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-   -   My Mom-Brain, Lungs, Bone (http://her2support.org/vbulletin/showthread.php?t=53215)

binghamk101 02-15-2012 07:12 PM

My Mom-Brain, Lungs, Bone
 
In 2007 my mom was diagnosed with HER2+ stage 2a. She had a lumpectomy, radiation and chemo. In July 2011 we found out she was stage 4 with mets in her lungs, bones and brain. She had WBRT, navelbine and tykerb (made her really sick and had to stop), then taxotere and Herceptin. In December she went in for what was supposed to be a routine hernia laprascopy. She developed a fistula and almost died. She was on TPN and in the hospital for 7 weeks. She hasnt been able to have chemo for almost 10 weeks becuase she still has an open wound in her abdomen from the surgery. In the last few days we have found that the spot on the lung has increased and lymph nodes are now involved. Today we found there are new spots in her cerebellum and front lobe. They are considering WBRT again or Gamma Knife. In the last week she has lost all control of her right leg probably due to nerve damage from the brain or spine (waiting on spine MRI results). Other than the leg, she feels okay. Our family is terrfied and needs stories of encouragement. Has anyone had gamma knife in the cerebellum? Anyone done WBRT more than one? I need help! I am lost!

Jackie07 02-16-2012 03:05 AM

Re: My Mom-Brain, Lungs, Bone
 
Clin Transl Oncol. 2012 Jan;14(1):43-9.
Predicting compliance and survival in palliative whole-brain radiotherapy for brain metastases.

Sabater S, Mur E, Müller K, Arenas M.
Source

Department of Radiation Oncology, Complejo Hospitalario Universitario, Albacete, Spain.

Abstract

Objective Brain radiotherapy is the main treatment for patients with brain metastases but its goal is just symptom control. Our aim was to study if different performance tools, used in geriatric practice, could improve patient selection for decision-making in the palliative brain radiotherapy setting. Patients and methods Data from 61 consecutive patients were analysed. In addition to Karnofsky Performance Status (KPS) their physical activity was assessed by means of the activity of daily living (ADL) and instrumental ADL (IADL) scales. A neurocognitive evaluation was performed with the Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) and with the Mini-Mental Status Exam (MMSE). Radiotherapy compliance and short survival were the endpoints of the study. Results High rates of cognitive impairment were found by both neurocognitive tools (Pfeiffer: 19.7% of patients; MMSE: 30%). Dependence was also highly prevalent, either measured by the ADL (50.8%) or by the IADL (43.3%). Nearly one third (27.9%) of patients died soon after radiotherapy evaluation. Longer survival was related to female, younger than 60 years, breast cancer primary tumour, steroid response, RPA class, and higher performance and neurocognitive score tools. A premature death was associated with neurocognitive tools, IADL and longer interval from brain metastatic diagnosis to radiotherapy. Twenty-three percent of patients were not able to finish the WBRT course due to clinical deterioration. The only variable related to compliance was a low MMSE score. Conclusions Results suggest that the geriatric tools analysed could offer information on brain palliative radiotherapy complementary to that offered by the more usual tools. It will be interesting to study if our data could be extrapolated to the general palliative oncological field.

Jackie07 02-16-2012 03:18 AM

Re: My Mom-Brain, Lungs, Bone
 
Couldn't find anything published after 2008:

J Neurooncol. 2008 Jul;88(3):331-7. Epub 2008 Apr 8.
Metastases to the cerebellum. Results and prognostic factors in a consecutive series of 44 operated patients.

Pompili A, Carapella CM, Cattani F, Fabi A, Giannarelli D, Giovannetti M, Mirri A, Occhipinti E, Telera S, Vidiri A, Pace A.
Source

Division of Neurosurgery, Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, Italy. pompili@ifo.it

Abstract

BACKGROUND:

Recent reports on large number of patients with brain metastases report that Whole Brain Radiotherapy (WBRT) and Radiosurgery (RS) should be the treatments of choice, particularly in multiple lesions cases. Among the prognostic factors, the cerebellar location was never considered, although this results in hydrocephalus, brain stem compression, ataxia, intracranial hypertension.
MATERIALS AND METHODS:

We evaluated 44 patients with cerebellar metastases operated over 6 years. Primary lesions were: Lung (15), Breast (12), Gastrointestinal (9), Gut (3), Ovary (2), Melanoma (1), Salivary gland carcinoma (1), Unknown (1). Lesions were <3 cm in 11 cases, > or =3 cm in 33. Average KPS scoring at admission was 69.9. Twenty nine scored > or =70, 15 < 70.
RESULTS:

Two patients died for surgical complications, 2 died within 1 months for other causes, 2 were lost to follow up. Eight had postoperative hematoma requiring reoperation, 1 had an occipital infarction. Average KPS scoring at discharge was 76.4, P < 0.002. Those patients that had complications scored less, the difference is significant (P < 0.008). Median survival was 8 months, 1 year survival rate 29.9%. Survival was correlated with either admission or discharge KPS (> or =70 vs. <70): P = 0.05 and P = 0.0001 respectively. None of the other parameters considered reached statistical significance.
CONCLUSIONS:

Open microneurosurgery is probably still the most effective therapy in improving survival and KPS in patients with large cerebellar metastases, given that the proper surgical technique is used and that complications do not occur. Specific data on cerebellar metastases as an independent subgroup are needed from radiosurgical series.

ElaineM 02-16-2012 11:50 AM

Re: My Mom-Brain, Lungs, Bone
 
I don't know anything about brain radiation. I just wanted to say I am sorry to hear about your Mom.
I wonder if some physical therapy might help her leg.
Keep strong. Stay positive. Take care.

Gabrielle 02-24-2012 02:02 PM

Re: My Mom-Brain, Lungs, Bone
 
I am so sorry you and your mom are going through this. Keep the faith.

Mtngrl 03-04-2012 07:41 AM

Re: My Mom-Brain, Lungs, Bone
 
I don't have experience with brain mets, but I want to join in telling you I'm so sorry for you and your family.

Cancer sucks.

Delaney 03-05-2012 07:24 AM

Re: My Mom-Brain, Lungs, Bone
 
I find out tomorrow if gamma knife worked for single brain met. Really hope so. Have no symptons but am on steroid so dont know if symptons being masked. Tomorrow wil tell for sure.

schoolteacher 03-06-2012 02:36 PM

Re: My Mom-Brain, Lungs, Bone
 
Delaney,

Please let us know the results. I am hoping you get a good report.

Amelia

Delaney 03-07-2012 10:38 AM

Re: My Mom-Brain, Lungs, Bone
 
Amelia, results not as good as I had hoped. A new spot showed up, small but still there and we will do gamma on that. Also skin more active than it was so new weekly chemo will be started as soon as I finish rads to my back. I have just decided to accept this and move on , hope for the best. I feel and look well. Its out of my control and some people are facing worse so onwards we go.

schoolteacher 04-09-2012 06:21 AM

Re: My Mom-Brain, Lungs, Bone
 
Delaney,

Glad to hear from you. Let us know how you are doing. You sound very positive. Are you still taking the steroids?

Amelia


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