Wife Just Diagnosed w/ ES SCLC - What Can We Expect?

Posted by rlogan @rlogan, Feb 19, 2022

My wife received the following diagnosis yesterday: Primary malignant neoplasm of lung, secondary malignant neoplasm of liver, secondary malignant neoplasm of vertebral column. Four months ago she had a chest x-ray performed and no anomalies were noted.

We have surmised that this is likely Extensive Stage Small Cell Lung Cancer.

She has been referred to a local oncologist and a PET-CT scan has been ordered by our doctor.

Last evening we requested an appointment at the Mayo Clinic - Jacksonville at the suggestion of a friend.

Can anyone tell us what we can expect over the next few days/weeks/months?

Interested in more discussions like this? Go to the Lung Cancer Support Group.

@merpreb

Bob- Oh dear, this is not something that you wanted to hear. Palliative care will help Liz stay as pain-free and as peaceful as possible while seeing if the new medication works. Do you have a name for it so I can do some research for you?

Do you still have hospice coming in once or twice a week? They are wonderful and will help you through this transitional time, no matter the outcome.

Please know that I think about you and Liz so much and I hope that this new pill can do what the chemo didn't.

When will she begin radiation?

Merry

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Hi Bob- How are things going today? Has the first radiation been scheduled?

Merry

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@merpreb

Hi Bob- How are things going today? Has the first radiation been scheduled?

Merry

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Good morning Merry, sorry about the delay in my response.
We still do not have a schedule for her palliative lung treatment. They may be waiting approval from out insurance company. She is pretty much bed-ridden at this time. The pain in her back and hips has increased steadily over the past several weeks and requires morphine pills morning and night with oxycodone at least once a day as a supplement. She was also prescribed Valium to help her remain calm. She can still walk very short distances, but requires additional oxygen during the process and for about 15-30 mins after during recovery.
She developed a severe rash that started on her buttocks and spread rapidly over her back, legs and stomach. Our family doctor prescribed hydrocortisone 2.5% and ketoconazole 2% which worked great. They gave us two small tubes (60 g total) of each and when we tried to get them refilled, they told us that these were supposed to be 30 day supplies. We used them in 3 days due to the large area we had to cover. We ended up using OTC hydrocortisone 1% and an antibiotic cream to finish getting rid of the rash.

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@rlogan

Good morning Merry, sorry about the delay in my response.
We still do not have a schedule for her palliative lung treatment. They may be waiting approval from out insurance company. She is pretty much bed-ridden at this time. The pain in her back and hips has increased steadily over the past several weeks and requires morphine pills morning and night with oxycodone at least once a day as a supplement. She was also prescribed Valium to help her remain calm. She can still walk very short distances, but requires additional oxygen during the process and for about 15-30 mins after during recovery.
She developed a severe rash that started on her buttocks and spread rapidly over her back, legs and stomach. Our family doctor prescribed hydrocortisone 2.5% and ketoconazole 2% which worked great. They gave us two small tubes (60 g total) of each and when we tried to get them refilled, they told us that these were supposed to be 30 day supplies. We used them in 3 days due to the large area we had to cover. We ended up using OTC hydrocortisone 1% and an antibiotic cream to finish getting rid of the rash.

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Good morning Bob- I'm sorry to hear that Liz is pretty much bedridden. I was hoping that her lung treatment had started. She is probably very tired from her meds-all put together they pretty much pack a powerful punch. Which she needs at this point. Are you staying home now or do you have someone taking care of her before your daughter arrives?

I know that you have recently attained power of attorney for health care. Do you have other legal papers settled? I know that this is a nosy question, but I want to make sure that everything runs smoothly for both of you.

I hope that you are well and taking a break every now and then. I realize that this is an awful time for you, but if you need to walk away for 15 minutes if you need it and if you can.

You are in my thoughts. You are not alone, Bob. All of us on Connect are here for your support.

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@merpreb

Good morning Bob- I'm sorry to hear that Liz is pretty much bedridden. I was hoping that her lung treatment had started. She is probably very tired from her meds-all put together they pretty much pack a powerful punch. Which she needs at this point. Are you staying home now or do you have someone taking care of her before your daughter arrives?

I know that you have recently attained power of attorney for health care. Do you have other legal papers settled? I know that this is a nosy question, but I want to make sure that everything runs smoothly for both of you.

I hope that you are well and taking a break every now and then. I realize that this is an awful time for you, but if you need to walk away for 15 minutes if you need it and if you can.

You are in my thoughts. You are not alone, Bob. All of us on Connect are here for your support.

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Merry, our best friend's mom is staying with us until our daughter arrives in June. Linda has been through extended illness and end of life care with several of her family members over the years. She is a real blessing that allows me to do the things away from home that need to get done without worrying if Liz needs something while I am away.

We are still waiting for the Radiologist to set a treatment start date and I will be asking tomorrow what the hold up is now. It will be a week since the planning CT and we should be getting some word by now.....

The Power of Attorney has been accepted by everyone that we have provided it to, so I think the legal stuff is covered.

Thanks for caring!!!!

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I am with Merry to ask you to make sure all legal papers in order. Wills, trusts, bequests...Sorry but now is the time to make totally sure of this while Liz is "of sound mind". I think you understand what I mean. I am following you and Liz here and pray for the best.

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@rlogan

Merry, our best friend's mom is staying with us until our daughter arrives in June. Linda has been through extended illness and end of life care with several of her family members over the years. She is a real blessing that allows me to do the things away from home that need to get done without worrying if Liz needs something while I am away.

We are still waiting for the Radiologist to set a treatment start date and I will be asking tomorrow what the hold up is now. It will be a week since the planning CT and we should be getting some word by now.....

The Power of Attorney has been accepted by everyone that we have provided it to, so I think the legal stuff is covered.

Thanks for caring!!!!

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Good morning Bob- I really hope that you get answers about the hold-up of Liz's treatment. You are very patient to wait a whole week to find out. I wouldn't. Don't be afraid to push.

I am so happy that Linda is staying with you and helping Liz. What a gift. I'm sure that you are soaking up every bit of information you can from her. And I'm sure that you are counting the days until your daughter will be home for the summer. What is her name?

Not to end on a sour note but please think about what Dee recommends too. All of these, if they are applicable are very necessary at some point. If Liz is drugged up or unconscious it will be too late for her to make decisions- in the eyes of the law especially.

I'm sure that you will, but please let me know, when you can, about the hold-up. From where I am sitting no word in a week is inexcusable.

When we can only use words it's often difficult to know exactly how to respond. Perhaps I could offer more? Do you think that Linda and I should talk so that we are on the same page?

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@rlogan

Good morning Merry, sorry about the delay in my response.
We still do not have a schedule for her palliative lung treatment. They may be waiting approval from out insurance company. She is pretty much bed-ridden at this time. The pain in her back and hips has increased steadily over the past several weeks and requires morphine pills morning and night with oxycodone at least once a day as a supplement. She was also prescribed Valium to help her remain calm. She can still walk very short distances, but requires additional oxygen during the process and for about 15-30 mins after during recovery.
She developed a severe rash that started on her buttocks and spread rapidly over her back, legs and stomach. Our family doctor prescribed hydrocortisone 2.5% and ketoconazole 2% which worked great. They gave us two small tubes (60 g total) of each and when we tried to get them refilled, they told us that these were supposed to be 30 day supplies. We used them in 3 days due to the large area we had to cover. We ended up using OTC hydrocortisone 1% and an antibiotic cream to finish getting rid of the rash.

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Bob- Ask the doctor if he will prescribe a larger tube. Explain that the tubes don't last very long because of the area it needs to cover. I have a tendency to lather these things on. Maybe cut back a bit if you can?

Please don't worry about answering me right away. I know that things must be hectic. But please don't hesitate to ask me for help!

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@dedehans

I am with Merry to ask you to make sure all legal papers in order. Wills, trusts, bequests...Sorry but now is the time to make totally sure of this while Liz is "of sound mind". I think you understand what I mean. I am following you and Liz here and pray for the best.

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Liz & I have been married for 47 years this Sept. Everything we own is joint except her 401k which we sent a copy of the Power of Attorney to the administrator last month. We believe that we have our legal house in order, should the need arise. Thanks for your concern and sound advice Dede.

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@merpreb

Good morning Bob- I really hope that you get answers about the hold-up of Liz's treatment. You are very patient to wait a whole week to find out. I wouldn't. Don't be afraid to push.

I am so happy that Linda is staying with you and helping Liz. What a gift. I'm sure that you are soaking up every bit of information you can from her. And I'm sure that you are counting the days until your daughter will be home for the summer. What is her name?

Not to end on a sour note but please think about what Dee recommends too. All of these, if they are applicable are very necessary at some point. If Liz is drugged up or unconscious it will be too late for her to make decisions- in the eyes of the law especially.

I'm sure that you will, but please let me know, when you can, about the hold-up. From where I am sitting no word in a week is inexcusable.

When we can only use words it's often difficult to know exactly how to respond. Perhaps I could offer more? Do you think that Linda and I should talk so that we are on the same page?

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Merry, we found out that the hold up is the insurance company wants a peer to peer discussion with the Radiologist to discuss the requested palliative radiation treatments before they decide on whether to approve them or not. Unfortunately for Liz, the doctor is away until next Tuesday, which means we will have lost last week, this week and next week before treatment will be scheduled, if at all. Our Human Resources VP has called the insurance company representative for my work place and has asked if they can expedite the approval, based on circumstances. I explained to the HR VP that this treatment is Liz's only option at this point, since the chemo failed to control the tumor growth. The insurance company was supposed to get back with us today, but like everything else lately, this too was an empty promise. I will be calling again tomorrow morning to get a status.

Our daughter's name is Vicky.

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@rlogan

Merry, we found out that the hold up is the insurance company wants a peer to peer discussion with the Radiologist to discuss the requested palliative radiation treatments before they decide on whether to approve them or not. Unfortunately for Liz, the doctor is away until next Tuesday, which means we will have lost last week, this week and next week before treatment will be scheduled, if at all. Our Human Resources VP has called the insurance company representative for my work place and has asked if they can expedite the approval, based on circumstances. I explained to the HR VP that this treatment is Liz's only option at this point, since the chemo failed to control the tumor growth. The insurance company was supposed to get back with us today, but like everything else lately, this too was an empty promise. I will be calling again tomorrow morning to get a status.

Our daughter's name is Vicky.

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Just a quick reminder here. The first thing you have to learn is that when you receive a dX of any serious problem, and it is not your MD or especially a DO which gives the dX, no doctor on earth, or even at Mayo, will believe it. And if any part of it is based on genetics, just put the teakettle on the stove and listen to it prattle on. The current state of affairs in genetics is purely Hellish, with only a couple labs getting credit for good work. Even my own PCP at Samaritan refuses to request a full genome for me because he does not know how to cure whatever might show up on the monitor. oldkarl

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