The Diagnosis

What a shock it was to see the PET Scan


Attendance with the Oncologist  –  Confirmed metastasis to the liver – Sandy and I were shown my lung X-rays and could see that they were clear (normal) and were told that if they (the doctors) had relied only on those X-rays I would have been given a clean bill of health.

Dr Roy then shared the results of the PET Scan with us which showed the centre of my lungs, the bronchial tree and an area on the liver lit up like a Xmas Tree indicating where the cancerous cells were

We were gobsmacked to say the least, the PET Scan certainly showed the extent of the cancer which certainly knocked the wind out of my sails…to say the least.


ACTUAL DIAGNOSIS
Extensive small cell neuroendocrine – Stage IV – Liver and mediastinal lymph nodes metastasis

Extensive small cell neuroendocrine

Extensive – Cancer has spread to the other lung, the fluid around the lung (the pleura) or to other organs in the body. 

Small Cell Lung Cancer (SCLC) is a neuroendocrine tumour that represents about 15% of all lung cancers.
SCLC occurs predominantly in smokers.
SCLC is distinguished clinically from most types of non-small cell lung cancer (NSCLC) by its rapid doubling time, high growth fraction, and the early development of metastases.

SCLC often starts in the bronchi, then quickly grows and spreads to other parts of the body, including the lymph nodes.

SCLC stages are classified in two ways:
1. Limited stage
The cancer is found in one lung, sometimes including nearby lymph nodes.
2. Extensive stage
Cancer has spread to the other lung, the fluid around the lung (the pleura) or to other organs in the body.

SCLC usually presents with disseminated disease, and treatment strategies have focused on systemic therapy.
Although SCLC is highly responsive to both chemotherapy and radiotherapy (RT), it commonly relapses within months despite treatment.

neuroendocrine tumor (NET) is a rare type of tumor that arises from specialized body cells called neuroendocrine cells. These cells have traits of both nerve cells and hormone-producing cells, and release hormones into the blood in response to signals from the nervous system.

Small Cell Lung Cancer Cell Dividing
Cancer cells metastasis to Lymph Nodes and Liver
Mediastinal Lymph Nodes

Stage IV

Stage IV means that the cancer has spread to other organs or parts of the body.
It may also be called advanced or metastatic cancer.

Liver and mediastinal lymph nodes metastasis

The liver is an organ only found in vertebrates which detoxifies various metabolites, synthesizes proteins and produces biochemicals necessary for digestion and growth. 
After the lymph nodes, the liver is the most common site of metastatic spread.
The majority of liver metastases present as multiple tumours. 
Mediastinal lymph nodes are glands that are located in the part of the chest that lies between the sternum and the spinal column.
This region is referred to as the mediastinum, and contains the heart, thymus gland, windpipe, and large blood vessels. 

Metastasis – The spread of cancer cells from the place where they first formed to another part of the body. In metastasis, cancer cells break away from the original (primary) tumor, travel through the blood or lymph system, and form a new tumor in other organs or tissues of the body

The oncologist told us that I would be elligible to participate in an Immunotherapy Clinical Trial in conjunction with Chemotherapy if I was interested, I said that I would be and he immediately made a phone call and obtained permissions and authorisation whilst we were there.

Treatment was then discussed and subsequently scheduled to begin on the 14/01/2020 

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