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my father has brain mets - please help


LindaMRG

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Dear Friends,

Last night my father had a seizure, was brought to ER, then had another seizure in ER. CT showed 1 1cm brain met and two smaller ones. There is swelling which caused the seizure. He is on anti seizure med and a med to reduce the swelling in the brain.

Please help me, what are the options for brain mets? What is gamma knife/cyberknife? Can he have the same radiation he is having on his tumor done on his brain?

I feel like Im having a bad dream. Any information and prayers are so appreciated.

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Hi Linda,

Sorrry to hear about your father. Don't know about brain mets. I'm sure others will respond to your post. Cary gave a very good presentaion on gamma knife/cyberknife a while back. Thought I would dig it out for you so you would not have to go looking for it. Peace, take care and God Bless.

Rich

From previous post dated 10/28/03:

Hi,

Here is what I found when i did a search, hope this helps.

Cary

Cyberknife

The Cyberknife is a new high-technology system that delivers LINAC radiosurgery using a robotic arm controlled by an image-guided computer technology similar to that used by the military in cruise missiles. The Cyberknife was approved by the FDA in July 1999.

Unlike conventional radiotherapy systems where the treatment machine is not able to verify the position of the tumor, the Cyberknife can define and confirm critical information concerning the position of the tumor during the treatment. Through the use of this "smart bream" technology, the accuracy of targeting is improved. According to latest research results (see Chang et al, Neurosurgery, page 140, January 2003), the accuracy of Cyberknife targeting is comparable to that of fixed (attached) frames such as in Gamma Knife treatments, and more accurate than for relocatable frames based on either bite blockes or masks, such as used for FSR.

Dr. John R. Adler (Professor of Neurosurgery, Stanford University) has provided more details about the increase in accuracy:

the RMS error measured was 1.2 mm in this paper [by Chang et al], which is in fact considerably less than the 1.8-2.0 mm errors reported for skeletally attached stereotactic frames.

This improvement comes at the price of exposure to additional radiation, in the form of X-rays. There are two ceiling mounted X-ray cameras that target the regional anatomy around the tumor, and a high speed computer that analyzes the images. The data is converted into information about the location of the patients' features, such as bone structure. The computer can account for any small changes in the position of the patient during treatment, and can deliver the radiation dose to the target with high precision.

According to Dr. John R. Adler, this additional X-ray exposure is not a concern:

the exposure to the head during a standard single treatment or even the more typical 3 stage procedure used at Stanford for acoustic neuroma, adds up to no more than the x-ray dose administered in 1 or 2 CT scans. Such a dose is much less than scatter given off by a treating linear accelerator for example, and is widely considered by most radiosurgical practioners, to be inconsequential.

It is important to note that Cyberknife differs from FSR in more than just the method of positioning. A crucial difference is that the robotic arm delivering radiation during Cyberknife treatment does not perform a continuous motion, as for standard FSR treatment with LINAC. Rather, it makes many short stops; the X-ray based targeting as well as the radiation shots are only applied during these stops rather than throughout the motion. Conceptually, this is more akin to Gamma Knife, where the radiation comes in individual beams that intersect at the tumor.

While the Cyberknife is a great new technology for those parts of the body which cannot be accurately repositioned by other means, it is not yet clear that there is a benefit to using it on the head, where the skull allows for other repositioning technologies. While the Cyberknife's targeting may be more accurate than FSR, the combination of additional X-rays and the change in radiation pattern from a continuous sweeping arc to discrete shots may offset the benefits. This issue can only be resolved after we have treatment outcome data for large samples of Cyberknife and FSR patients.

Those who wish to know more about the Cyberknife technology are referred to the website of the CyberKnife Society, located at www.cksociety.org This is a non-profit organization is dedicated to patient education and scholarly exchange regarding the Cyberknife.

Gamma Knife

Gamma Knife surgery is recognized worldwide as the preferred treatment for metastatic brain tumors and has successfully treated primary brain tumors and arteriovenous malformations. The Gamma Knife offers a non-invasive alternative for many patients for whom traditional brain surgery is not an option and removes the physical trauma and the majority of risks associated with conventional surgery. This effective treatment only requires an overnight hospital stay with periodic follow-up. It is proven safe over the long term and is recognized and covered by most insurance plans.

The Gamma Knife allows noninvasive cerebral surgery to be performed with extreme precision, sparing tissues adjacent to the target. Based on preoperative radiological examinations, such as CT-scans, MR-scans, or angiography, the unit provides for highly accurate irradiation of deep-seated targets, using a multitude of collimated beams of ionizing radiation.

Gamma Knife surgery represents a major advance in brain surgery, changing the landscape within the field of neurosurgery. Its development has enhanced neurosurgeical treatments offered to patients with brain tumors and vascular malformations by providing a safe, accurate and reliable treatment option. Gamma Knife enables patients to undergo a non-invasive form of brain surgery without surgical risks or a long hospital stay.

Gamma Knife surgery is unique in that no surgical incision is made to expose the inside of the brain, thereby reducing the risk of surgical complications and eliminating the side effects and dangers of general anethesai. The "Blades" of the Gamma Knife are the beams of gamma radiation programmed to target the lesion at the point where they intersect. In a single treatment session, 201 beams of gamma radiation focus precisely on the lesion. Ove time, most lesions slowly decrease in size and dissolve. The exposure is brief and only the tissue being treated receives a significant radiation dose, while the surrounding tissue remains unharmed.

There are numerous brain lesions for which treatment, either surgical or with radiation, is associated with considerable mortality or morbidity due to factors such as depth and inaccessibility of the lesion, its proximity to arteries, nerves and other vital structures, and the radiosensitivity of adjacent normal tissues. Even if access is possible, surgery still involves risks of hemorrhage, infection and other post-operative complications. In addition, a lengthy hospital stay is usually required.

With the Gamma Knife, a surgical incision is not required; the attendant risks of open neurosurgical procedures (hemorrhage, infection, CSF leakage, etc.) are therefore avoided.

Published reports indicate that the Gamma Knife may be used as an alternative to standard neurosurgical operations or as an adjunctive therapy in the treatment of residual or recurrent lesions left unresected by conventional surgery. Radiosurgery can be especially useful for those patients who are not suitable for standard surgical techniques due to illness or advanced age. In many neurosurgical cases, the Gamma Knife is the only feasible treatment.

Conditions for which application of the Gamma Knife is considered most effective are:

1. Intracranial tumors such as:

acoustic neuromas, pituitary adenomas, pinealomas, craniopharynigiomas, meningiomas, chordomas, chondrosarcomas, metastases and glial tumors.

2. Vascular malformations including arteriovenous malformations.

In addition to the above mentioned indications, clinical experiences exists in the treatment of functional disorders such as trigeminal neuralgia, intractable pain, Parkinson's desease and epilepsy.

ADVANTAGES OF GAMMA KNIFE

* Gamma Knife is a neuro-surgical tool designed exclusively for the treatment of brain disorders.

* The lesion being treated receives a high dose of radiation with minimum risk to nearby tissue and structures.

* The cost of Gamma Knife procedure is often 25 to 30 percent less than traditional neurosurgery.

* Patients experience little discomfort.

* The absence of an incision elimates the risk of hemorrhage and infection.

* Hospitalization is short, typically an overnight stay. Patients can immediately resume their previous activities.

* Gamma Knife technology allows treatment of inoperable lesions. The procedure offers hope to patients who were formerly considered untreatable or at very high-risk for open-skull surgery.

Leksell Gamma Knife is a registered trademark of Elekta Instruments, Inc.

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Linda,

My dad had radiation to the tumor in his shoulder and the brain met all at the same time. It was like a fifteen minute procedure where they did them both at once.

It's doable Linda. Don't forget that. I believe he caught his brain met early and there are ALOT of folks here who have weathered thru brain mets.

Keep us posted. Am praying for you and your dad.

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Hi Linda..

I too have been diagnosed with 2 mets to the brain. I will be undergoing wholehead radiation which lasts ten days and its primary purpose it to attack and destroy any microscopic (unseen) mets. They will follow that up with one day of radiatactic surgery which zeroes in on the two mets that they DO see. I will be happy to let you know how it goes as we proceed.

Hope this helps a bit. Hang in there!!

God Bless you and your Dad..

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I had brain met. As far as im concerened it is very treatable and beatable. A lot of treatments available. I wish thats the only mets I had. I had 3 mets like your dad 1 big one (2cm) and two small ones. I received whole head radiaion 14 treatments than got MRi 2 months after. The small ones GONE, BIg one down to 29mm. and the doc feels it may still shrink and if it doesnt then we can do sterotatic surgery.

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Dearest Friends,

Thank you, thank you and thank you again. I am printing this whole thread to give to my father. I told him your stories verbally but it will be good if he has them to look at when he needs to.

Rich, many thanks again for that valuable information that I now have to ask oncs about.

Mo- What exactly is PCI? Also, thank you for your encouraging words.

Katie - thank you for your positive encouragement, I could hear the sincerity of your words, and they truly lifted my spirits.

JudyB- thank you for always being there to cheer me on when I am at my lowest.

Peg- thank you for sharing your story and positive encouragement. It helps not only me, but my whole family.

Francine - wishing you the very best with your treatments and please do let me know how your treatments go. I do want to know.

Ray- thank you for sharing your story again, I knew you had brain mets, just didnt remember the details. Ive shared your story with my father, as it is very close to his. Wishing you the very best.

Once again, this board saves me from drowning. I love you.

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Linda

i just have one caution to add. If the anti-seizure med your dad is on is Dilantin. Please watch him. This is an extremely powerful medication and can cause side effects of its own. My mom was put on it after she had a grand mal seizure but this happened after her brain mets had already been treated. we think her seizure was brought on by too much morphine.

watch for swelling in the legs and purple discoloration in the feet .

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Linda,

PCI is "Preventative Cranial Iradiation" in other words, I am having 15 blasts to the brain in hopes of NOT getting brain mets. I have had 8 so far and other than fatigue, a bit of a headache and some minor depression, I have been doing well. I think the depression is more caused by the holiday than the treatment but that is another story.

I hope they can take care of your Dad and prayers will continue.

God Bless,

MO[/code]

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Cathy,

Thank you so much for your prayers, means more than I can say, I mean that sincerely.

Shellie,

Yes, he is on Dilantin and I will surely look for those side effects, thank you very much.

Mo,

Thanks for that info, always wondered what that was. Wishing you MUCH success!!!

Love you all.

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