[Rolepaul]

kaiulanis,
This is a tough situation to be in. As Mario indicated, I think zapping the tumors locally and then introducing the Intrathecal Herceptin is probably the best method to do things. The results have been very promising so far.
I would have your doctor talk to Dr. Amal Melhem-Bertrandt at the Breast Cancer Center for MD Anderson Cancer Center in Houston Texas. There is ongoing work to show that IT Herceptin does remove the tumors in the brain and spine, but only when the Herceptin levels are higher than is being used for the Clinical Trial by Dr. Razier at Northwestern Hospital in Chicago (and Sloan Kettering in New York). I would ask for a Compassionate Use (or Compassionate Care) protocol to be started. This is done by having the doctor go to the Internal Review Board of the hospital. Once it passes there, the doctor goes to the drug company (Genentech/Roche in San Francisco) and they approve it, followed by the insurance company. Typically the IRB is the tough place, as Genentech and the insurance company will both approve this treatment. Start at 40 mg per week for four weeks, then go to 1.3 mg/kg of body weight. This will seem high, but clearing of the drug from the spinal fluid is very quick, with a half life of 36 hours or so. They can then follow the tumors being broken down in MRI scans every four weeks, follow the spinal fluid protein and glucose, and by the symptoms becoming less pronounced (walking, headaches, etc.). Let me know if I can do any more.
Paul