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WBR vs Radiosurgery


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Hi All,

I have had radio surgery twice - Jul, 2005 and Jul 2006, each for new mets. I had no symptoms, was diagnosed as part of my routine workup and then follow up. Both were successful, except I had some edama which caused headaches from the second procedure.

Now the have found additional, new mets. The coice is between WBR, supported by the Radiology Oncolocist and another Radiosurgey. I am inclined to elect to have an additional radio surgery. It has no discomfit, no side effect, (except the headaches, managed by a low dose of decadron), and I'm up and about the next day.

What I am interested in is the results of those who have had WBR. That is any changes that occurred and if the effect was on going or returned to normal and how long it took. Also what were the effect of the radiation itself?

Thanks to anyone who can provide me some info to assist in my decision.


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I think the main problem which happens to be the main benefit is that radiosurgery is very focused, so it will zap the mets that are seen but any micrometastsis that are there is does nothing to them.

I have heard sometimes radio surgery is done then WBR to take care of anything the radio surgery misses.

There are radio-sensitizers like rsr13(?) and xyctrin (sp?) that are in trials and other drugs like temador for brain mets

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I had CK in Oct. for one brain met. I thought it killed the tumor as well as anything surrounding it

Had my 1st MRI two weeks ago, according to rad. onc. said tumor is responding very well (Shrinking). The symptoms I had are almost gone and I am off the decadron(yeaaa!!!)

I had two open surgeries, 2004 and 2/2006. Had SRS afer the 1st surgery. Nuerosurgeon said it was encapsulated and he got it all, I question what he said. Especially after having SRS after...

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Here's what I know/ think...

I have a friend whose husband had WBR 5 years ago. He now suffers from dementia (52 years old) most likely casued by the WBR. Things may have changed in the last 5 years.

I was at the neurosurgeon yesterday w/ my mom talking about WBR vs. Gamma. He likened it to what he called the 'dandelion effect'.

Say you have a dandelion in your yard. Conventional wisdom states that pulling the one dandelion is useless--you have to treat the whole yard. He said that is the historical view of WBR--treating the whole yard.

The dr. then said this is fine, if all of your neighbors are treating their yards. The problem is that LC (according to the dr) "seeds" brain mets often. It would be like treating your yard, only to have the seeds from your neighbors' yards take over. He said that WBR will treat all the cancer 'seeds' that are currently visible, but they can easily reseed. He also talked about the possible damagine effects of WBR.

Mom has opted to go with Gamma, with MRIs every 8-12 weeks to see if anything new pops up. The hope is that, if anything does, we will be able to treat it quickly with more Gamma.

I know other people have had success with WBR, but it is not the route we are choosing. Fortunately, all of Mom's drs support this, so we aren't questioning ourselves. I hope you find some answers!

:) Kelly

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From what I understand. Gammaknife and Cyberknife keeps brain met or mets in control. One can have this treatment over and over, but not with WBR. From what I have read, WBR is old technology... I also had the option of WBR and I chose not go that route due to the side effects. Affects each person differently.

Gammakife and CK is so precise and doesn't damage good tissue in the brain. CK is mfg by Accuray.com. and GK is mfg by Leskill(sp?) Liskell (?) Look at Stanford University website...

Sending prayers and hugs,


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I think Kelly had a very good answer.

Also it depends greatly on each individual case. If there are many brain mets then I believe Gamma or Cyberknife is not an option.

It seems in your case Karen that there was one met that was isolated and encapsulated so the neurosurgeon got it all.

So again I believe there is no general answer that can answer each case. I just spoken in general terms from what one Dr told me and what I have read.

Sometimes gamma is given and then the "field" is made bigger to cover more area.

The trade off is more is covered with WBR but possibly there is more damage also. The good thing about SRS is that it is targeted, but it will not get distant mets.

Unfortunately there are no pat answers and that is why the Drs have to be consulted for each individual case

Karen I am glad things are going well for you.

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