Looking for experience or advice about the situation that my Mom is in. The brain mets have really done a number on her. This is all uncharted territory and it really upsets me that I can't figure out if things are bad, good, or the same. It's either the steroids or the mets that are giving her so much trouble. She has been on steroids for about 4 weeks now, I think. She got to the point to where she could barely think of the right words to say. She wouldn't get any sleep, only averaging 3 to 4 hours per night. My Mom's symptoms had us so scared that she decided to go ahead with whole brain radiation (wbrt).
She has had 3 sessions of low-dose wbrt (out of the total of 15 sessions suggested to her by her 2nd radiation onc.) We were waiting to hear from a couple Neurosurgeons about the possibility of Gamma Knife or Cyber Knife, but one called back after the first session of wbrt and the other one called the next morning. They both agreed that she would be a candidate for any type of stereotactic radiosurgery (srs) given she only had 4 mets with the largest being 3.5cm. The largest met was the one that had the other options besides wbrt in question because of it's location in the back right part of the brain. They were cautious of the swelling it might cause that would lead to other symptoms. Both neurosurgeons also said that they didn't think wbrt was a bad idea and to maybe use srs after wbrt to clean up anything left behind.
So, we went ahead with the wbrt and she seems to have small improvements. She could barely write anything before and now she can write single words. She is talking slightly better. She can get around a little better too. Her personality has gotten a little better. But, I really still don't know what to think. I have read where symptom improvement does not occur right away with wbrt. She doesn't necessarily want to do anymore wbrt treatments but she doesn't want to mess anything up.
Has anyone ever switched from wbrt to srs?
Reply # - May 23, 2016, 08:18 AM
Hello,
Hello,
Welcome to GRACE. I'm sorry to hear about your Mom's brain mets and the troubling symptoms they've caused, but encouraged to hear that they are improving, especially after just a few WBRT sessions. I can't say I've really heard much about patients switching mid-stream from WBRT to SRS, but since she is so early in the WBRT regimen, it is pretty likely that any damage to healthy tissue has been fairly minimal, so it doesn't seem as though changing now would be a problem. If she were further along in the treatments, then I would think that she should probably complete the sessions and get all of the anticipated advantage of WBRT (clearing the brain of any micrometastases as well as the visible lesions). Four or maybe five lesions is about the limit of what most radiation oncologists will treat with SRS, but if two neurosurgeons have agreed that it is an option, it's something to be considered.
JimC
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