Hello,
My Mom had a BC lump removed 5 years ago followed by radiotherapy.
2 years later she was diagnosed with triple negative BC.
She had chemo sessions and Pet Scan came back negative 1.5 year ago.
Now she had a stroke, unable to move with hallucination.
She had a Cat scan. Result below.
She's on cortisone., awake and able to walk some.
Further tests are being done.
She's in another country and we'd like to bring her to the States for treatment.
Would appreciate opinion about her diagnosis, her chances and whether it's treatable.
Thanks,
"Right sided weakness. History of Ca lung treated with Radiotherapy.
There are at least 3 large areas of low attenuation in both cerebral hemispheres.
The one on the right is seen just behind the occipital horn of the lateral vertical
is showing a high attenuation nodule within its center.
An impression of another high attenuation is suspected in the parietal lobe on the right side near the vertex.
The one on the left cerebral hemisphere is causing some mass effect on the occipital horn of the lateral vertical.
The three areas are not reaching the brain surface, giving the appearance of finger like towards the surface.
There's no focal abnormality in the posterior fossa.
The features mentioned are suggestive of metastatic disease from Ca lung.
Further evaluation IV contrast or MRI is needed."
Reply # - May 11, 2015, 09:21 AM
Hello Anthony,
Hello Anthony,
Welcome to GRACE. I am sorry to hear of the findings from your Mom's CT scan. The best scan for imaging possible brain metastases is an MRI, so if that has been ordered it may provide a better picture of what is going on. If these do represent brain metastases, radiation would be the treatment of choice. If there are just a few mets, focused radiation such as CyberKnife may be an option; otherwise whole brain radiation (WBR) would likely be recommended. You can read about WBR here.
In addition to the effects of her stroke, brain mets and the swelling associated with them, can also cause some of the symptoms you describe. The swelling may be reduced by the use of steroids such as cortisone or dexamethasone (Decadron), and this can significantly improve symptoms.
Cancer that has spread beyond the organ of origin is considered stage IV. While stage IV breast cancer is not curable, there are many therapies available which can be tailored to her specific type of cancer. You may want to read Dr. Cianfrocca's "Breast Cancer 101" post here.
There seems to be some inconsistency in the description of her cancer in the scan report, likely just an oversight by the radiologist who wrote it, as it is described as lung cancer. That's something you may want to clarify with her doctor.
Good luck with your Mom's treatment.
JimC
Forum moderator.
Reply # - May 11, 2015, 09:56 AM
Hi Jim,
Hi Jim,
Thanks so much for the informative post.
Sure gives me and my sisters some comfort.
Will be reading up on the links.
Reply # - May 14, 2015, 06:54 AM
A little update.
A little update.
She had MRI. The neuro surgeon said there are 3.
He could remove 2 through surgery and send her for radiation.
I'm waiting for MRI report to get second opinion from US doctor.
How successful is surgery on these cases?
Thanks
Reply # - May 14, 2015, 09:21 AM
Hi Anthony,
Hi Anthony,
Surgery for brain mets, as for any surgery to remove specific areas of cancer, tends to be successful especially if the margins of the tissue removed are clear. If there are micrometastases in the brain (cancer cells too small to see on a scan), then new metastases may appear. If so, whole brain radiation can be used to eradicate all the cells in the brain, seen or unseen.
JimC
Forum moderator
Reply # - May 14, 2015, 09:39 AM
Hi Jim,
Hi Jim,
My sister spoke to the surgeon.
He's comfortable working on 2 that are on the surface.
The deeper one, he won't mess around with and planning to radiate.
It looks like they'll be doing surgery there as they're concerned about the long plane trip over here.
Still waiting for MRI report for second opinion.
Thanks again for the info.
Reply # - May 18, 2015, 04:30 AM
I'd love to get the opinion
I'd love to get the opinion of a neurosurgeon on this one.
She has 3 tumors. 2 can be operated on. 1 can't.
He's planning to operate on the first one Wednesday. Wait a week,
and the do the second one.
The one that's causing the problems won't be dealt with until a month after the second surgery with radiation.
Is that standard?
Thanks
Reply # - May 18, 2015, 04:55 AM
Hi Jim,
Hi Jim,
By all means, if you know about this, I'd appreciate your opinion as well.
Thanks
Reply # - May 18, 2015, 07:05 AM
MRI report
MRI report
Metastatic parenchymal brain desease
Associated ederma and 9mm midline shift to the right side
associated compression of the left ;ateral ventricle
2 metatstic nodules contain blood degradation products
Metatstic dural disease
Metastatic bone marrow disease of the skull
Moderate chronic form of small vessel aschemic disease
Left maxillary chronic sinusitis
Findings, I'll add later.
Reply # - May 18, 2015, 08:12 AM
Hi Anthony,
Hi Anthony,
It sounds like a complicated situation, if in addition to the three brain mets there are also metastases to the dura and skull. In such complex matters, it is difficult to second-guess decisions being made locally by medical professionals with full access to all the medical records.
That being said, and keeping in mind that I am not a medical professional, when brain mets appear and are causing symptoms, a timely response is usually recommended, since growing brain metastases can cause significant problems. In that regard, waiting a month to deal with the brain met that's "causing the problems" would not be my choice.
I would seek recommendations from your Mom's oncologist as well as a radiation oncologist, since surgeons tend to think of everything in terms of surgical response.
JimC
Forum moderator
Reply # - May 18, 2015, 08:19 AM
Hi Jim,
Hi Jim,
Yes, I spoke to the surgeon.
It is complicated.
He said they could do radiation after 10-15 days after second surgery.
They plan to do targeted radiation.
I'm heading there tonight.
Thanks again for the help.
Reply # - May 29, 2015, 10:20 AM
Hi Jim,
Hi Jim,
Mom had both surgeries done and doctor is very pleased.
She's stable and able to communicate well.
Slightly able to walk with plenty of help.
Targeted radiation to start in 2 weeks.
Forgot to ask if it's Cyber Knife or other method.
We're so grateful.
Thanks for the help. :)
Reply # - May 29, 2015, 01:53 PM
Hi Anthony,
Hi Anthony,
So glad to hear that surgery went well. Continued best wishes for healing and effective, well-tolerated radiation.
JimC
Forum moderator
Reply # - September 30, 2015, 04:20 AM
Hi Jim,
Hi Jim,
My mom was still dealing with extreme fatigue.
MRI showed tumors were shrinking with nothing new.
Few weeks ago, the craniotomy site was swollen with what seemed like fluid underneath.
They did MRI and there was extensive fluid in the brain, more so than the scan a month earlier.
They decided to do nothing and couple weeks later she had seizures and is intubated for 10 days now.
Today they're going to place a trach.
I got a second opinion and was told they can drain the fluid but they refuse to do it at the hospital.
The MRI report clearly says extensive fluid but the neurologist at the hospital think it's brain atrophy,
and draining the fluid won't help.
Any opinion would be appreciated.
Reply # - September 30, 2015, 09:16 AM
Dear Anthonyn,
Dear Anthonyn,
I'm so very sorry your mom and the family are going through such a terrible situation. I'm afraid we are unable to give any kind of opinion in this situation. Our doctors don't treat in this type of situation and would be left to neuro docs and family to decide between more invasive procedures or comfort care. If your mom has a living will it may help to know what she would want done in this type of situation. This is indeed a difficult time for you are the ones making the decisions for your mom. Knowing she is will die is so difficult but having to have a say in it is much more so. If it helps to know most every doctor wants for their loved ones and themselves to have peace and comfort care when there's little hope for recovery.
I hope,
Janine
Reply # - September 30, 2015, 09:22 AM
Thanks Janine for the kind
Thanks Janine for the kind words.