Metastasis to Brian, Pleural Fluid on Both Lungs - 1256029

Mon, 04/29/2013 - 16:40

My dad has the following diagnosis
NSCLC Lungs Cancer Metastasis to the brain
Pleural Fluid in both lungs
Coughs no stop
lost weight
His oncologist/ pulmonary Drs have done the following
Thoracentesis-cancer cells present
Tube thoracotomy on right lung
Chemotherapy every three weeks ( palliative care)
Had to do gamma knife surgery for the brain tumor
since the occurrence of pleural effusion Oncologist is reluctant to
request gamma knife procedure
Should I insist?

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JimC

Hello lekenkia,

I'm not sure from your post which part of your dad's body would be the target of the requested gamma knife procedure. If it's in the brain, there is no reason not to proceed - that would be a standard treatment for a single brain metastasis, and the presence of a pleural effusion would not be a factor. If the target is the lung or another organ, and it is not being done to alleviate symptoms such as blockage of an airway or pain, than the presence of the pleural effusions (and the brain metastasis) is certainly a factor, since that indicates that his cancer has spread to the bloodstream. In most cases, local treatment such as radiation is not recommended because there are already cancer cells in other parts of the body, even if they can't currently be seen on scans, and you would just be chasing the cancer wherever it appears, only to have it appear again somewhere else.

You can read Dr. West's thoughts on this subject here: http://cancergrace.org/cancer-101/2011/01/01/cancer-101-faq-i-have-meta…

JimC
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JimC

lekenkia,

Has one gamma knife procedure to the brain already been performed, and would this be a second procedure to the same spot or a different lesion? Have you asked the oncologist why he is reluctant to request the second procedure?

If your dad has lost a lot of weight and is sleeping most of the time (and it's not due to medication), then his oncologist may feel that the chance of benefit from the procedure is not great enough to offset the discomfort of another gamma knife procedure. As difficult as it may be, it might be helpful to try to have a frank discussion with the oncologist about the reasons for not recommending gamma knife at this point.

Wishing you and your dad well on the path that is chosen,

JimC
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