› Forums › General Melanoma Community › Brain mets…WBRT or SRT?
- This topic has 30 replies, 7 voices, and was last updated 13 years, 10 months ago by
kylez.
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- January 17, 2012 at 8:57 pm
For those of you who have either dealt with this or have some base knowledge, I would love some advice! I had one 3 cm brain met in Dec 2011 which was resected and so far we have not found any other mets. I am being offered radiation and have to choose between whole brain radiation therapy (WBRT) or Sterotactic Radio therapy (SRT or gamma knife). I am not quite sure which to choose at this point. Since there were no other mets it seems reasonable to me that the SRT is a better option as I am leary of the WBRT when there is no other measureable disease.
For those of you who have either dealt with this or have some base knowledge, I would love some advice! I had one 3 cm brain met in Dec 2011 which was resected and so far we have not found any other mets. I am being offered radiation and have to choose between whole brain radiation therapy (WBRT) or Sterotactic Radio therapy (SRT or gamma knife). I am not quite sure which to choose at this point. Since there were no other mets it seems reasonable to me that the SRT is a better option as I am leary of the WBRT when there is no other measureable disease. My thought, and that of one of th two radiation oncologists that I have spoken with, is that I could do the SRT for the tumor bed and then if there are any other mets in the future I can get the WBRT for that, particularly if I am unlucky enough to get brain mets that are inoperable. I have a call in to my oncologist so that I can speak with her about it but I know I need to make a decision soon and I am just stumped. Any thoughts or input would be greatly appreciated.
Thanks!
Brenda
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- January 17, 2012 at 9:11 pm
SRT!!!!
Save WBR if needed when you have several mets. While sometimes you don't have a choice you have to think of damage to healthy cells. I was offered SRS as a first choice because my tumor was so deep that a crainectomy would cause damage. My issues now are edema but the tumor itself is dying. Tomorrow I have an appointment with my team to discuss the next step.
My local oncologist is the only medical person that I consulted that even brought WBR up. I talked to 5 other medical Doctors that I had worked with in the past with melanoma or were the current nuerosurgeon.
Whatever you choose, you cannot look backwards.
Good luck and it would be worth it for an appointment with another institution to get another opinion if your not feeling sure.
Linda
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- January 17, 2012 at 9:11 pm
SRT!!!!
Save WBR if needed when you have several mets. While sometimes you don't have a choice you have to think of damage to healthy cells. I was offered SRS as a first choice because my tumor was so deep that a crainectomy would cause damage. My issues now are edema but the tumor itself is dying. Tomorrow I have an appointment with my team to discuss the next step.
My local oncologist is the only medical person that I consulted that even brought WBR up. I talked to 5 other medical Doctors that I had worked with in the past with melanoma or were the current nuerosurgeon.
Whatever you choose, you cannot look backwards.
Good luck and it would be worth it for an appointment with another institution to get another opinion if your not feeling sure.
Linda
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- January 17, 2012 at 9:11 pm
SRT!!!!
Save WBR if needed when you have several mets. While sometimes you don't have a choice you have to think of damage to healthy cells. I was offered SRS as a first choice because my tumor was so deep that a crainectomy would cause damage. My issues now are edema but the tumor itself is dying. Tomorrow I have an appointment with my team to discuss the next step.
My local oncologist is the only medical person that I consulted that even brought WBR up. I talked to 5 other medical Doctors that I had worked with in the past with melanoma or were the current nuerosurgeon.
Whatever you choose, you cannot look backwards.
Good luck and it would be worth it for an appointment with another institution to get another opinion if your not feeling sure.
Linda
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- January 18, 2012 at 2:53 am
SRS
Read my patnet, radiation can have negative side effects. If your 1 tumor has been resected, are they offering wait and see as an option? Remember, it is your choice. Surgery can sometimes be curative.-
- January 18, 2012 at 6:03 pm
Believe it or not, I haven't met with my new oncologist to even discuss overall treatment options. The radiation oncologists I have met with do not recommend wait and see, though it has crossed my mind. My husband would freak out if I did that! I know it is my choice but with 2 small kids at home and only being 36 years old, I really think it would be worth my while to fight and try some of the treatments, just don't want to cause long term damage if it isn't necessary.
Thanks for the input!
Brenda
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- January 18, 2012 at 6:03 pm
Believe it or not, I haven't met with my new oncologist to even discuss overall treatment options. The radiation oncologists I have met with do not recommend wait and see, though it has crossed my mind. My husband would freak out if I did that! I know it is my choice but with 2 small kids at home and only being 36 years old, I really think it would be worth my while to fight and try some of the treatments, just don't want to cause long term damage if it isn't necessary.
Thanks for the input!
Brenda
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- January 18, 2012 at 6:03 pm
Believe it or not, I haven't met with my new oncologist to even discuss overall treatment options. The radiation oncologists I have met with do not recommend wait and see, though it has crossed my mind. My husband would freak out if I did that! I know it is my choice but with 2 small kids at home and only being 36 years old, I really think it would be worth my while to fight and try some of the treatments, just don't want to cause long term damage if it isn't necessary.
Thanks for the input!
Brenda
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- January 18, 2012 at 6:38 am
Hi Brenda
I was faced with the same probelm. I had 3 mets – 2 that were removed via crainiotomy and 1 that was zapped with SRT. My radiation oncologist said after that the standard was to do WBR and my neurosugeon said the same. But I was not satisfied with this as I did some research to find that WBR has many more long term side effects and does NOT increase life expectancy. All it does is keep the melanoma at bay for a longer time. What my radiation oncologist and surgeon did not know (or at least they had not been epxposed to it) was the fact that I was going to take the new BRAF drug Zelboraf. While the clinical trials are still underway, what I am hoping for is that Zelboraf does the same thing (keeps the mets at bay) – with fewer long term side effects. There are indeed short term side effects, but I can deal with them. I don't want to tell you what to do – but I would consider getting tested for Braf mutation and if you are indeed positive – maybe go with Zelboraf or another Braf inhibitor. It will at least give you time. My plan is to stay on Zelboarf until it doesn't work, or long enough until I am strong again and able to go after the disease with ipi or another chemo agent that has the potential for a durable long term response. I hope that helps Brenda. Feel free to contact me and ask follow up questions. I hope and pray for the best for you.
David
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- January 18, 2012 at 6:38 am
Hi Brenda
I was faced with the same probelm. I had 3 mets – 2 that were removed via crainiotomy and 1 that was zapped with SRT. My radiation oncologist said after that the standard was to do WBR and my neurosugeon said the same. But I was not satisfied with this as I did some research to find that WBR has many more long term side effects and does NOT increase life expectancy. All it does is keep the melanoma at bay for a longer time. What my radiation oncologist and surgeon did not know (or at least they had not been epxposed to it) was the fact that I was going to take the new BRAF drug Zelboraf. While the clinical trials are still underway, what I am hoping for is that Zelboraf does the same thing (keeps the mets at bay) – with fewer long term side effects. There are indeed short term side effects, but I can deal with them. I don't want to tell you what to do – but I would consider getting tested for Braf mutation and if you are indeed positive – maybe go with Zelboraf or another Braf inhibitor. It will at least give you time. My plan is to stay on Zelboarf until it doesn't work, or long enough until I am strong again and able to go after the disease with ipi or another chemo agent that has the potential for a durable long term response. I hope that helps Brenda. Feel free to contact me and ask follow up questions. I hope and pray for the best for you.
David
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- January 18, 2012 at 6:38 am
Hi Brenda
I was faced with the same probelm. I had 3 mets – 2 that were removed via crainiotomy and 1 that was zapped with SRT. My radiation oncologist said after that the standard was to do WBR and my neurosugeon said the same. But I was not satisfied with this as I did some research to find that WBR has many more long term side effects and does NOT increase life expectancy. All it does is keep the melanoma at bay for a longer time. What my radiation oncologist and surgeon did not know (or at least they had not been epxposed to it) was the fact that I was going to take the new BRAF drug Zelboraf. While the clinical trials are still underway, what I am hoping for is that Zelboraf does the same thing (keeps the mets at bay) – with fewer long term side effects. There are indeed short term side effects, but I can deal with them. I don't want to tell you what to do – but I would consider getting tested for Braf mutation and if you are indeed positive – maybe go with Zelboraf or another Braf inhibitor. It will at least give you time. My plan is to stay on Zelboarf until it doesn't work, or long enough until I am strong again and able to go after the disease with ipi or another chemo agent that has the potential for a durable long term response. I hope that helps Brenda. Feel free to contact me and ask follow up questions. I hope and pray for the best for you.
David
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- January 18, 2012 at 5:59 pm
David,
Thank you so much for your input! I had the BRAF test done but I don't know the results yet. I have done some research and have been really nervous about the possible long term effects of WBR. Especially if it doesn't increase life expectancy, though no one has even talked about that with me as we are still trying to determine if there is any other mets in my body (looking at lungs and thyroid). I have a simulation appointment tomorrow with local radiation oncologist who really strongly recommended WBR. I have the option of going to Bethesda Naval Hospital for SRT with the first radiation oncologist that I met with immediately after surgery. I am really leaning towards that, especially if the local guy doesn't support SRT.
Thanks so much again for your info and input! I will probably get in touch with you for questions…our cases seem fairly similar and I would love to, pardon the pun, pick your brain a bit.
Brenda
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- January 18, 2012 at 5:59 pm
David,
Thank you so much for your input! I had the BRAF test done but I don't know the results yet. I have done some research and have been really nervous about the possible long term effects of WBR. Especially if it doesn't increase life expectancy, though no one has even talked about that with me as we are still trying to determine if there is any other mets in my body (looking at lungs and thyroid). I have a simulation appointment tomorrow with local radiation oncologist who really strongly recommended WBR. I have the option of going to Bethesda Naval Hospital for SRT with the first radiation oncologist that I met with immediately after surgery. I am really leaning towards that, especially if the local guy doesn't support SRT.
Thanks so much again for your info and input! I will probably get in touch with you for questions…our cases seem fairly similar and I would love to, pardon the pun, pick your brain a bit.
Brenda
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- January 18, 2012 at 5:59 pm
David,
Thank you so much for your input! I had the BRAF test done but I don't know the results yet. I have done some research and have been really nervous about the possible long term effects of WBR. Especially if it doesn't increase life expectancy, though no one has even talked about that with me as we are still trying to determine if there is any other mets in my body (looking at lungs and thyroid). I have a simulation appointment tomorrow with local radiation oncologist who really strongly recommended WBR. I have the option of going to Bethesda Naval Hospital for SRT with the first radiation oncologist that I met with immediately after surgery. I am really leaning towards that, especially if the local guy doesn't support SRT.
Thanks so much again for your info and input! I will probably get in touch with you for questions…our cases seem fairly similar and I would love to, pardon the pun, pick your brain a bit.
Brenda
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- January 18, 2012 at 2:47 pm
My husband had the exact same thing, except his brain met was twice the size. He had a craniotomy, then 3 weeks later had gamma knife (same as SRS, or at least similar). The oncologist and neurosurgeon were sure this was the right plan, since he had no more brain mets. The thought is to save WBR until necessary for unressectable mets. There are some pretty scary side effects from WBR, and minimal from SRS. FYI…my husband had his craniotomy on Nov. 30 and gamma knife on Dec. 22. He’s doing great…still tired, but feeing good. -
- January 18, 2012 at 2:47 pm
My husband had the exact same thing, except his brain met was twice the size. He had a craniotomy, then 3 weeks later had gamma knife (same as SRS, or at least similar). The oncologist and neurosurgeon were sure this was the right plan, since he had no more brain mets. The thought is to save WBR until necessary for unressectable mets. There are some pretty scary side effects from WBR, and minimal from SRS. FYI…my husband had his craniotomy on Nov. 30 and gamma knife on Dec. 22. He’s doing great…still tired, but feeing good. -
- January 18, 2012 at 2:47 pm
My husband had the exact same thing, except his brain met was twice the size. He had a craniotomy, then 3 weeks later had gamma knife (same as SRS, or at least similar). The oncologist and neurosurgeon were sure this was the right plan, since he had no more brain mets. The thought is to save WBR until necessary for unressectable mets. There are some pretty scary side effects from WBR, and minimal from SRS. FYI…my husband had his craniotomy on Nov. 30 and gamma knife on Dec. 22. He’s doing great…still tired, but feeing good. -
- January 19, 2012 at 4:38 am
Brenda, you might want to check this webinar out tomorrow (Thur):
https://www1.gotomeeting.com/register/271562473
It's put on by one of the other large melanoma patient advocate web sites.
That's the live webinar, they usually post an archive for replay a few days later.
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- January 19, 2012 at 4:42 am
Should have put in description:
Veronica Chiang, MD, neurosurgeon, and director of the Gamma Knife Program at Yale's Cancer Center will present: Radiation Treatment of Brain Metastases in Melanoma on January 19th at 5pm EST.
When you go to the page, there's still a chance to submit questions if they have time to take some.
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- January 19, 2012 at 4:42 am
Should have put in description:
Veronica Chiang, MD, neurosurgeon, and director of the Gamma Knife Program at Yale's Cancer Center will present: Radiation Treatment of Brain Metastases in Melanoma on January 19th at 5pm EST.
When you go to the page, there's still a chance to submit questions if they have time to take some.
-
- January 19, 2012 at 4:42 am
Should have put in description:
Veronica Chiang, MD, neurosurgeon, and director of the Gamma Knife Program at Yale's Cancer Center will present: Radiation Treatment of Brain Metastases in Melanoma on January 19th at 5pm EST.
When you go to the page, there's still a chance to submit questions if they have time to take some.
-
- January 19, 2012 at 4:38 am
Brenda, you might want to check this webinar out tomorrow (Thur):
https://www1.gotomeeting.com/register/271562473
It's put on by one of the other large melanoma patient advocate web sites.
That's the live webinar, they usually post an archive for replay a few days later.
-
- January 19, 2012 at 4:38 am
Brenda, you might want to check this webinar out tomorrow (Thur):
https://www1.gotomeeting.com/register/271562473
It's put on by one of the other large melanoma patient advocate web sites.
That's the live webinar, they usually post an archive for replay a few days later.
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