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Possible Mets to the brain,,,


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My sister was diagnosed with lung Cancer a couple of weeks ago. Since then she had several tests done and one of them showed questionable spots on her brain. However, she also has MS and has had lesions on her brain from that. So, the RI Dr.'s wanted her to start radiation on her brain right away. She waited to get a second opinion from a Dr. in Boston, who said, that although the spots on her brain ARE questionable, he wouldn't start radiation until he knew for sure what they were. So she is starting her first round of chemotherapy for the lungs this Fri. and they are going to keep a close watch on the brain.

Does anyone have any thoughts on this? I am still terrified for her, and beside myself thinking about the mets to the brain. But I know this Dr. in Boston is well known and the best in the area so I am hoping he is right. Thanks.

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Don't assume that it means it is a bad sign. I have looked at your post a couple of times both initially and to read the two responses, but I don't have the knowledge to help you. I do agree with Muriel despite my limited knowledge. It seems like radiation can only be given in limited amounts, so why waste that tool when you don't know if it is actually cancer. I hope you get some resolution.

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I am so sorry to hear about your sister. I will keep her in my thoughts and prayers.

I do not have a lot of first-hand knowledge of radiation but it does make sense to me to not start a radiation program unless they know for sure that it is really cancer.

Please keep us updated on your sister. She sure is lucky to have you.

Hugs - Patti B.

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Couple questions. First: non samall cell or small cell lung cancer? Second question: are these the only potential tumors outside her lungs or are there other potential metastasis (i.e on the liver, bones or spine?).

Are the potential brain mets currently symptomatic (e.g. headaches, blurred vision, balance problems)? If so, I'd rpobably be far more willing to get treatment sooner rather than wait.

One additional point to put out there that would definitely affect my thinking. With brain radiaition, there is "whole brain radiation" (WBR) and various targetted forms of brain radiation.

The targetted brain radiations are great for taking out individual brain tumors and very easy/quick with little if any side effects. And can be done on an as needed basis (e.g. on multiple metastasis as they appear)

Whole Brain Radiaition is for extensive mets or lots of little tumor seeds. Usually you have 15 or so sessions of radiation (sometimes more depending on dose), but it's a one time deal. (if the mets come back, you can't do WBR again). In small cell lc, Its now established that WBR makes the brain a less hospitable place for SCLC, so its become extremely common for extensive SCLC patients to get WBR before brain mets have even been detected.

But, WBR is a witch. Its just necessary sometimes.

If I were in your shoes I'd be FAR more inclined to seriously consider a targetted radiation---and if she were asymptomatic, I'd be pretty willing to wait and see for 6 weeks.t I would only do WBR if my onc was fairly certain that the spots werte acutally mets. keep us posted.

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btw, I see from your into post that the onc told you "possible stage 3" and mostly fluid. If it is staged by numbers than the onc at least suspects it is non-small cell lung cancer. the fact that its mostly fluid suggest that there is pleural effusion. If their are cancer cells in that fluid, than the stage is IIIB.

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Thank you all for your replies. I'm sorry I got a little defensive. I'm really edgy lately! Adrian, I'm not really sure about the symptoms. I will ask my brother in law soon. When I'm with my sister, I like to keep things light and only talk about it if she brings it up first. I believe the only other signs of mets were in the brain. But I don't think she has been dizzy. She teaches dance aerobics and has been doing her classes twice a week! I do believe she is non small cell.

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