A few weeks ago, my mom (71) was diagnosed with sclc following weight loss over the Summer. She feels well and had no signs beyond weight loss and the occasional energy dip. She was immediately put on a treatment plan of chemo and radiation. I believe chemoradiation is the norm for SCLC that’s characterised as limited (ie. is confined to the chest / lungs with limited involvement of nearby nodes). However, she will have two cycles of chemo before commencing radiation. My question is, isn’t chemoradiation supposed to be concurrent? If so, why the delay? She is fragile to due low BMI but has had no side-effects so far from her first cycle of chemo (cisplatin and etoposide). She has no other medical conditions.
My second question is related to her outlook. The diseases is labelled “limited” but I only find the grimmest predictions. The pulmonologists said that if left untreated she would not have had much time left. Which comes as a shock to someone feeing fine with normal energy levels. With treatment the doctors said something about two years, but also that the treatment is aimed at curing and not just controlling. This contradiction is supposedly resolved by saying that once cured, it will come back, and that then further treatment options are limited (repeat chemo impossible). This almost makes it seem that it is better to have extended SCLC which is treated with immunotherapy. So I am a little lost as to how the limited disease variant has a materially similar outlook as the extended disease outlook.
My third question relates to what to do. I am the only child to my father who is turning 75 and my mother who is turning 72 in a few months. I live in the UK (since 20 years) whereas they live in Europe a Eurostar ride away. I have been able to go with her to attend her first chemo sessions and have done a lot of work to set up support, which at this stage they don’t really want as not needed (home care, shopping assistance, help with meals and cooking) since she still feels fine. It’s all felt like a death sentence to someone who isn’t suffering. As things progress, I feel I need to decide whether I should return home for the remainder of her illness. This to avoid my father becoming overwhelmed (I don’t want him driving around each night od Winter for take away meals, for example) and to provide my mother with moral support. At the same time, they probably don’t want me there all the time. They want to continue to live their normal lives now while this is still possible. Given the dire prognosis on most medical sites, however, I am conscious that things can change rapidly and previous little time may be left. I don’t want to end up living with more regret or guilt than I already do. I already that had I been more vigilant, I could have ensured that as a smoker she had regular CT scans rather than ignoring months of weight loss. The GP was at fault there, putting it down to a poor diet. The GP referred her to a dietitian and told her to come back in four months. I feel like my mom’s been let down tremendously in life and that makes it even more heartbreaking.
Does anyone has advice, medical baaed on experience or emotional in terms of what the right level of on the ground presence is? Leaving my job and life in London behind would be a major change. I own a home here where I live with my long term girlfriend. At the same time, I cannot live with the feeling of abandoning my parents at a time where their health is failing. The medical uncertainty isn’t helping.
Thank you.
