Brain tumor in fright frontal lobe but speech is slurring? - 1254070

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howardw
Brain tumor in fright frontal lobe but speech is slurring? - 1254070

Hi everyone,

The neurologist said that the left side of the brain controls speech. My mom has a tumor on the right side. Her speech has deteriorated and she is slurring her words.Her cognitive functions are alright.

She did have multiple mets but except for one the rest disappeared while on Tarceva. Could the mets be so small they don't show on any scan, but still affect her at the microscopic level?

She had Cyber knife on the remaining tumor it never WBR.

Howard

Dr West
Reply To: Brain tumor in fright frontal lobe but speech is

While that's possible, it's not likely at all that metastases that are so small they can't be seen would lead to neurologic symptoms. One thing we'd be concerned about is the possibility of leptomeningeal carcinomatosis, or cancer cells in the fluid bathing the brain and spinal cord, and attaching to the meningeal lining around the brain and spinal cord. That can sometimes be seen on scans (though it's notoriously difficult and unreliable), and sometimes it is diagnosed by a lumbar puncture ("spinal tap") that takes out fluid from outside of the spinal cord and detects cancer cells there. Unfortunately, if that's the case, it's a notoriously difficult complication to treat effectively.

There are also many other things that can lead to these kind of changes, including medication issues and/or metabolic issues, and these are more readily reversible. It's certainly appropriate to contact her doctor to discuss the potential value of a further workup to learn more.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

dr. weiss
Reply To: Brain tumor in fright frontal lobe but speech is

Here's a link that addresses leptomeningeal carcinomatosis and a unique treatment option for patients with EGFR mutation.

double trouble
Reply To: Brain tumor in fright frontal lobe but speech is

Dr. Weiss... I think you forgot the link... :lol:

Dr West
Reply To: Brain tumor in fright frontal lobe but speech is

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

craig
craig's picture
Reply To: Brain tumor in fright frontal lobe but speech is

FYI - and here's another, a new report from the Netherlands of two cases that might be of interest:

Title: High-dose, pulsatile erlotinib in two NSCLC patients with leptomeningeal metastases—One with a remarkable thoracic response as well

http://www.lungcancerjournal.info/article/PIIS016950021300010X

Best hopes,

Craig

_________________________________
Stage 4 ROS1+ [mucinous BAC] adenocarcinoma NSCLC since 2011
Xalkori (crizotinib) 5 yrs
Alimta (pemetrexed) + carboplatin (mere months)
TPX-0005 (repotrectinib) TBD (1+ years as of Fall 2018)

laya d.
Reply To: Brain tumor in fright frontal lobe but speech is

Awesome. . .Thanks for the links Craig. . .

Laya