My dad has the Small Cell Lung Cancer and it is not in the brain but the doctor says he wants to do radiation on the brain to prevent it from coming there. Has anyone had this done? Any side effects with this? They said headaches? Any information? Thanks for your help!! Aubyn
SCLC is intrinsically sensitive to chemotherapy (NSCLC is not). SCLC is one of the very few forms of carcinoma for which chemotherapy has some positive effect on survival. You'd think that if it is so sensitive to chemotherapy then why PCI? Well, SCLC is also very aggressive, tends to metastasize readily and grow rapidly. Median survival is on the order of 9-10 months, rare patients have long-term remissions (years).
Recurrences are much more difficult to treat. Brain metastases are common with SCLC, hence the use of prophylactic whole brain radiation (PCI). PCI comes in safer doses with fewer side effects, but when to use it is controversial. Patients who are candidates for whole brain radiation are selected because they are thought to have limited survival times of less than 1-2 years, before the effects of radiation necrosis would show up.
Several studies in the '90's convincingly showed there was no survival benefit or prolonged independence in patients who received whole brain radiation therapy. The efficacy of this kind of radiotherapy has not been established. The most interesting part of the studies were the patients who lived the longest. Patients in the observation group who avoided whole brain radiation had an improvement in survival.
Large-molecule drugs do not cross the blood-brain barrier (BBB), their concentration in the central nervous system (CNS) is very low. The concentration of radiolabeled large-molecule drugs in the CNS is found to be significantly lower than in other organs, and thus undetectable in the brain, in the spinal cord or in any other site of the CNS. If they do not penetrate well into the CNS, it may represent a tumor 'sanctuary' site for these regimens.
It makes me wonder, if they radiate just the whole brain but not the spinal cord, how does PCI benefit the patient? Any theoretical cancer cells in the spinal cord would eventually infiltrate the brain.
The problem of penetration into the CNS is not as nearly as severe for small-molecule drugs. Large molecules cannot permeate through the narrow spaces, however, fat soluble (lipophilic) molecules can dissolve through the capillary cell membranes and are absorbed into the brain. A few brain diseases consistently respond to lipid-soluble small molecules.
If your father had any of these "small molecule" drugs, perhaps they would benefit theoretical cancer cells from going to the brain, better than PCI. Temodar is one of those drugs. Avastin has been showing as an aggressive brain cancer drug.
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Hello!
My Dad also has SCLT-Ext..he was diagnosed in April and he actually just finished his brain radiation on Tuesday. I think it is very common with this type of cancer...they do it to the brain to prevent it from spreading there. As far as side effects..everybody is different; my dad was very lucky! He had his radiation 5 days a week for two and a half weeks and the only side effect he had was that he was tired the first couple days! I say go for it! Good luck to you and your dad! and remember a positive attitude is suppose to help with side effects from chemo/radiation! If you have any questions you can always send me a message!
God Bless,
Megan
Hi there,
I was dx with Lt.SCLC in March of 06, had 6 cyles of Chemo, 6 weeks of Chest Radiation and after waiting for 8 weeks to let my body heal a bit I had 15 PCI treatments.
I have been blessed by God to still be here and God willing I will be able to grow old with my husband and see many grandkids grow up.
I have no side effects from the PCI as of yet. Sometimes I lose my train of thought but who doesn`t do that.
Good luck and God bless you
Kerstin
Hi, here's hope too. I was dx with sclc-ls in May 07, had 6 rnds chemo, 6 wks chest radiation and 11 PCI treatments in Dec 07. Now, 8 mos later, I have no side effects except just being a little low on energy sometimes. But, I just lay down and take a quick nap and feel better - something I never did very often before!
I expect no side effects from PCI. Yes, I was told they may come in a year or so, but I think positive and live every minute!
God Bless Everyone,
nkb
I have Stage III NSCLC and still elected to do PCI. There is not medical evidence that it is effective, but there are also no studies that say it is not. I did three weeks (2 grays per day X 15) and so far have not experienced any side effects except loss of hair and some fatigue. Long term effects? Who knows....I HOPE I have long term effects!
Good luck!
I was diagnosed with SCLC-limited in June 06. I had chemo and radiation to the lungs. I consulted with my radiologic and medical oncologist and at the time they felt I should not do the brain radiation. I have been cancer free until my last scan 9/24/08. It has shown up in the brain and I started radiation yesterday. My radiologic oncologist still believes it was good decision not to have the brain radiation at that time after the initial treatments. I was told that side effects would be tiredness and headaches, but the good news is it won't be half as bad the side effects from the radiation I had on my lungs.
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