[agness]

I was told SRS 4-6 weeks post resection, to let things heal first. You need to do planning at least a week or so before. I waited until week 7 to start since I had guests visiting at 6 weeks and my kids were back at school by then.

Do you know what her brain lesion was like consistency or vascular-wise?

Like you, I wanted to save WBT for later since it is known to affect cognitive function. That recent study from this year on the Fred Hutch site says multiple SRS is a great way to manage brain mets.

My neuro-onc wanted me back on Herceptin, and suggested using a lumbar puncture to see if the drug was getting in through the BBB. I've done two lumbar punctures now, one week apart, looking for circulating tumor cells or evidence of Leptomeningeal invasion (LMC) but so far all clear. I'm not on any targeted therapies right now.

I'm thinking of delaying my third lumbar puncture for some weeks as it isn't showing anything useful right now. Statistically the odds are high for LMC. Empirically we know that my cancer responded with a PCR to systemic TCHP. Adjuvant Herceptin was hard on my system ultimately, giving me migraines (never had before tx) and causing my limbs to ache day and night, though no evidence of heart damage. I would rather do aggressive monitoring and then jump on it at the first sign of spread with Intrathecal therapy and consecutive systemic therapy to try to knock it out completely.

They just don't know anything and the odds are awful for central nervous system mets but they keep dishing out the same crap and expecting different results -- that's a sign of insanity, right?

[I got 5 LINAC frameless SRS treatments, about 2 weeks later I started shedding from the treated area]

I hope this is helpful.