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Dear Pam,
GET that Brain MRI!
First of all, Xeloda, technically speaking is not systemic. It is only supposed to be activated by and changed into 5-FU by tumors. I would be really surprised if it is activated by free-floating micro-mets; so it is not a profilactic treatment.
Second, although the Xeloda (capecitabine) molecule is small enough to cross the blood brain barrier, most HER2 cancers do not respond well to chemo alone; and since herceptin does not cross that BBB, you would not get that double punch effect for brain mets; thus the need for a small molecule like Tykerb.
Conclusion: your onc is only speculating and the only way to be sure is get that brain MRI!
Good luck,
Al
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Primary care-giver to and advocate for Linda, who passed away April 27, 2006.
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