Went to see the oncologist today. She stated that not only have the lesions in the brain grown, but there are several new areas. She also stated there are now areas on the adrenal glands, spleen, and multiple lymph nodes in the chest. Surprisingly, she only has neurologic symptoms..her breathing is great! Mom was given two options: do nothing and enjoy the remainder of her time or try another chemo. It seemed pretty clear that the oncologist was uncertain whether or not the chemo would even be effective on the brain lesions. She isn't a candidate for any more radiation..the risk would not outweigh the benefit due to her previous WBRT and extensive disease. She is so weak and so forgetful. I really feel at this point that the side effects of the chemo (infection risk, weakness, nausea, diarrhea, etc) will destroy her quality of life. She seems content right now..she smiles and laughs and although she is forgetful, she isn't bothered by it most of the time. If the oncologist told us the chemo had a good chance of penetrating the blood brain barrier, I would be all for it. Unfortunately, mom doesn't have enough cognitive awareness to make a decision. She relies on all of us to guide her. I had many conversations with her and am very close to her. She didn't want treatment from the beginning, but when she was given weeks to live back in July, she decided she had some unfinished business, and underwent chemo/radiation. She responded very well to the initial treatment. However, she is only two months out from her last round of chemo and the lesions have all grown significantly. I am so torn..I know in my heart that she would want to just enjoy her time with her family around her and not be sick any more. However, a couple of her children said they are not ready to let her go and therefore want to try the chemo. She is not as healthy as she was last summer when she first got treated. She has lost 30 lbs, barely eats, can barely walk, and has fallen 3 times in the past 3 weeks. I feel like some family members are making decisions for selfish reasons, but I don't want to be blamed for doing nothing. Her husband just wants her to be comfortable. He and I are her health care proxys. She chose us because she knew we would be able to honor her wishes when the time came. Does anyone out there have any experience with second line chemo for the treatment of brain mets? Am I being unreasonable by not giving it a chance? I just don't have the heart to see her go through all those side effects without any reassurance that it will benefit her. I feel should should be surrounded by her loved ones instead of limiting contact due to low white blood counts and infection risk. My heart is breaking. Please share any thoughts.