SCLC Diagnosis - Salt Sodium Levels

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Hi All,

I am so sorry to post on here again. Feeling a little lost today.

So, yesterday my Dad saw the Oncologist for the first time, treatment plan discussed, 4 sessions of chemo and also to start immunotherapy on Thursday (29th) and will be monitored regularly and see what changes have happened after the 4 sessions. He has SCLC which is also on his spine and liver.

He had some blood tests done before seeing the Oncologist yesterday morning and we got a phone call yesterday afternoon to say they wanted him to go to hospital as they wanted to give him fluids and get his salt sodium levels back to normal before Thursday as they are all over the place and it may be an overnight stay as it was late in the day.

Today, we have spoken to the nurse and as a precaution they have done another chest x-ray and a scan of his head, monitoring his bloods by blood tests but she assured us this is nothing out of the ordinary and there is a consultant at the hospital seeing to him also. They are limiting his fluid intake as they want to get his sodium levels back to normal, I don’t know why having limited fluids would do this?

He is on a lot of painkillers at the moment, Paracetomol and Codeine, Oramorph etc and he has been on painkillers for many many weeks! I was hoping the Oncologist would take him off them.

He is very down, he’s dreading the chemotherapy, he’s scared and the first question he asked the Oncologist was “how long”. My Mum put a stop to that straight away and said, that is not what we are here for and the Oncologist said “I’m not going to tell you that, because it all depends on treatment response and you”, so my Dad is basically seeing all of this as how long! He’s eating, although constipated but I think that is from all the Codeine, he’s down but we are really trying to encourage him to be positive and fight this, he has been given a chance. The Oncologist was so happy he could offer him immunotherapy.

Apologies for the long message but I wondered if anyone had any insight into the sodium? He’s been on painkillers for so long now, I think half the problem he’s having, constipation, mood etc is contributed by the painkillers. We are just worried now that if they can’t level out his sodium, they will delay his treatment and we wanted that to start yesterday!

Thank you

Lucie x

Alison P over 2 years ago

Hi Lucie, in response to your question regarding Sodium and Small Cell Cancer there is a link between a low sodium level and Small Cell cancers. In fact it can be a diagnostic red flag and in a known lung cancer can help to indicate if it is small cell or non small cell. Though a biopsy is always needed to confirm.

The low sodium is a result of a syndrome called SIADH - I suggest you google it as it will be better explained than I can! Your Dads sodium will have dropped slowly and he may be fairly asymptomatic but headache and confusion are a sign of a low sodium and if it gets to low he could run in to more severe problems. You can’t correct it rapidly as the body doesn’t like that so a more gentle approach is required. There is a drug called Demeclocycline which has been used effectively in the past - it is actually an antibiotic but has a side effect of effectively correcting sodium levels in SIADH. I can’t say if it is still used but I can’t see why not - you can ask and again google can give you all the information on it.

Any opiate based analgesic will lead to severe constipation - so oramorph, codiene and morphine all fall in to this category. If he’s in pain he will need the analgesia so the Oncologist won’t stop the painkillers. You haven’t said where the pain is so it’s difficult to say but if the pain is caused by the tumour then any treatment that reduces it’s size may then reduce pain and make him less reliant on analgesia.

Hope some of that helps?

Always question - it helps you to understand and in anxious times we need to feel we understand the facts.

Good luck xxx

Essex1 over 2 years ago in reply to Alison P

Hi Alison,

Thank you for your reply, the information was very helpful. Hopefully we will find out a bit more today and he can get home as soon as possible, we do not want his treatment delayed.

Thank you

Lucie x

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