WBRT

[dmfan71]

My dad has chosen to do WBRT for many brain mets and it has spread to the lining of the brain.  His dr suggested it and said if he didn't think my dad could benefit from it, he wouldn't have suggested it.

He said it would keep things at bay.  Since the surgery, he has had many issues, vision problems, loss of hearing in 1 ear and almost completely in the other, coordination and walking issues.  He said these things would not worsen from the WBRT.  Is the whole point of WBRT to keep things at bay and to keep cancer from spreading?  I should have asked the dr this, but how long do the results from WBRT last? 

I'm just confused as the lung dr said without further treatment on the lung the median survival is 4 months....the brain dr said we need to deal with the brain/tumors before immunotherapy on the lung...they will either start this Monday or next Monday WBRT....it will be 2 weeks, Monday-Friday then a recovery period of 2-4 weeks...so that will bring us to 6-8 weeks before we can start immunotherapy and the dr said depending on how he responds to WBRT they will see if that's even doable. So by looking at timing, it doesn't make sense...maybe they can start immunotherapy at the 2 month mark even if the median survival is 4 months?  Does opdivo work quickly?

another general question...if a dr thinks you are out of options, do they come out and say that?  The lung dr told my parents that he's in a grave situation and wouldn't begrudge him if he chose not to do immunotherapy...but then the brain dr is all for WBRT....Sorry if this all sounds like rambling on....I am just very confused.

If anyone can shed some light I would be so thankful.  I guess my whole point is why do WBRT if you aren't doing immunotherapy?

 

thank you

Michelle

[Tom Galli]

Michelle,

I'll try to shed some light.  Brain mets can be devastating.  Depending on a lot of things (the number, size, location and more), they can start to effect a host of body functions and mental capability.  That is likely why the radiation oncologist is advising dealing with the brain tumors first.  If they are not arrested, he might have a far shorter time of survival and or very poor life quality during his time left.  The tumor in the lung is serious; it may grow and could metastasize but it doesn't have the threat of nervous system or cognitive disfunction.  Of course WBRT has risks associated with it.  Administration techniques and methods have improved but it could cause some disfunction.  Most I know who've had it have reported difficulty keeping their balance or headaches.  If the brain mets are controlled, even with a 2 month delay, immunotherapy can or may work. So I think your radiation oncologist is advising you correctly as concerns what to address first.  Who is projecting the recovery period, the radiation oncologist or the medical oncologist?  If the former, the latter may be inclined to be more aggressive in administering immunotherapy.

You've asked a good and difficult general question and I'll answer it with a generality.  If you seek medical treatment from a physician, you'll most likely get medical treatment. If you ask a frank question, like all things considered, might my father have a better quality of remaining life without treatment, you may get a discussion on that topic.  I think the patient or family need to prompt physicians with that question.  They are predisposed to heal.

Again, I am so sorry to learn of your dad's diagnosis.  You are blessed for helping him through this trying time.

Stay the course.

Tom

[dmfan71]

Thanks so much for your reply Tom....I really struggle with what the doctors are and aren't saying which is why I question if they would be candid or not.

Yes, they are predisposed to heal which I never thought of that way before. 

The medical oncologist said that recovery from radiation would be approx. 2-4 weeks.  He said lets see how your dad does with the radiation and take it from there, meaning how his body deals with that then lets see if immunotherapy is an option.

My dad did seem to walk out of there with a little hop in his step so to speak which leads me to believe that he does want to try and fight this so I am all for what my dad wants to do.  We know time is limited, and we probably don't have years but even if we get a more months or a year I think its what he would like to try for.

I really appreciate your responses to my questions   I'm sure I will have more as time goes on.

Thank you.

Michelle