Drastic cognitive changes after stereotactic brain radiation - 1294424

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saralou1118
Drastic cognitive changes after stereotactic brain radiation - 1294424

My father is 59..had bad reflux and started to lose use of right side of body.. in Oct he was diagnosed with Squamous cell esophageal cancer with a brain met...2 days later, brain surgery (no radiation to the brain), chemo and radiation to the esophagus. During this treatment, brain tumor came back bigger and quicker, 2 months later 2nd brain surgery in the same spot. Movement came back and then lost it again before 2nd surgery...had radiosurgery to the tumor bed (which kicked his butt) in March....he was feeling alright, some movement back, positive attitude, got results of his PETscan was NED...2 days later everything started declining...compete loss of movement to the right side, extreme fatigue, and now suddenly a quick decline in his cognitive functions. My mother and I have been his caretakers and have just seen this downward shift in everything. This all happened so quickly. Very concerned about the extreme memory loss, lack of word retrieval, and overall 24 hour fuzziness. Also he constantly feels nauseous with a cough. All of our Drs are brushing off these symptoms saying they are all due to radiation and chemo..his last radiation treatment to his brain was March 8. Not sure if this is normal after brain radiation? This has just all been unbelievable and has taken away my basketball coaching, athletic, health conscious father. Not sure if we wait out these symptoms...thank you!! - Sara

JimC
Hi Sara,

Hi Sara,

Welcome to GRACE. I'm sorry to hear of your father's continuing difficulties. Radiation to the brain can cause any of these symptoms, especially when the same area has previously been subjected to surgery. The effects of radiation are not always immediate, as the process of damage to both cancerous and healthy brain cells can take weeks. Chemo and radiation can also take its toll on a patient.

All of these effects can take time to resolve, and for some patients it can be a long process. You mentioned a PET scan, which doesn't provide much information about cancer activity in the brain, since normal tissue in the brain shows a great deal of activity, and the entire brain "lights up" on such a scan. Do his doctors plan a follow up brain MRI? It is common to delay a brain MRI until some time has passed after radiation, since the effects of that radiation do not become clear for a least a couple of months. At that point, you should be able to judge the efficacy of the brain radiation.

I hope his symptoms begin to improve very soon.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

onthemark
HI Sara,

HI Sara,

I'd also be having many of the same thoughts and concerns if I were in your shoes. Is your father getting a brain MRI as Jim suggested? Since his last radiation treatment was March 9, it would be appropriate follow up now.

I would also ask for a neurological exam. From what I have read on the web, your father's symptoms don't sound typical for symptoms of radiation to the brain although I would guess it would depend on which areas of the brain were irradiated and other factors as Jim suggests.

cards7up
Is he still taking steroids?

Is he still taking steroids? If not, then I'd ask his doctor if he could have edema and need them for a while longer. Scar tissue called necrosis happens in the brain as well and could be causing him issues. I'd think his doctors would be more proactive on the side effects. If they're not, then I'd get a second opinion.
Take care, Judy