HER2 Support Group Forums - View Single Post - I don't know what to say other than HELP !!!

Joan M · 02-06-2011, 08:15 PM

Jacqui,

It seems that some hospitals in New Zealand have Gamma Knife according to these articles:

http://www.healthcareitnews.com/news...nstall-web-pas

http://www.modernmedicine.com/modern.../detail/702751

Oncologists have a tendency to recommend wbr even though other procedures work well. Wbr has been the standard of care for many years, but that is changing, especially if there’s only one tumor in the brain. Sometimes surgery is performed and then followed up with targeted radiation (targeted means it just targets the area of the tumor, not the whole brain). Other times a drug like Lapatinib is used because it's supposed to be able to cross the blood-brain barrier, as was mentioned above.

I don't know how your insurance works, but are you able to get an appointment directly with a radiologist at one of these hospitals? The radiologist would be able to tell you whether Gamma Knife has been used for brain metastases.

T-DM1 doesn't seem right to me in your situation, since I believe you would have to fail several treatments for advanced breast cancer before you could qualify, among other things, like the trastuzumab (Herceptin) molecule doesn't pass through the blood-brain barrier. But some of the ladies on this board who are in that trial would be able to give you better information than I can.

Joan

02-06-2011, 08:15 PM	#18
Joan M Senior Member Join Date: Oct 2007 Posts: 1,851	Re: I don't know what to say other than HELP !!! Jacqui, It seems that some hospitals in New Zealand have Gamma Knife according to these articles: http://www.healthcareitnews.com/news...nstall-web-pas http://www.modernmedicine.com/modern.../detail/702751 Oncologists have a tendency to recommend wbr even though other procedures work well. Wbr has been the standard of care for many years, but that is changing, especially if there’s only one tumor in the brain. Sometimes surgery is performed and then followed up with targeted radiation (targeted means it just targets the area of the tumor, not the whole brain). Other times a drug like Lapatinib is used because it's supposed to be able to cross the blood-brain barrier, as was mentioned above. I don't know how your insurance works, but are you able to get an appointment directly with a radiologist at one of these hospitals? The radiologist would be able to tell you whether Gamma Knife has been used for brain metastases. T-DM1 doesn't seem right to me in your situation, since I believe you would have to fail several treatments for advanced breast cancer before you could qualify, among other things, like the trastuzumab (Herceptin) molecule doesn't pass through the blood-brain barrier. But some of the ladies on this board who are in that trial would be able to give you better information than I can. Joan __________________ Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!! Last edited by Joan M; 02-06-2011 at 08:17 PM..