Hello Maggie,
thank you for posting for your friend. I do hope she contacts either the
ACOR group list or posts here herself.
It's very difficult relaying information through a third party and sometimes
I only give out bits of information, to ease a person through difficult
subjects (once I've gotten a better sense of how they'll handle such
information, of course and/or what their doctor has told them ).

Everyone reacts differently to chemos, and it's complicated by combinations
of chemos (and their other health issues if applicable or their general
health before the diagnosis and sometimes age) but here's the two that
you've mentioned.  So if you are able to obtain any of the above info, it
would be helpful.

http://www.cancerhelp.org.uk/help/default.asp?page=4102  VP16 Etoposide
http://www.cancerhelp.org.uk/help/default.asp?page=4002 cisplatin (platinum
based)

It's my understanding that platinum based chemos have a potential for more
side effects (as compared to say a Gemzar) and it's the only way to have a
chance to shrink the tumour.  Given the above, all I can say is contact his
doctor if anything not listed in the above (or unexpected) starts to occur.
Another option (which might not be a bad idea) is to contact hospice who can
help monitor the situation on an as needed basis and if at some point, it's
decided that the chemo isn't working and they stop it and want "palliative
care" they've already been in contact with one of their choice who knows the
situation and is at the ready to help at home or help them decide if
palliative care in hospital would be the better choice. And/or with
complications if the surgery occurs.  If she's pretty well alone (with few
family/friends) resources, she'll really need someone nearby she can call at
a moment's notice and have some reassurance that someone will drop by at
planned intervals.
There's three such organizations mentioned in our FAQ
http://www.cancersupporters.com/asc/links.html (probably all have offices or
satellite sites operating near her).

As to the scheduling of the chemos, I would be guessing, perhaps Steph (when
he comes by) would recognize what that means, so watch for other replies.

There's perhaps some coping tips here, but for instance, if he has trouble
with nausea or seems dehydrated, if she's not someone who is medically
inclined, she may not recognize signs of or know which to try first, the
tips or call the doctor, I would say the latter.
http://www.cancer.gov/cancerinfo/coping/  but it's handy to look through to
get a general idea of what some of the issues might be.

I'll have more for you in a bit.
J
PS We usually recommend that posters "munge" their e-mail address before
posting so she won't be privately contact by scammers. I'll have to leave
that with you/her.

Was thinking that the best person to ask about the above is the oncologist.
She has the right to contact the cancer centre (hospital) unless her husband
has specified that she can't, but they will usually speak to the closest
relative. She may not be able to talk directly to the oncologist but most
places have a team.  Well here a "primary nurse" is assigned to each patient
and can be called.  The info about the chemo schedule (I would hope) would
be listed in the file or (s)he would know what the treatment plan is.

I have 2 websites
http://www.radinfonet.com/cme/krinsky2/krinsky2_04.htm
Yet this is a variant of prostatic carcinoma known as small-cell or
anaplastic carcinoma of the prostate. Figure 47 presents another example of
small-cell carcinoma of the prostate. Although this disease has been in
oncology literature for some time, it was only introduced to radiology
literature in 1998, when Larry Schwartz published a paper on small-cell
carcinoma of the prostate in Radiology.

Unfortunately, small-cell carcinoma of the prostate has a very poor
prognosis. Patients with this disease may have carcinomatosis and visceral
metastasis. And, as the tumor does not secrete PSA, 60% of these patients
will have normal PSA and will therefore not respond to the typical
antiandrogen therapy or orchiectomy. They will, however, respond to
platinum-based chemotherapy. In a way, small-cell carcinoma can be
considered oat cell carcinoma of the prostate.

In other parts of the body, such as the pancreas, small-cell or
neuroendocrine features portend a better prognosis. In small-cell carcinoma
of the prostate and of the colon however, these features mean a much worse
prognosis.

and
http://www.sma.org/smj/96sept16.htm (I'm not posting the whole article)
Primary small cell undifferentiated carcinoma of the colon and rectum,
either pure or combined with another histologic type (or types), is an
unusual malignancy, accounting for less than 1% of all colorectal cancers;
only 94 cases have been reported in the English-language literature.1-5 The
histologic type of malignancy complicating long-standing ulcerative colitis
is usually adenocarcinoma arising on a dysplastic large intestinal mucosa.6
Few cases of other types of cancers in the colon and rectum have been
reported in association with ulcerative colitis.7-15 We describe a case of
primary small cell undifferentiated carcinoma (SCUC) of the rectum in a
patient with a history of ulcerative colitis and present a review of the
literature.

Based on the diagnosis of small cell neuroendocrine carcinoma and metastatic
liver disease, the patient had eight courses of palliative radiotherapy. No
invasive procedure was done until 3 months later, when the patient was
readmitted for a pathologic fracture of the left femur. A biopsy specimen of
the femur was positive for metastatic SCUC, with immunopositivity for
cytokeratin (AE1/3), synaptophysin, chromogranin, and NSE. During the same
hospital admission, a subcutaneous nodule was found in the left breast, but
no biopsy material was obtained. The patient died during the same hospital
admission; autopsy was declined by the family.

DISCUSSION

Ninety-four cases of primary SCUC of the colon and rectum have been reported
in the English-language literature; the majority of these cases have been
reported or reviewed in a few review articles.1-5 We analyzed the clinical
data in all cases. The patient's age was recorded in 75 cases, with a peak
incidence in the sixth and seventh decades (Fig 4). Despite these late
occurrences of the disease, it was also reported in patients in their third
decade. Tumor location was recorded in 77 cases. The most common location of
the tumor is the rectum, followed by the cecum and the sigmoid colon. It has
never been reported in the descending colon.

Gaffey et al2 described at least three degrees of histologic differentiation
of these tumors. The least differentiated subtype is the small cell
neuroendocrine-oat cell variant characterized by small tumor cells (2 to 3
times the size of the mature lymphocytes) and scanty cytoplasm. The most
mature cell type is the moderately differentiated neuroendocrine carcinoma
manifested by large tumor cells with vesicular nuclei, prominent nucleoli,
and relatively abundant cytoplasm. These neoplasms are histologically
intermediate between typical carcinoids and small cell undifferentiated
carcinoma. The third tumor type is the small cell
neuroendocrine-intermediate variant, which is a transitional histologic type
between the other two types. Even though the mitotic activity of these
tumors decreases with the more differentiated types, no differences in
clinical appearance have been reported. Ultrastructurally, membrane-bound,
electron-dense, neurosecretory cytoplasmic granules have been observed. The
number of these organelles correlates with the degree of differentiation.
Immunohistochemical data are available in 32 reports (including our case).
All tumors were positive for cytokeratin, with decreased positivity for NSE
and chromogranin (Fig 5). It seems that the chance of immunopositivity for
the neuroendocrine markers (eg, NSE, synaptophysin, chromogranin) is higher
with the more differentiated tumors. This may be attributed to the increased
number of neurosecretory granules in the tumor cells. However, the validity
of this statement is lacking because of the insufficient number of cases.

Regardless of the histologic subtype, these tumors are highly aggressive
compared with their adenocarcinoma counterparts of the same stage, and they
are associated with a mean survival of 11 months.2 Therefore, histologic
distinction plays an important role in management of the patient's disease
and in predicting the prognosis. Based on the light microscopic appearance
of these tumors, it may be difficult at times to distinguish the small cell
undifferentiated carcinomas from other "small blue cell tumors," ie,
lymphomas, malignant melanomas, and anal canal "cloacogenic"
carcinomas.3,5,16 In such instances, the diagnosis can be confirmed by
immunohistochemistry or electron microscopy.
[]
I forget what "mean survival "means as opposed to "median survival" so I'll
have to look that up. In addition, I would think that depends (or varies)
depending on how early (or later) the cancer gets detected.

Hang in there, in case I can find something else or Steph drops by to help
me to know whether I should search under a different term such as oat cell.

More to follow.
J

If I posted websites of the above, ignore them. They're website "search
results" and I just discovered don't work when clicking on them. (sorry for
the inconveniene, I keep forgetting that "search results" don't usually
work)
Here's better ones
<http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrug
s/Cisplatin>
Cisplatin
and
<http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrug
s/Etoposide>
Etoposide VP16.

so it looks like he's getting Cisplatin all day one day, then Etoposide for
day 2 and 3, then 2 weeks later start the routine all over again. In
between, they'll be checking his bllodwork (I'm guessing) and/or she'll have
to be monitoring for some of the items listed in the above two (unless
they've given her a printout of what to watch for)
J