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mkrny · 10-24-2006, 12:12 PM

We were confronted with this in March. Here's my opinion based on our experience:
1. first explore surgical removal,
2. also talk to rad onc to see if radio surgery is viable, they will likely discuss whole brain radiation(WBR) as well,
3. set yourself up to start the tykerb trial right after surgery

Ask surgeon (and rad onc) about potential deficits after surgery. If tumor is in a good spot and surgeon is confident about complete removal with minimal deficits then cutting it out should be strongly considered as first step. If WBR is part of your tmt see if your rad onc will let you do some chemo in parallel since there is evidence that BBB opens up during WBR allowing chemos to come in.

My wife's status didn't present a clear path as she had & has leptomeningeal decease (cancer in CSF). She had WBR, radio surgery, IT MTX + chemo to body and now is on a tykerb/xeloda trial. Both tykerb & xeloda have small molecular structure small enough to pass through BBB so having brain mets shouldn't eliminate you from consideration. In fact it may be one of the inclusion criteria in some of the trails.

Hope this info helps.
Keep on fighting,

10-24-2006, 12:12 PM	#4
mkrny Senior Member Join Date: Mar 2006 Location: LI, NY Posts: 38	We were confronted with this in March. Here's my opinion based on our experience: 1. first explore surgical removal, 2. also talk to rad onc to see if radio surgery is viable, they will likely discuss whole brain radiation(WBR) as well, 3. set yourself up to start the tykerb trial right after surgery Ask surgeon (and rad onc) about potential deficits after surgery. If tumor is in a good spot and surgeon is confident about complete removal with minimal deficits then cutting it out should be strongly considered as first step. If WBR is part of your tmt see if your rad onc will let you do some chemo in parallel since there is evidence that BBB opens up during WBR allowing chemos to come in. My wife's status didn't present a clear path as she had & has leptomeningeal decease (cancer in CSF). She had WBR, radio surgery, IT MTX + chemo to body and now is on a tykerb/xeloda trial. Both tykerb & xeloda have small molecular structure small enough to pass through BBB so having brain mets shouldn't eliminate you from consideration. In fact it may be one of the inclusion criteria in some of the trails. Hope this info helps. Keep on fighting, __________________ Maryann & Ken __________________ Stage IV, Her2/Neu 3+++, Er & Pr positive, Primary mets to brain/CSF, bones & lymphs DX: 2/01, DCIS Rt one, Neoadjuvant chemo, MRM 7/01 Rads to chest, neck, lower spine, pelvis WBR & cyberknife Numerous chemo/hormonal cocktails along the way 10/11/06: Started Trial of Lapatinib/Xeloda, after 2 cycles it is declared a failure for us. 11/24/06: Now starting rads to upper spine then IT herceptin 12/07: Took a turn for the worse and entered hospice. Enjoyed remaining time with family and friends feasting on cookies and sushi. 4/11/07: Peacefully passed on. Maryann will be missed by all.