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Joan M · 03-31-2011, 09:08 PM

Rick,

It seems that your wife has already started the treatment process with WBR, if I'm reading your post correctly. I would agree on a second opinion for follow up, as the WBR was just the beginning of the process to keep your wife's brain mets under control.

As mentioned, several chemo drugs do cross the BBB like Xeloda and Temodar, as well as the targeted antibody Tykerb (similar to Herceptin), which attacks HER2+ breast cancer via a pathway different from Herceptin.

Your wife can be given a combination of these drugs, and I would also ask the doctors whether she can take Herceptin again and possibly a combination of Herceptin and Tykerb. Studies have shown that the combination works well, even though it seems that some doctors are reluctant to give these two drugs together. So, the WBR is not the only treatment for brain mets.

It's also important to find out whether you wife has mets anywhere else, as this will affect a doctor's choice of drugs and drug combinations.

As Chrissy mentioned, if all the mets do not go away or if some of them come back after the WBR, your wife has other options with targeted radiation treatments to zap individual mets.

I had one brain met. It was 2.6 cm and treated with surgery and then 5 shots of IMRT. That was in October 2008.

I'm wishing your wife success in her treatments. Keep the faith. There are other options.

Joan

03-31-2011, 09:08 PM	#9
Joan M Senior Member Join Date: Oct 2007 Posts: 1,851	Re: Brain Mets Rick, It seems that your wife has already started the treatment process with WBR, if I'm reading your post correctly. I would agree on a second opinion for follow up, as the WBR was just the beginning of the process to keep your wife's brain mets under control. As mentioned, several chemo drugs do cross the BBB like Xeloda and Temodar, as well as the targeted antibody Tykerb (similar to Herceptin), which attacks HER2+ breast cancer via a pathway different from Herceptin. Your wife can be given a combination of these drugs, and I would also ask the doctors whether she can take Herceptin again and possibly a combination of Herceptin and Tykerb. Studies have shown that the combination works well, even though it seems that some doctors are reluctant to give these two drugs together. So, the WBR is not the only treatment for brain mets. It's also important to find out whether you wife has mets anywhere else, as this will affect a doctor's choice of drugs and drug combinations. As Chrissy mentioned, if all the mets do not go away or if some of them come back after the WBR, your wife has other options with targeted radiation treatments to zap individual mets. I had one brain met. It was 2.6 cm and treated with surgery and then 5 shots of IMRT. That was in October 2008. I'm wishing your wife success in her treatments. Keep the faith. There are other options. 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!!