to see if it might be there as well! Any words of advice or anything????
3 Answers from the Community
carm (Best Answer!)
Carm is very knowlegble and you need to read his reponse in depth. I have/had extensive (stage IV) SCLC. The best thing that I can tell you is to remind him of all of the people that care about him and love him. You have to be careful not to make it a guilt trip. When I got my diagnosis (Sept 12) the first mistake that I made was look up survial rate, not good. Then the anger of how I wasted my life. Then saying XXXX it get it over with and let me die. Then how much I still want to do. Then the desire to prove the satistics wrong. I have never been a quiter and I wasn't about to quit now. After talking with my oncologist I realized that if I fought this the way the plan worked I may not get rid of this cancer but I COULD beat it and live with it as a chronic illness. In Feb 13 the results came back that the main tumor had shrunk and showed no activity and all of the metastasies (bone and liver) had disappeared. That was after 6 rounds of chemo, 3 times a week every other week. I won't lie there were times when I was in front of the toilet that I wanted to just die then and there. If it wasn't for my wife and my other caregivers(my mom dad and aunt) I may have given up. I survived that and started feeling stronger within a month or so afterwards. My oncologist asked me to see one of his associates, a radiation oncoligist, about doing some preventative radiation on my brain. SCLC has a strong tendency to go to the brain and even though nothing had showed up in any of the scans I should think about it. Asking questions about pros and cons I opted for doing 6 weeks once a week of radiation to my brain just in case any cancer that was too small to be seen on the scans. Again this improves my survial rate.
I wish you the best and hope your Dad reconsiders. Know that all of us on this web site are there for each other and for you too. Feel free to ask lots of questions. There are a lot knowledge available to you. Jack
The first step is to get him to a facility that specializes in LUNG CANCER. This is a life or death requirement. There are treatments that can prolong life and you need to remind your Dad that as odd as this seems older people taking LC treatments often times do better than younger people.
Right now he is in shock over the Dx. Give him a little time to process all of this. He is frightened. But tell him that there are children who take treatments for every type of cancer.. The youngest LC person is 4 years old. If they can do it he can too. I think if he were in the hands of experts they would help him understand his treatment.
Carm did give you a great deal of information but it might be too much for you right now. And that's O.K. because its normal.. Call the Lung Cancer alliance and find an expert facility near you. Just ask your Dad to talk to them and make decisions after that.
Also find a American Cancer Society facility since they have a ton of information pamplets from the NCI on all subjects for cancer./