Home Forums Melanoma Diagnosis: Stage IV Understanding Treatment for brain Mets

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  • #21543
    ncdaniel
    Participant

    My wife was told this week she now has a small spot on her brain which may eliminate some treatment options unless treated. My question is what process have others used to treat brain Mets ? Radiation or other treatments? Did this correct this and provide clear MRI afterwards? Any advice or help on this topic would certainly help me better understand treatment information.

    Thanks, NCDaniel

    #62323
    Johnfdc7
    Participant

    Hi Daniel

    I discovered that I had 2 x 4mm brain mets in Nov 2012. I was started on Dabrafenib (BRAFi) immediately. After 3 weeks the mets had halved in size. Had stereotactic radiosurgery in Nov 12. Thankfully things stable since then although July scans showed a little swelling around one of the irradiated sites – this has been put down to a side effect of the SRS.

    #62324
    gostan
    Participant

    I had SRS for an 8mm met in June and again for a new 6mm met on August 1st. First met is stable and I will know about the second on September 12th where I am hoping for a clear MRI at that time. The SRS radiation had no side effects for me Other than from the meds I had to take during the week of treatment.

    #62325
    Catherine Poole
    Keymaster

    NC Daniel,

    Sorry to hear about your wife, but the new radiation treatments really are quite good for brain mets. Please view our webinar by Yale expert neurosurgeon, http://melanomainternational.org/webinar/2012/01/radiation-treatment-in-brain-metastases

    It is very easy to understand. As the others responded, it is treatable and then your wife can move onto other treatments. Where is she going for therapy? That is important to get her to a top treatment center that does a lot of melanoma and brain radiation.

    #62326
    ncdaniel
    Participant

    Catherine Poole wrote:

    NC Daniel,

    Sorry to hear about your wife, but the new radiation treatments really are quite good for brain mets. Please view our webinar by Yale expert neurosurgeon, http://melanomainternational.org/webinar/2012/01/radiation-treatment-in-brain-metastases

    It is very easy to understand. As the others responded, it is treatable and then your wife can move onto other treatments. Where is she going for therapy? That is important to get her to a top treatment center that does a lot of melanoma and brain radiation.

    Cathrine she is going to U of M Michigan any thoughts on treatment there?

    #62327
    buffcody
    Participant

    I’ve been receiving treatment at the University of Michigan since June 2012 with Stage IV having been discovered with a metastasis to the lung and unknown primary. After lung resection in July 2012, two brain metastases were found on MRI in October. The decision was made to begin systemic treatment with ipi in late October and use SRS to radiate both brain tumors in December. The decision to hold SRS of the two brain tumors until just before the third ipi infusion was deliberate in an attempt to create the most beneficial synergistic effect between ipi and SRS (brain resection was ruled out by the neurosurgeon primarily I believe because of my age, 72). While there is every reason to believe that the malignancy of the two brain tumors ceased, the leftover from one of the radiated tumors seems to have been responsible for subsequent seizures, and last week I had a craniotomy with the expectation that the removal of the “debris” would eliminate these seizures going forward. Every indicator so far is that there is no sign of cancer in the brain and that the operation successfully removed the troublemaker.

    The University of Michigan uses LINAC not Gamma Knife or Cyber Knife. This was a posting from 6 years ago explaining the choice.

    Real-time Precision: LINAC vs. CyberKnife

    We would like to provide you with the latest information about the technology and expertise that the University of Michigan has to offer patients who have cancer treated with stereotactic radiation therapy. We are extremely proud of our oncology services and want to be sure to answer your questions about the different technologies currently being promoted in the media.

    LINAC: Better Plans and Finer Adjustments

    At the University of Michigan, we have more than 10 years of experience with focused high-dose radiation treatments and have treated hundreds of patients safely and effectively. In addition, we have a highly active and productive research program and are at the forefront of novel therapy development. Our team uses an advanced linear accelerator (LINAC), for which we use customized software developed at Michigan. This software is an integral part of radiation treatment and permits us to develop better plans for therapy than those produced by standard commercial technology. In our efforts to continually improve treatment options for patients, we are doing cutting-edge research on tumor imaging that permits us to focus the radiation to the precise spot it needs to go.

    In 2005, we evaluated another technology for treating tumors called CyberKnife, and we felt it was inferior to the LINAC we ultimately purchased. In the past, we have also considered the Gamma Knife, another form of stereotactic radiation therapy. All three devices are capable of treating a small tumor or other lesion with a high dose of radiation. However, the LINAC can make a CT scan of the patient prior to treatment, which permits us to make finer adjustments than the CyberKnife. In addition, our current technology allows the radiation to be focused as finely as either the CyberKnife or the Gamma Knife. For this and other technical reasons, we chose the LINAC.

    How to Choose?

    We have been asked how a patient should choose between providers with different technologies. Our answer is always the same: You should choose based on the knowledge, experience and skill of the team of physicians, not on the basis of a particular machine or technology.

    I have been very satisfied with my treatment at U. of M. and the teamwork between clinical oncology, radiological oncology, and neurological oncology that has been part of it. I’m also happy to be able to report being NED at this time despite four metastases, including two brain, blessedly unusual for someone 15 plus months into a journey like mine.

    #62328
    Alinamartin
    Participant

    Brain is the most sensitive part of the body. Small disturbance in the tissues can be quiet disastrous. Radiation or the medicines let allow your consultant to make this decision. In my opinion give him/her free hand and ask that do what they think best.

    #62329
    gostan
    Participant

    I was advised at DF/BWH in Boston that SRS was the way to go for for 1 or 2 small brain mets. My two SRS treatments were really pretty non-invasive. WBRT was another story. Best of luck. Speak to your doctors and you will come upon the correct course of action.

    #62330
    Alicia
    Participant

    I had two small brain mets 9 years ago which were succesfully treated with SRS. I am still here and doing great (you can see me in the patients video).

    Best of luck!

    Alicia

    #62331
    Catherine Poole
    Keymaster

    Yes, many patients do fine for years to come after treatment of brain mets. Our video can be seen here: http://melanomainternational.org/events-webinar/patient-experience-video

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