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Question about WBR


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My mom just had an MRI to see what was going on after she had some strange vision disturbances and dizzy spells this weekend. They got the results back and the original two tumors were completely gone! Yea! But...there was a new tumor in the back of the brain where the vision is controlled which explains why she was seeing things. Does anyone know if the WBR would have gotten back there or is it possible that since it was so low in the brain that it could have been missed?

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Whole brain RT should have covered that area, but the radiation oncologist who did it should be able to confirm. Either way, for a solitary met after WBR, stereotactic radiosurgery (AKA Gamma Knife) is certainly an appealing option.

We have generally felt that chemo and other "whole body" therapies don't get into the brain and are unlikely to shrink metastases there. More recently, some evidence suggests that this is probably not quite true, but some agents may be better at treating disease in brain than others. The EGFR inhibitors like Iressa, and now Tarceva, have had many patients with documented responses, so in a patient with brain metastases, that might be one more argument to use Tarceva. In a never-smoker with lung cancer, though, I'd already be highly inclined to pursue Tarceva early.

Good luck.

-Dr. West

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