Brain Met 7 years after Lung Cancer Diagnosis

Portal Forums Lung/Thoracic Cancer Lung Cancer Complications Brain Metastases Brain Met 7 years after Lung Cancer Diagnosis

This topic contains 2 replies, has 2 voices, and was last updated by JimC Forum Moderator JimC Forum Moderator 4 months, 1 week ago.

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January 13, 2018 at 2:50 pm  #1293782    

palmyramom

Hi,

I’m seeking advice on what to expect and questions to ask as my mom faces upcoming surgery to remove a 3cm tumor (maybe 2, I don’t have facts straight) from her cerebellum. The neurologist I spoke with briefly will be referring her to a larger hospital, to which she will be transferred today or soon.

I found this forum to be the MOST valuable support in 2011-2012 when my mom was diagnosed with Stage3B Lung cancer (adenocarcinoma). Gaining so much advice from this forum, she successfully went through removal of the lower lobe of her lung at UVA, chemotherapy (Altima), and radiation. The surgery was complicated and nicked the recurrent laryngeal nerve, which partially paralyzed her vocal cord, but reinnervation surgery helped. She recovered from treatments very well. Radiation was her big fear, and damage from that has caused substantial scarring that continues to accumulate and is problematic.

The intervening years have been full of vigor and health, gardening, and a very successful shoulder replacement.

This past year she had a breast cancer diagnosis (stage I ductile, very small) that was fully resectable via lumpectomy with seemingly effortless recovery and started chemo that would remove estrogen from her system. The breast cancer was determined to be separate from her lung cancer. It was found because she received scans twice a year.

She had a clear brain MRI at the end of 2016. Nausea and dizziness (that she attributed to the chemo pills) became so bad at Christmas that she couldn’t eat and was bedridden. After the second hospitalization, the doctors ran an MRI and discovered the brain tumor(s). Via blood tests, they think it is related to lung cancer.

What should I be asking about the surgery? Is it OK for her to receive treatment at UVA, or should we try to get into Duke for treatment? Mom is very fearful of brain radiation treatment. What are the options?

Thanks for your help and support!


Mom DX 3/11: Stage III NSCLC (adeno)
Chemo: 3 rounds of carbo/alimta (last infusion 6/16/11)
Surgery 6/22/11: Upper left lobectomy and 19 nodes removed, 1+ (surgical complication = partial vocal cord paralysis)
Radiation: 35 rounds (end 11/2/11)
1/12: Thyroplasty for vocal cord
11/12 nerve reinnervation re same
12/11 ‚Äď 8/17 Scans: stable (yeah)!
8/17: lumpectomy for breast cancer (not related to lung) stage I.
9/17 and continuing: RX to eliminate estrogen.
12/24/17: Extreme nausea and dizziness.
1/10/18: MRI discovers 3mm cerebellum tumor.
Concerned about treatments for brain mets.
Hoping all treatments have optimal effects & results.
Wishing strength to everyone fighting cancer!

  • This topic was modified 4 months, 1 week ago by  palmyramom.
  • This topic was modified 4 months, 1 week ago by  palmyramom.
  • This topic was modified 4 months, 1 week ago by  palmyramom.
  • This topic was modified 4 months, 1 week ago by  palmyramom.
January 14, 2018 at 8:31 am  #1293786    
JimC Forum Moderator
JimC Forum Moderator

Hi palmyramom,

I’m sorry to hear of your mom’s latest troubles. In most cases, the discovery of a new tumor seven years after a previous diagnosis tends to indicate a new cancer, as the chance of recurrence after that interval is low (although not zero). Dr. West wrote about this subject here.

Possibilities other than a lung cancer recurrence or new lung cancer include metastasis from the breast cancer, a primary brain tumor or something that is not cancer at all. Although the treatment options include surgery and/or radiation, surgical resection of the brain lesion will allow the doctors to test the tissue and determine just what it is. Radiation oncologist Dr. Loiselle discusses treatment for solitary brain metastases here.

Both UVA and Duke have good lung cancer programs (one of our contributing experts, Dr. Craig L . Slingluff, practices there), and each should have experienced and highly capable surgeons and radiation oncologists.

Best wishes for successful treatment.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

January 17, 2018 at 4:10 pm  #1293809    
JimC Forum Moderator
JimC Forum Moderator

Hi Michele,

From everything you have said, the main question is choosing a procedure that will provide the maximum benefit while keeping damage to healthy tissue to a minimum. If the radiation oncologist doesn’t have a preference between the two procedures, then it’s safe to assume that he/she feels that either would be just as effective, but that the multiple days of treatment compensate for the reduced precision of the first procedure.

If those assumptions are verified by the doctor, I think the main line of questioning for her doctor centers on which procedure is less likely to damage healthy tissue. That being said, brain radiation is very precise, and the amount of radiation passing through any given area of healthy tissue is very small. Multiple beams converge at the site of the tumor, where the cumulative radiation dose is highest.

Wishing your mom good results from her therapy.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

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