Home Forums Melanoma Diagnosis: Stage IV Gliadel wafer for brain met?

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  • #21388
    Brendan
    Participant

    Hi Everyone,

    I am back in the hospital and craniotomy #2 is scheduled for Monday. I will get a chest, abdomen, pelvis CT scan tomorrow (Sat) to see if I have any mets below the neck. As of now, my brain met recurrence is the only known met in my body.

    My med onc (who has not yet talked to my neurosurgeon or rad onc) mentioned the possibility of a gliadel wafer, a treatment primarily used for gliomas. I have just started to research, and it appears that WBR follows the wafer and I would like to hold off on the WBR if possible. I have not yet tried temodar, maintenance ipi was discussed, and so was the potential for PD-1 in a couple months.

    My first brain met was removed through craniotomy in Nov, and the recurrence came back in five months so, as always, timing is everything.

    Does anyone have any experience with these wafers? Thanks for your help.

    Brendan

    #61414
    kylez
    Participant

    I’ve not heard of that, Brendan (true for lots and lots of things though).

    Something else I’ve never seen discussed on any forums, that is slightly similar, is brachytherapy (radiation seeds). My neurosurgeon said that if I got a recurrence requiring another craniotomy, that before he sealed it back up, he might line the resection cavity with radiation seeds. I don’t know how many neurosurgeons do that. Here’s one description, http://radonc.ucsf.edu/treatment_programs/brachytherapy.html” class=”bbcode_url”>http://radonc.ucsf.edu/treatment_programs/brachytherapy.html

    #61415
    Brendan
    Participant

    Thanks, Kyle. The wafer uses chemo instead of radiation, but similar idea. The surgeon seals the wafer in the cavity and it targets any remaining cells while not causing the usual systemic side effects. I picture a dissolvable pill on your tongue-sort of.

    Here’s a link:

    http://m.hopkinsmedicine.org/neurology_neurosurgery/brainwaves/fda_approves_chemo_wafers.html

    Brendan

    #61416
    Brendan
    Participant

    HI,

    My surgeon and med onc have decided to use the wafers (no WBR). The surgeon has used them before. My CT on Sat (chest, abdomen, pelvis) was clear, so I wll be NED after surgery, now 21 months at Stage IV. This will certainly get through the BBB, and then it’s more wait and see.

    Craniotomy is planned for Tues.

    Brendan

    #61417
    Catherine Poole
    Keymaster

    The Scientific Board finally got back to me with an answer about this: “so Gliadel wafers are not new at all – this is just making them much smaller. in general as a neurosurgical population we do not believe they work – just increase toxicity.”

    #61418
    Brendan
    Participant

    Catherine,

    Thanks for your asking the board. You’re the best!

    Brendan

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