Side effects of PCI

My 64 yo mom has SLSC and has completed 6 rounds of chemo and the chest radiation. She is scheduled for PCI after an MRI next week. Her way of dealing is by not looking up anything and only using the info given to her by her docs. I'd like to be able to give her an idea of what the PCI is like (side effects) based on those going through it. If any of you have a moment to respond it would be appreciated.

This is a wonderful forum.
Thanks, Kristin

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Kristin,
What is PCI? Good luck to your Mom & you.
Janet h

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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 (prophylactic cranial irradiation)? Well, SCLC is also very aggressive, tends to metastasize readily and grow rapidly.

Recurrences are much more difficult to treat. Brain metastases are common, hence the use of PCI. 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.

PCI is supposed to come in safer doses than WBR (whole brain radiation) with fewer side effects, but when to use it is controversial. 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.

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Hello, I have a few things to tell you about PCI. I had it done almost 2 years ago, after going through Chemo and Chest Radiation, to treat Lt.SCLC. The only side effects I had where burned ears, redness on top of my head and it took my hair about 3 month to come back, it still is somewhat thin but at least I have hair. That`s it for side effects for now, none of us knows what the future has in store for us. I am blessed and very thankful to be here. I do realize that some people on the site are very bitter due to losing a loved one and I do feel for them, I lost my Mother at a young age. Think about the PCI like this.....yes you might have some sort of forgetfulness, but that`s a far cry from Brain mets.
Take care and God bless you
Kerstin

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Thanks for your responses. It turns out that the brain MRI showed my Mom has 2 areas of mets. Alll the news has been so great thus far so it really was shocking news. The research says a matter of months once SLSC has spread to the brain (even with tx.) We are a very close family of 6 kids and our Dad died of a heart attack at age 49. We need to be prepared. Is this really what will happen?- Is it likely we will lose our mother before the year is out?

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KTMJ, I know how you feel about wanting to be prepared. I lost my 79-year-old father to SCLC this past February. I don't post much here anymore, but I check this site almost every day. Your plea for information prompted my post.

My father was dx in April 2007. I do not know of the research that says once SCLC spreads to the brain the patient "has a matter of months." My father responded to the chemo very well, and no MRI ever detected cancer in my father's brain. Nonetheless, cancer was most certainly in the brain about 7 months after his chemo as he experienced seizures, some confusion, and other clear symptoms. We first suspected cancer in the brain about the time of his last chemo treatment (September), and my father went through PCI. This may or may not have been effective for the brain cancer. We never knew for sure because a month or so later, the cancer eventually went into his spinal cord. We continued to fight but in the end, the beast won. As I said, my father died this past February 5th.

I tell you this not to scare you but because you said you wanted to be prepared, and I can identify with and appreciate that. I can only share our experience above, but want to remind you that there are others out there who have challenged the beast and won. No one can tell you how long your Mother has. NO ONE.

Up until the very end, my family had many wonderful times together and remained positive and upbeat and supportive. While it was very hard to lose my father--we are also a very close family--I had a much easier time with grief because we all stood strong and hopeful together through it all. My father knew I was always there for him and that I was his advocate every step of the way. That is something I will always be very proud of, and I know he was very proud of me.

My father was there with me when I came into the world, and I was there with him when he left for the next. There was no greater gift he could have given me, nor I him. How long one has is not the most important thing, it's what you make of what you have, whether that be one day or many years.

In short, you prepare for the worst and hope for the best, as the old saying goes. There is no reason your Mom cannot be one of the lucky ones, but no matter the outcome, you have an opportunity to find a love and closeness you never thought possible. Keep your eyes on that, and you will be fine no matter what happens.

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irmaly,

Thanks for responding. Your thoughts were so helpful. I am packed and will leave with my 2 litttle girls in the AM to spend an indefinite amount of time with my mom. The upside is that all the young cousins and siblings will be together with my Mom. I don't quite know how to negotiate this type of 'life event' but I imagine that time, closeness, humor and tons of hope and love will help.

Thanks for your words,

Kristin

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