Ven Posted July 13, 2004 Share Posted July 13, 2004 Margaret, Good Luck on this trip and I certainly hope all goes well for you. Best Regards, Ven Quote Link to comment Share on other sites More sharing options...
rwoodburn Posted July 14, 2004 Share Posted July 14, 2004 Margaret, A solitary brain metastasis in the setting of NSCLC is controversial. The treatments can range from surgery followed by whole brain radiation to radiosurgery alone. In regards to WBR and Radiosurgery the options are as follows: 1. radiosurgery alone 2. WBR alone 3 WBR followed by radiosurgery Radiosurgery alone has the advantage of being a one day treatment with minimal side effects and risks if the size and location is appropriate. As mentiioned in the other posts, the main risks or WBR are decreased thinking ability and decreased memory. Neither are completely debilitating but the effects can be significant. The tumor should be less than 2.5 cm. The disadvantage is that there is a 30-40% chance of having additional tumors in the brain in the future. If additional tumor do occur, then repeat radiosurgery can be performed or a person could proceed with WBR at that time depending on the situation and the person's desires. WBR alone carries the above stated risks. WBR decreases the chance of developing additional brain tumors to around 10%. WBR alone has an additional disadvantage in that the chance of the visible brain tumors regrowing is very high (50-70%). The option of WBR followed be radiosurgery is the most aggressive treatment. It has the advantage of decreasing the chance of tumor developing elsewhere in the brain to 10% and controlling the visible tumor(s) 90-93% of the time. Of course, the risk of getting the effects from WBR would exist. Looking at all the studies, there does not seem to be a statistical impact on a person's longevity between the above options. It is a very controversial subject and most physicians have their biases. I believe that it is largely a personal decision, if of course, the clinical situation is appropriate for radiosurgery(small tumor size, low number of tumors, and other things). Gamma Knife is equipment that is used for radiosurgery. It is the gold standard and the most precise. Other types of equipment are linear accelerator based machines and a robotic machine named the cyberknife. The increased precision of the Gamma Knife may not be that important in most clinical situations. I would be happy to answer any questions. I think that a second opinion is a good idea. RW Quote Link to comment Share on other sites More sharing options...
SJAS Posted July 14, 2004 Share Posted July 14, 2004 Margaret, We have been through this exact dilemma recently. In Dec., Steve was to have WBR. We literally cancelled sitting in the radiation office for the first tx after having done some extensive research the night before. We demanded to see a Gamma Knife specialist and it seemed Steve would be a good candidate. The Tumor Board required a triple-dose MRI and by then Steve's tumors had disappeared from chemo. So all tx ended, but the controversy did not. His onc. and radiologist both wanted him to do WBR anyway prophylactically. The neurosurgeon totally disagreed and said WBR is too major of a step to take unless absolutely necessary. We finally just had to make the decision and live with the consequences. We refused WBR. Unfortunately, by Feb. Steve had 15 brain mets. He then had to do WBR, but we both still have some concerns about it. His health was terribly impacted by the WBR. He was completely wiped out and is still in a slow recovery. I would DEFINITELY read up on both procedures, and see a Gamma Knife specialist. I have read that some places are using CyberKnife for brain mets too. Sorry this is so long, but this is such an important step. Ifwe can give you any other info, just PM me. Take care. Quote Link to comment Share on other sites More sharing options...
barbara w Posted July 15, 2004 Share Posted July 15, 2004 I have nothing to add to the information presented by so many, but I wanted you to know that you're in my thoughts and prayers. Keep up your spirits - so many people are praying for you. Quote Link to comment Share on other sites More sharing options...
BeckyCW Posted July 15, 2004 Share Posted July 15, 2004 Margaret, I'm sorry I missed your post about this and am only seeing it now. I, too, have no medical information but wanted to let you know I'm thinking of you and praying for you. I'm so glad you're seeking 2nd and maybe even 3rd opinions to decide what's best for you. Please let me know if there's anything I can do for you. I'm house-bound for a week or so now, but I live relatively close and would do anything I can to help. BeckyCW Quote Link to comment Share on other sites More sharing options...
mhutch1366 Posted July 19, 2004 Share Posted July 19, 2004 Margaret, I am so sorry to hear.... Prayers, always, my friend. XOXOXOXOX MaryAnn Quote Link to comment Share on other sites More sharing options...
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