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This question was answered on Sun 21, Sep 2008 10:49pm by Dr Paul S, MD

sclc metastasized to lymph nodes and bones-stage IV


    
Asked by tesla55 (Female; 50; twice pneumonia, high blood pressure,acid reflex ulcer,smoker for 30 years she quit for a year after this bad cough started,now diagnosed with the above info, and is going through the standard chemo and she started to smoke again!!!; Relevant drugs:I dont know ) on Sun 21, Sep 2008 09:36pm

Which counts in your CBC blood work tell if the chemo is working? Her hemoglobin has been 9.8 9.2 8.1 8.2after a transfusion it went up to 9.8 her plt are low, right now 137x10 and rbc is always low 2.63 2.64 she has had 9 tratments shouldn't it be gone? Can you tell by the readings if its gone?
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Answer by Dr Paul S, MD  on Sun 21, Sep 2008 10:49pm:

Hi there. If we are dealing with solid tumors such as that of SCLCA, the blood picture may not be an accurate gauge of response to treatment (in contrast with blood cancers such as leukemia where you would expect improvement in red or platelet counts during treatment). It is a better gauge of benefit if the tumors of SCLCA are shrinking or responding during the course of treatment that can be evaluated by serial examinations such as the CT scan. Her present blood picture may be a reflection of the chemotherapy side effects which should be managed supportively (like blood transfusions or blood growth factors). Again, the blood parameters are not the gauge of chemotherapy effectiveness in this setting. Regards.

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Follow up:

Clarification by tesla55 on Tue 23, Sep 2008 01:56am: 
OK..another question if she does go into remission, will smoking bring it back faster? She had the CT scan
today to see her progress so your answer was right on the money!
Clarification by tesla55 on Wed 29, Oct 2008 12:15am: 
She went into remission Sept28th then she got the pneumonia, hospitalised for 2 days. She recieved 2 blood
transfusions and lots of antibotics. Yesterday she recieved Zometa for 30 minutes and comes back in 6 weeks
for CT scan. Everybody I read about gets it every 4 weeeks, why is she only getting it one time? She still is
smoking a pack a day even after the pneumonia. She says she is going to die anyways. I try to convince her she
will have another day, another month, another holiday but she does what she wants and that that. If she needs
chemo again will it work? Or does the bad out weigh the good. The first treatment is your only chance at
remission and when it comes back, nothing will help like the the first treatment did. Right? Can you tell me
how long she would have after it returns with no more treatment? Thank you for all your replies...

Comments:

Comment by on Tue 23, Sep 2008 07:33am: Hi. Smoking can indeed cause more mutations in the cells and can therefore cause an accelerated return and proliferation of cancer cells. Also, smoking while on treatment can cause drug resistance within the cancer cells increasing the chance of treatment failure.

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