Help! 2nd Craniotomy or Gamma Knife/WBR
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Help! 2nd Craniotomy or Gamma Knife/WBR

› Forums › General Melanoma Community › Help! 2nd Craniotomy or Gamma Knife/WBR

  • Post
    • October 29, 2011 at 10:21 pm
    azurliene
    Participant

    My dad was just diagnosed w/ Melanoma that has metastized to the brain. Long story short, they cannot find Melanoma in any other part of his body. He had two tumors in his brain, one was removed 2 weeks ago via craniotomy revealing that it was in fact metastized melanoma. The dilemma right now is how to best deal with the remaining (known) tumor.

    My dad was just diagnosed w/ Melanoma that has metastized to the brain. Long story short, they cannot find Melanoma in any other part of his body. He had two tumors in his brain, one was removed 2 weeks ago via craniotomy revealing that it was in fact metastized melanoma. The dilemma right now is how to best deal with the remaining (known) tumor. It is approx 2.5×3…we are meeting with a series of Drs and his neurosurgeon this week, but it seems the options are a 2nd craniotomy followed by Gamma Knife and/or WBR or WBR (they want to shrink before GK?) and then Gamma Knife in place of the craniotomy.

    This tumor is on the RT side, near a blood vessel – the neurosurgeon feels he can remove but of course stated the risks again. This being said he feels surgery 1st would be the best route. (his recovery from the first one was amazing) The radiation docs on the other hand say why risk the surgery risks when you could just do WBR and Gamma Knife. They are reviewing together with a tumor board before giving us their final recommendation, but in the meantime I am researching like crazy and would love to hear opinions if anyone has been in a similar dilemma.

    I hate the risks of surgery and there is a chance they would not be able to get all of the tumor with it being adjacent to a blood vessel, but I just want it out and I guess my concern with going the gamma knife/WBR route is if the tumor didn't take to the radiation, we would be left with less time, scar tissue making a craniotomy more difficult and  the chance of the tumor (or another) growing.

    Help! Thoughts? Also, we are at Barnes Jewish Hospital ST. Louis/Siteman but would love to hear recommendations re: hospitals best for melanoma in the bran too…

    Thanks for any help – I really appreciate it!!!

    Aften

    Also, I created this blog for my dad in case you want more details re: his case…

    http://earlstrieker.blogspot.com/

Viewing 5 reply threads
  • Replies
      • October 30, 2011 at 1:53 am
      FormerCaregiver
      Participant

      Aften, welcome to our forum. I wonder if your dad has had whole body CT and PET scans yet? As melanoma is very devious in what it can do, I feel that it is important to have both of these scans in order to get an accurate assessment of the overall situation.

      Surgery is usually the preferred initial option for melanoma treatment. Gamma Knife and/or WBR may also be considered, but that would depend on medical opinion and individual circumstances.

      A number of treatments can then be used systemically, and there are many people in this forum who have had good results. Therefore, I encourage you to fill in some info on the profile page that you may wish to create for your dad. This will help us to help you better.

      Best wishes

      Frank from Australia

        • October 30, 2011 at 2:43 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

        • October 30, 2011 at 2:43 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

        • October 30, 2011 at 2:43 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

        • October 30, 2011 at 2:44 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

        • October 30, 2011 at 2:44 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

        • October 30, 2011 at 2:44 am
        azurliene
        Participant

        Hi Frank,

         

        Thanks so much – I will try to fill in more info on the profile tonight. My dad had a full body CT and full body PET as well as eye and extensive skin screenings a few weeks ago before his first craniotomy but none of the tests revealed any signs of tumors, enlarged nodes or cancer (other than the two tumors in his brian)…they did the 1st craniotomy because they couldn't determine a source or type of cancer – the path from the first tumor/craniotomy revealed Melanoma

        They didn't remove both tumors at the same time because one was on the let and one on the right, but both affecting fine motor skills – they didn't want to risk even temp paralysis so they removed the bigger of the two first…. they were able to remove it in full, but will likely follow up with some sort of radiation at some point pending how they handle the second tumor – trying to determne best option for tackling the 2nd

        Neurosurgeon says he would do 2nd craniotomy (it is 2.5×3 close to a bloodvessel) but believes removing by surgery is the best

        Oncologist/radiation dr think WBR then gamma knife ….I like the idea of no craniotomy, but worried about wasted time with this option if the gamma knife is not effective in shrinking it…in this case, also worried about bleeding/rupture and scare tissue et all making a craniotomy at a later date harder to do

        still waiting to meet with the chemo/med specialist this coming week…afterwards the three Drs (along with the "tumor board") are going to get together to let us know what they feel the best route would be, but I was hoping for a few opinions before this….

        he's 59 and generally speaking they keep saying he is "young and in good health"

        so nice to here of some positive stories on here – this is the first site where I don't feel alone and that there is hope – the statistics all over the web have been eating me alive

        Thanks again for any opinions re: the options and/or recommendations for good hospitals to look into if we were to get another opinion

        http://earlstrieker.blogspot.com/

         

         

         

      • October 30, 2011 at 1:53 am
      FormerCaregiver
      Participant

      Aften, welcome to our forum. I wonder if your dad has had whole body CT and PET scans yet? As melanoma is very devious in what it can do, I feel that it is important to have both of these scans in order to get an accurate assessment of the overall situation.

      Surgery is usually the preferred initial option for melanoma treatment. Gamma Knife and/or WBR may also be considered, but that would depend on medical opinion and individual circumstances.

      A number of treatments can then be used systemically, and there are many people in this forum who have had good results. Therefore, I encourage you to fill in some info on the profile page that you may wish to create for your dad. This will help us to help you better.

      Best wishes

      Frank from Australia

      • October 30, 2011 at 1:53 am
      FormerCaregiver
      Participant

      Aften, welcome to our forum. I wonder if your dad has had whole body CT and PET scans yet? As melanoma is very devious in what it can do, I feel that it is important to have both of these scans in order to get an accurate assessment of the overall situation.

      Surgery is usually the preferred initial option for melanoma treatment. Gamma Knife and/or WBR may also be considered, but that would depend on medical opinion and individual circumstances.

      A number of treatments can then be used systemically, and there are many people in this forum who have had good results. Therefore, I encourage you to fill in some info on the profile page that you may wish to create for your dad. This will help us to help you better.

      Best wishes

      Frank from Australia

      • October 30, 2011 at 2:52 am
      kylez
      Participant
      Hi Aften,

      Siteman is the NCI-designated cancer in MO so that’s probably the best place to be in you area. I go to a similarly designated facility in mine.

      WBR can have something like a 20% dementia rate afterwards I believe. Or an 80% non-dementia rate to look at it another way. But if craniotomy #2 can be done plus gamma knife I think that would be a pretty good option.

        • October 30, 2011 at 3:04 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

        • October 30, 2011 at 3:04 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

        • October 30, 2011 at 3:04 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

        • October 30, 2011 at 3:05 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

        • October 30, 2011 at 3:05 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

        • October 30, 2011 at 3:05 am
        azurliene
        Participant

        Thanks Kyle, I really apreciate the opinion

      • October 30, 2011 at 2:52 am
      kylez
      Participant
      Hi Aften,

      Siteman is the NCI-designated cancer in MO so that’s probably the best place to be in you area. I go to a similarly designated facility in mine.

      WBR can have something like a 20% dementia rate afterwards I believe. Or an 80% non-dementia rate to look at it another way. But if craniotomy #2 can be done plus gamma knife I think that would be a pretty good option.

      • October 30, 2011 at 2:52 am
      kylez
      Participant
      Hi Aften,

      Siteman is the NCI-designated cancer in MO so that’s probably the best place to be in you area. I go to a similarly designated facility in mine.

      WBR can have something like a 20% dementia rate afterwards I believe. Or an 80% non-dementia rate to look at it another way. But if craniotomy #2 can be done plus gamma knife I think that would be a pretty good option.

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