Spot on Brain - 1268766

Hi Lorrie,

I'm sorry to hear about your scan findings, although it is good news that your lung and stomach are still stable. Dexamethasone is often prescribed to reduce or prevent swelling associated with brain metastases. That swelling can be a major cause of neurological symptoms. The prescription for Zantac may be unrelated to your cancer, but you would have to ask your own doctors the reason it was prescribed.

I would expect that your doctor will review the MRI with you and suggest a course of action. If he feels that these spots represent cancer (based on their appearance and a comparison with past MRIs (if any)), he may suggest focal radiation such as cyberknife to those spots.

We will keep you in our thoughts.

JimC
Forum moderator

So sorry to hear this. Did you mean Xanax? This would help with the sleeplessness caused by the steroids. And the anxiety. Wishing you the best. Take care, Judy

Hi Lorrie, I'm so so sorry you've got these brain mets but glad they're not causing symptoms. How interesting the things were glad about today. ;)

I'll make sure Dr. West or another faculty comments.
It seems to becoming more often 2 mets are being treated individually with cyberknife though it depends. On what it depends I'd be interested in finding out more myself.

If crizotinib is still working outside the brain and side effects are manageable oncologists are leaving people on the treatment after brain mets. Whether or not oncologists are leaving people on the criz during radiation treatment I don't think they are but I know it's not been studied.

Keeping you in my thoughts,
Janine

The Zantac was recommended because the steroids (dexamethasone, also known as Decadron) increase the risk of an ulcer, and medicines to reduce stomach acid can reduce that risk.

For someone with 3 or fewer small and asymptomatic brain lesions, it would be far more common to recommend stereotactic radiosurgery (CyberKnife, GammaKnife) than whole brain radiation. Some oncologists might recommend switching from XALKORI to Zykadia (ceritinib), which has more activity in the brain, but it also has significantly more side effects for most people. Many, and I would say most, oncologists would treat a patient's brain metastases with radiation, keep the XALKORI going, and keep monitoring the brain for additional mets. But if more and more brain metastases emerge, switching to Zykadia to treat within the brain more effectively makes more and more sense.

Good luck.

-Dr. West

Hi Lorrie, I'm so sorry you're going through all this.

I don't know that you have the thin clear secretion that are present with bronchorrhea but the whizzing is one of the big problems people have especially trying to sleep. Dr. West consistently and as recently as last month describe it as notoriously difficult to treat without treating the cause. Unfortunately that isn't always possible. Certain Spring, Debra, Linnea and Craig all have written about it trying to find ways to deal with it. Here is a post that you may find has ideas you've not tried. But there are many other discussions as well. http://cancergrace.org/topic/any-updates-on-treatment-of-bronchorrhea

Hope you feel better soon,
Janine

Hi Lorrie,

Congratulations on completing WBR! I hope you will start to rebound very soon. I don't have any specific suggestions other than trying to remain active while pacing yourself. It's not like working out, where there is a benefit to pushing yourself hard. Just take it slow and your energy will return.

JimC
Forum moderator

Hi Lorrie,

I'm so sorry to hear that you are in such pain. If your cancer center/hospital has a pain/palliative care specialist and/or inpatient unit, I agree that a consultation with them would be in order. Managing pain is what they do best, so I would give them a try.

I hope that you can feel better very soon.

JimC
Forum moderator

Lorrie, I'm so sorry you're not home yet and have this nasty problem. It's not uncommon to have thrush when you have a suppressed immune system.

This is what Mayo says about thrush, "Adults with weakened immune systems. Most often your doctor will recommend antifungal medication. But Candida albicans (thrush) can become resistant to many antifungal medications, especially in people with late-stage HIV infection. So a drug called amphotericin B may be used, but only when other drugs aren't effective, as it can cause serious side effects." http://www.mayoclinic.org/diseases-conditions/oral-thrush/basics/treatm…

Keeping you in my thoughts.

Janine

Hi Lorrie.

I'm sorry to hear what a rough month you've had! I hope you are starting to feel better and they've come up with something to help w/ the thrush. I wish you the best of luck in rehab so you can get home soon!!!!

Take care,
Lisa