*Staging of Small Cell Lung Cancer

Although small cell lung cancers can be staged like NSCLC, most doctors prefer a 2-stage system. These are "limited stage" and "extensive stage." Limited stage usually means that the cancer is only in one lung and in lymph nodes on the same side of the chest.

Spread of the cancer to the other lung, to lymph nodes on the other side of the chest, or to distant organs indicates extensive disease. Many doctors consider small cell lung cancer that has spread to the fluid around the lung an extensive stage.

Small cell lung cancer is staged in this way because it helps separate patients who have a fair prognosis and may be cured, from those who have a worse outlook with no chance of cure. About two-thirds of the people with small cell lung cancer have extensive disease when their cancer is first found.

(*from the American Cancer Institute)

Thanks Katie, I have seen so many questions about the difference in staging for these different types.

May I add that even extensive stage there is hope. I know the experts say there is no cure for us BUT there are a few of us that keep going and going like the Energizer Bunny. We always have HOPE.


Love Cindy

_________________
[size=10:07600f51db]'I can do all things thru Christ who strengthens me' (and He does!)

I am a 50 yo (DOB 10/13/56), wife, mom of 3, ER nurse (semi-retired).
I was 44 and diagnosed 2/2001 SCLC Extensive R Lung, mediastinal area, vessels of the heart, and L adrenal gland, Cisplatin and Camptosar (Irenotecan) x 9 mos.
Remission 1 yr.
June 2002-youngest got her drivers lis. OH NO! 1st Milestone.
Relapsed in 2/2003, tumor in L lung-6 wks radiation and chemo- carboplatin, VP-16 for 6 mos. also in Feb. 2003 I fell and broke R leg-surgically repaired.
Last chemo treatment Aug. 2003.
Sept 2003 son got married! Another milestone met!
March 2004 pericardial effusion.
Dec. 2004 pericardial effusion still present but smaller and stable
Feb. 2005-I made it--4 years!!!!( since the day I was diagnosed, YEAH!)
Remission TWO YEARS (Aug. 2005)!!!!!!!!!! This time
August 1, 2005 CT scan shows NED and MRI confirms I am still empty headed!
Nov. 2005-all scans STILL NED!!
FEB. 2006- 5 YEARS SINCE DIAGNOSIS!!!
March 2006-All scans still NED
July 2006-All scans NED
Aug. 2006-3 years no chemo-oh yeah!
Dec 2 2006 Middle daughter was married!! Another milestone!
Oct. 2006-All scans NED
Feb 2007-All still NED !!6 YEARS since orig diagnosis!!
June 2007-NED NED NED!!
June 2007 Youngest daughter turned 21!! She was 14 at my diag!
August 2007-4 years since last chemo!!
April 2008-still clean, almost 5 yrs since last chemo, Praise God!

Pic- CindyRN and KatieB at the 2007 Bash
[/size:07600f51db]

Thanks for adding that Cindy.

It was clear that we had to post something on both types of LC about staging because people always want to know that information...and this information came straight from ACS.

but I HATE THIS STATEMENT,

and I was so glad to see you reply with your message of inspiration!!!

_________________
- Katie Brown, Co-Founder of LCSC- Director of Support & Advocacy

18 yr cancer survivor.
Certified Patient Navigator
www.iamkatiebrown.com


In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


facebook http://www.facebook.com/lungevity

"No chance of cure" does NOT, however, preclude staying "stable" for a long, long, time...having a remission or period of NED (No Evidence of Disease) and/or a plain old MIRACLE!!

"No chance of cure" is NOT the same as a death sentence, NO MATTER WHAT THE ACS OR ANY STATISTICS SAY!!

Thanks, Katie, for explaining for all...the differences in staging between sclc and nsclc. But as Cindy said, Hope is a major key to removing much of the "scary stuff" from an extensive dx.

_________________
Addie
Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying,
"I will try again tomorrow." mary anne rademacher

DX 5/10/04 -SCLC-limited left lung 1.5cm "patchy infiltrate" with mets to mediastinal lymph nodes
5/13 - 21: Bone marrow test, bone scan, brain MRI and abdominal CT....all clean.
Confirmed limited stage.
5/28 - 9/15: 6 cycles of chemo - carboplatin/etoposide
6/24 - radiation X31 begins, daily Amifostine shots.
7/21 - rescan, cone down on radiation, some shrinkage noted...hooray!!
8/11 - radiation finished! Mild esophagitis, despite Amifostine.
10/4 - CT of chest/abdomen/pelvis
10/5 - brain MRI
10/6 - Results of tests: NED!! And empty headed!
11/1 - 11/17: PCI. Hair today, gone tomorrow again...but otherwise no problems.
Jan 3, 2005: CT scan chest/abdomen/pelvis - results: Still NED!
Mid Jan. - Feb: stomach issues, nausea
2/11/05: Cancer is back in liver, pancreas.
New chemo - Topotecan:
1st cycle: 2/21 - 2/24
2nd cycle: 3/14 - 3/17
3rd cycle: 4/4 - 4/7
4/11 - Chest/abd. scan - 50% shrinkage!! Pancreas "normal"!!
4th cycle: 4/25 - 4/28
Transfusion: 5/6 & 5/7
Chemo cut from 4 days to 3
5th cycle: 5/16 - 5/18
6th cycle: 6/6 - 6/8
CT of chest/abdomen/pelvis - 6/14/05: Pancreas, spleen, biliary tree appear "normal". 4 liver tumors perhaps slightly smaller. Results: essentially "stable". Will continue with Topotecan 3X every 21 days.
7th cycle: 6/27 - 6/29
8th cycle: 7/18 - 7/20
9th cycle: 8/8 - 8/10
Brain MRI - 8/11: multiple mets
CT chest/ab/pelvis - 8/15: still stable!!
Brain radiation:8/22 - 9/7
10th cycle chemo - 8/29 - 8/30 cut to two days to avoid counts tanking.
11th cycle: 9/19 - 9/21
12th cycle: 10/10 - 10/12
Brain MRI: 10/11- all clear but for two tumors, both greatly reduced.
10/20: Chest/abd./pelv. CT scan - liver tumors growing again.
10/31: Switching to Taxotere
11/9: Hospitalized. Two masses-in cervical & lumbar spine. Radiation
11/23:Aphasia...seizure? MRI...brain tumors are back. Started on Temodar.

Someone had asked me to post some general staging information and since I am not a medical professional I chose to post this excerp from the ACS.

I have witnessed miracles here everyday and I absolutely believe there are people proving statistics wrong each and every day!

I certainly did not post this to take away any hope. Let me add again that this is an excerp from the American Cancer Society. This is not my personal opinion or view. And I posted it because someone asked me to.

thanks!

_________________
- Katie Brown, Co-Founder of LCSC- Director of Support & Advocacy

18 yr cancer survivor.
Certified Patient Navigator
www.iamkatiebrown.com


In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


facebook http://www.facebook.com/lungevity

Extensive SCLC is a statistically ominous dx. However, understanding the meaning of the statistics provides hope as well as despair. Everything is based on averages and the average survival rate is based on ALL pts diagnosed (those who are older, sicker, with multiple mets, those who are quite sick at dx, etc. as well as those with single mets, who are younger, in better health, etc. The onc's quote studies that combine all extensive sclc patients thus the negative portion of the statistic model includes pts with the more negative presentations as well as those with better presentations. Were their studies separating the specific condictions of the universe of extensive sclc pts, the statistics would look quite a bit better.

Thus, doing all things to move yourself from 'below the line' [50% percentile] to above where possible statistically improves your survival rate - not a miracle, just ststistics and common sense. E.g. statisticaly, 75% of reocurrence of extensive SCLC recurs to brain. Therefor WBR (or PCI) has been found to diminish that number by 20-25%, thereby lowering statistically probabilityof reocurrence to brain (the prinipal killer) and therefore increasing chances of survival - that's not a miracle - that's just common sense.

Thousands have extensive ext. sclc, (inlcuding me) and if even 15% survive long term, that's a BIG number - and can be you. The take-away here is that, under some circumstances, you can control, to some degree, your future - it is not simply fate and miracles. Where possible make the statistics work for you as opposed to being their prisoner.

Katie, thanks for this thread. I didn't know that SCLC and NSCLC were staged differently and it caused some confusion when I talked to people at my new Cancer Support Group. Now I know that's probably true for cancers other than lung cancer.

Judy in Key West

_________________
Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.

Thank you, foplaw, for what I consider an excellent post. Too many people seem to discard statistics altogether just because they see numbers that haven't factored out all the relevant variables. If they REALLY don't believe in statistics, I'd love to play poker or blackjack with them!

Ellen

_________________
-66-yr-old woman
-Dx 12/26/07 at age 63
-Stage 4 NSCLC, adenocarcinoma, with mets to local lymph nodes, salivary gland, and pelvis, later vertebra.
-Have chosen to do no chemo or chest radiation -- have had radiation to pelvis and spine to lessen discomfort and, mainly, to lessen likelihood of stress fractures and nerve root damage. Successful!