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Old 08-09-2007, 10:21 PM   #1
tousled1
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Smile CyberKnife Consult

Well, I had my CyberKnife consult yesterday but was too tired to post about it. Today I had my chemo treatment so I think I'm running high on the Decadron premed so please bear with me as I may ramble and skip around. Also my hemoglobin was down to 9.9 so I was barely functioning. I got a Procrit shot today so I'm ready and rearing to go.

At any rate The luck of the Irish is back with me and also I have Brenda's brain met guardian angel on loan for now. I will return it to her soon. I met with radiation oncologist Mark McLaughlin Wednesday afternoon. He's so good looking, as sweet as the day is long, caring, empathic and has great bed side manner, takes his time, explains everything in great detail. He's just the greatest. What more can I ask for? He did my radiation after my bilateral mastectomy. I'm so lucky to have him on my team. Actually, I'm lucky I have the entire team I do. They are moving fast on this brain met and of course my lung mets.

Dr Mark explained to me that the reason the ctscan only showed one blip was that a regular ct takes slices (pictures) every 5mm so my brain met showed up on only one image. Hence the need for the MRI. Also, he told me that if the brain met had been any smaller it would not have showed up at all and I would have had to wait until I developed symtoms in about 8-9 months. The location of the met would affect my left side - control of the leg in particular.

Next step is to get authorization from my insurance and then a consult with a neurosurgeon and then get fitted with the special face mask and then get the CyberKnife procedure. Also I will get another scan done but this one will take slices every mm as the CyberKnife is accurate to within a mm. Dr Mark said that with the mm slices it may show more mets in the brain but they would be extremely small and also could be taken care of by CyberKnife. He siad that all this including the CyberKnife procedure should be done within the next two weeks. The good thing is that I can continue with my regular chemo during the entire process. Also due to the size of the brain met I will only require one treatment. More treatments if by chance they find additional brain mets, which I don't think they will. Gotta keep that positive attitude going.

My next lucky break is that Wellstar Kennestone in GA has the CyberKnife. It's the only facility in GA that has it. Before the CyberKnife you had to have the GammaKnife or Whole Brain Radiation. So you see the luck of the Irish is holding out here. I'll be happy to pass it on once I'm done with it to anyone who needs it. An Kennestone is only a 10 minute drive from my home-- can't beat that and my cancer treatment center is right next door.

All in all the consult went very weel and I am happy with everything. Now all I want is for things to move along quickly which I'm sure they will.

I want to again thank each and everyone of you for your wonderful support while I'm going through all this. I really, truly appreciate the support and encouragement, experiences and just knowing that you are here for me. It means the world to me.. I couldn't get through all this without your amazing help. You are the greatest and I thank you from the bottom of my heart, I really do. I also wish nothing but the best for all of you. together we can fight this fight and get NED. That could be our theme - Let's get NED!

As things get lined up I promise I will keep you informed. thanks again for being here for me.
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Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 08-10-2007, 01:01 AM   #2
Chelee
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Kate, This Dr. Mark sounds awesome. I wish I had a onc like that. Sounds like he has a great plan....one I would feel very confident with. I'm so impressed on how fast they are moving on this...you are in very GOOD HANDS. That is also great to hear how early they caught this met...tiny little thing...easier to blast it and send it out to the twilight zone.

What is really GREAT news is ONLY ONE trt! I'm glad you have such an awesome team that you can trust and count on. It sounds like things are falling into place nicely considering the circumstances. I wish this wasn't happening to you and that you didn't have to go through all this...but at least you can continue on your chemo and you don't have far to go for trt...thats a major plus. You just hang in there and know that we are all here for you. I have been keeping you in my thoughts & prayers. With the attitude you have and that wonderful onc its certainly a winning combination. NED is just around that corner.

Sending lots of positive thoughts your way.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 08-10-2007, 03:37 AM   #3
Mary Anne in TX
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Good Morning Kate!
A million hoorays for your Irish luck! It was so good to wake and find your message and to know, most of all, that you are in such great hands! It matters so much who takes care of us. You hang on to that Irish luck for the next couple of weeks as you walk through this experience. Oh, yes, and carry along all the well wishes and prayers from your Her2 family!
luv, ma
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MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 08-10-2007, 04:35 AM   #4
Joe
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Cyberknife and Gamma Knife are basicly the same procedure.

Regards
Joe
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Old 08-10-2007, 07:18 AM   #5
pattyz
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Joe,

While the radiation focally given may be basically the 'same', the experience is VERY DIFFERENT.

Three times I had Linear Accelerator screwed on headframes, (more similar to the Gamma Knife) ,waiting all day from 7am to done at 6pm, with the headframe on, taking pain meds when the 'pin sites' became painful, trying to drink or eat anything with that huge frame on head, trying to 'rest' or get 'comfortable', getting the headframe removed being very painful in itself, the excruciating headache for two hrs after each of the three procedures........

Compared to CyberKnife. Less than an hour to make the mask. Seconds with hot mesh on face.

In at 10:30am, mask tightly fastened down on table, tight on face, an hour for multiple sites treated, out the door at noon. I did this twice, two days apart to address six brain mets.

So, for me personally... I would never say that CyberKnife and Gamma Knife are basically the same procedure. Not even close.

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Old 08-10-2007, 08:32 AM   #6
Mary Jo
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Kate, Kate, Kate.............

YOU are awesome! Truly. An inspiration to us all. Your strength, determination and overall PEACE radiate from your posts.

I thank God for you here and also pray His CONTINUED presence in all you are going through. Of course I know He is and will CONTINUALLY be with you so, I thank Him right now for that.

Take care today - rest easy!!!!!

Sending all my love and prayers,

Mary Jo
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"Be still and know that I am God." Psalm 46:10

Dx. 6/24/05 age 45 Right Breast IDC
ER/PR. Neg., - Her2+++
RB Mast. - 7/28/05 - 4 cm. tumor
Margins clear - 1 microscopic cell 1 sent. node
No Vasucular Invasion
4 DD A/C - 4 DD Taxol & Herceptin
1 full year of Herceptin received every 3 weeks
28 rads
prophylactic Mast. 3/2/06

17 Years NED

<>< Romans 8:28
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Old 08-10-2007, 09:02 AM   #7
lilyecuadorian
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Wink

thanks for let us know ...everything , I'm checking everyday your post .... cyberknife and novelis ...are almost the same and the diferent with gammaknife ...is #1 is more precise and acurate and more fast ....and there using only five years ago ...gammaknife is being used it for 20 years ago so far ....I have novelis presedure twice and is really easy like cyberknife ......good luck and like my doctor said ...let hope this is the last one ......and like I say let's put this on GOD hands .....He will do it ...for you
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Lily
Diag April/06 5 months after give birth my son Max
stage IV mets on liver (5 tumors) 38 year old,
her2+++ and ER+PR+ from32 nodes 4 positives
mastectomy right breast chemo before surgery herceptin/carboplatin/taxotere ,clear and surgery have radiation 20, `& then herceptin and tamoxifen
NED until Aug/07 body only then 'n June 04-06-07 .1 lesion of 1.6 cm on cerebellum ...novalis ,open sugery
5m.m brain met again novalis, 4mm.In the liver. Waiting 2 months now 3 tumors enroll on T-MCC trial start first infusion Nov 5/07 at Dec 17 scan show one tumor despair the 2nd and 3th diminish Doc said great results until March/08 ct scan show progression
03-05-08 start tykerb & xeloda
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Old 08-10-2007, 10:11 AM   #8
chrisy
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Well, Kate, is that the decadron talking or do you have a crush on the fabulous Dr. Mark??? He sounds terrific - I'm so glad you have such a competent AND delightful team! Sounds like you and your team are very much on top of things. You are such a strong spirit - I so admire your diligence on this.

Take care
Chris
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Chris in Scotts Valley
June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 08-10-2007, 10:14 AM   #9
Joe
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Patty,

Christine had Gamma Knife 3 times and all took less than 3 1/2 hours.

Lily,

Gamma Knife has been used for 20 years but the features on the machines are constantly being upgraded and is comparable to Cyberknife.

I am not advocating one over the other but wanted to point out that they both use the same technology


Competition to treat benign and malignant brain lesions, vascular malformations, and functional conditions with stereotactic radiosurgery (SRS) has increased dramatically in recent years. All-in-one systems like the Accuray CyberKnife® are aggressively positioning themselves as being comparable to the Leksell Gamma Knife® in effectiveness and efficiency.

Gamma Knife stereotactic radiosurgery is the gold standard for the treatment of intracranial SRS procedures. Its clinical efficacy has been documented across nearly four decades, with more than 350,000 cases treated worldwide providing the data for 2,000+ publications in peer-reviewed medical literature. It is used as the performance metric against which other technologies (such as the Accuray CyberKnife®) are measured. Gamma Knife® has the most accurate dose planning, the most conformal treatment and lowest dose of radiation to normal tissue.

What is critical is the difference in dose outside the target for Gamma Knife® compared to the Accuray CyberKnife®.

Perhaps the easiest way is to compare, point for point, the Gamma Knife® with the Accuray CyberKnife®.


<TABLE id=table37 style="BORDER-LEFT-WIDTH: 0px; BORDER-RIGHT-WIDTH: 0px" borderColor=#254b72 cellSpacing=0 cellPadding=6 width="100%" border=1><TBODY><TR><TH vAlign=top width="50%" bgColor=#cccccc>Gamma Knife®

</TH><TH vAlign=top align=left width="50%" bgColor=#cccccc>Accuray CyberKnife®

</TH></TR><TR><TD style="BORDER-RIGHT: medium none; BORDER-LEFT: medium none" vAlign=top align=left width="50%" height=9></TD><TD style="BORDER-RIGHT: medium none; BORDER-LEFT: medium none" vAlign=top align=left width="50%" height=9></TD></TR><TR><TD vAlign=top align=left width="50%" bgColor=#e1f0fd height=77>201 source cobalt unit designed exclusively for non-invasive brain surgery</TD><TD vAlign=top align=left width="50%" bgColor=#e1f0fd height=77>Single source linear accelerator with robotic arm to compensate for patient movement during treatment; not exclusively used for intracranial SRS</TD></TR><TR><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Radiological accuracy better than 0.3mm</TD><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>1 mm accuracy; dose outside the target area is 2-6x greater than with the Gamma Knife®</TD></TR><TR><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Rigid immobilization to prevent head movement using a lightweight stereotactic head frame fixed to the outer skull. Provides exact MR and CT correlation from planning to treatment delivery in 3D</TD><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Non-rigid immobilization reduces head movement by using a thermoplastic face mask that is shrink-wrapped to the table during treatment. Provides relative MR and CT correlation from planning to treatment delivery in 3D. The Accuray CyberKnife® is inherently less accurate since the positioning is optically guided, not head-frame based</TD></TR><TR><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Treatment delivered during one session</TD><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Single or multiple treatments, possibly over a period of days</TD></TR><TR><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Target position is confirmed 10 times per second</TD><TD vAlign=top align=left width="50%" bgColor=#e1f0fd>Target position confirmed once every 10 seconds</TD></TR></TBODY></TABLE>
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Old 08-10-2007, 01:07 PM   #10
lilyecuadorian
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Post

Thanks for all the INF.
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Lily
Diag April/06 5 months after give birth my son Max
stage IV mets on liver (5 tumors) 38 year old,
her2+++ and ER+PR+ from32 nodes 4 positives
mastectomy right breast chemo before surgery herceptin/carboplatin/taxotere ,clear and surgery have radiation 20, `& then herceptin and tamoxifen
NED until Aug/07 body only then 'n June 04-06-07 .1 lesion of 1.6 cm on cerebellum ...novalis ,open sugery
5m.m brain met again novalis, 4mm.In the liver. Waiting 2 months now 3 tumors enroll on T-MCC trial start first infusion Nov 5/07 at Dec 17 scan show one tumor despair the 2nd and 3th diminish Doc said great results until March/08 ct scan show progression
03-05-08 start tykerb & xeloda
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Old 08-10-2007, 03:13 PM   #11
tricia keegan
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Smile

Kate you're being such a brave lady and have such a positive attitude through all this I really admire you and want to wish you ALL the luck of the Irish!!
(Hey you can never have too much of a good thing especially luck!)
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Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 08-10-2007, 10:16 PM   #12
Catherine
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Kate, Yeah, I kind of thought you were getting a crush on Dr. Mark also. Why not. We all love caring and thorough doctors, and if they are male and good looking all the better.

You are a brave one and we are all behind you.

Luck of the Irish, I have an eighth in me...and I will send my portion on to Georgia to add to your collection.

Catherine
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Catherine


Found my own lump in the shower
April 2006 at the age of 58
Stage IIB, ER- PR- HER2+++ multi focal tumors, largest 2.3cm
Chemo first: AC/Taxol over 16 weeks
Bilateral mastectomy Sep 06
33 rads after the surgery
1 year of Herceptin completed Dec 07
15 years and no recurrence as of April 2021
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Old 08-11-2007, 07:10 AM   #13
doh2pa
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Hi Kate,

I've been thinking of you so much this week, wondering how it is all going. I'm so glad you feel comfortable with cute Dr. Mark! He sounds like a gem. It is so much better when you can see the road ahead and know there is a plan of attack. And attack it is!! So many on this site have done so well before you, I know you will too.

Hang in there,
Donna
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Donna
Diagnosed 2/04 - Invasive ductal - no clean margins
node negative - er+pr+, her2++
Mastectomy 4/04 - 4 rounds AC
9/05 - mets to liver treated with carbo/ixabipelone/herceptin
3/06 - complete remission
9/06 - new liver mets, starting Taxotere/Herceptin
1/07 -Liver mets stable, staying on Herceptin
5/07 - Liver, lung progression - starting T/X
12/07 - Liver, lung progression - starting weekly Navilbene/Herceptin
4/08 - Liver progression - started Abraxane, Carbo, Tykerb and Herceptin
7/08 - Liver Progression - started Gemzar, Avastin and Tykerb
10/08 - Liver progression - starting Doxil
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Old 08-11-2007, 03:09 PM   #14
dorinda
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Kate, Sounds Like You Have A Great Team Over Seeing This Ordeal . It Does Make It Awee Bit Peaceful. A Wee Bit Of Irish Talk For You Lassie. Ha! I To Have Alittle Irish In My Hertiage And I Will Loan It To You Also. I Am Praying For You And I Know All Will Go Well. I Hope The Taxol Treatments Are Not To Bad For You. I Dont Take The Carpolatin (sp.) But The Taxol And Herceptine Are Bearable For Me. Take Care Dorinda
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nov 2006 dx. with bc. 3 tumors removed from left breast lumpectomy done. her2 postive er+pr-. scans showed extensive spine mets(to many to count) ,3 tumors on left rib,one tumor on skull and 3 tumors on liver. stage IV from get go. dec.2006 started chemo taxol and herceptine wkly. zometa monthly. rescanned in march 2007, liver tumors shrinking a little. bones to early to tell but pain is gone in my back. rescanned in june 2007. liver mets gone, bone scan looking better but still alot in my spine. still on taxol and herceptine. zometa monthly. rescanned in august due to ca 2729 going up. liver still good , mets in ribs and skull gone but multiple areas still on lumbar and sacrum. mri of brain august 07 negative for mets.I AM BELIEVLING GOD FOR MY HEALING.
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Old 08-12-2007, 09:59 AM   #15
Kim in CA
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Kate,

So glad to hear you are moving right along on getting rid of this sneaky little met. I feel it's soooo important to get after them when they are small. We are truly lucky to be living in a time where we have this technology available. You go girl!

Kim
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Diag. Feb 1997 4.5cm IDC <10%ER+, PR-. 5 out of 36 nodes +. Mastectomy followed by 3 rounds Adriamycin/Cytoxin.


5/1997 Hi Dose Chemo w/ Stem cell rescue. Spent 4 weeks in isolation ward. Then 6 weeks radiation.

9/2001 widespread mets to liver. 8 mos Taxotere/Herceptin brought me almost to NED. Stop Taxotere & add Femara .

11/2002 liver resection to remove spot that turned out to be necrosis. Officially NED!

7/2003 Tumor markers rising add Xeloda Disastrous reaction, 8 days hospital, but tumor markers came back to normal!

June -Dec 2004 UW Vaccine Trial.

7/2005 MRI single 11mm brain met
8/2005 Gamma Knife.

Brain MRI @3 months NED!

2006-2011 brain/body still NED

8/04/11 Taking Herceptin break, will monitor with tumor markers.

6/20/12 Tumor markers begin to rise. CA15-3 is 31.3 and Her2 Serum is at 17.1 Decide to repeat in one month.

7/23/12 CA15-3 now 49.3
Her2 Serum 26.8

8/6/12 Back on Herceptin
CA15-3 now 76
Her2 Serum now 49

11/7/12 Add weekly Taxotere for 4 cycles

2/2013 Stopped Taxotere added Perjeta. MRI shows approx. 50% reduction liver mets. CA15-3 still elevated @ 55. Will continue on just Herceptin & Perjeta.

November 2014 Continuing on Herceptin, Perjeta, and
Femara indefinitely. Guess I'm NED again, but watching those tumor markers carefully!

Dec. 2015 PET scan reveals mass in perirectal area of abdomen.biopsy confirms. Still Her2+, but no longer ER+. Bye bye Femara

Jan 2016 Begin Kadcyla

March 2016 PET scan shows tumor now barely visible, still NED everywhere else.
2016/2017 continue Kadcyla

November 2017 brain MRI reveals small focus of T2 hyperintensity with possible 4mm enhancing nodule. Short term follow up MRI suggested. Stay tuned...
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Old 08-12-2007, 01:12 PM   #16
Jean
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Kate,
So glad your with Dr. Dreamy! It sounds like you and Dr. Mark have
everything under control...I like that!

Sending you lots of love and prayers for easy treatments days.

Hugs,
Jean
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Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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Old 08-12-2007, 02:54 PM   #17
Shell
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Kate-

Thank you so much for taking the time to post - I've just finished with the WBR (too many for gamma knofe for me...) so I'm doing the decadron taper currently.

Your doctor sounds phenomenal and I am glad he took the time with you...

Kind regards,
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init diag 3/17/03-stage IIIC
ER-/PR-/HER2+++
CET x4 neo-adjuvant
lump & SNB 8/03
CET x2
radiation and herceptin/navelbine 11-03-1/04
1st reoccur to lymph nodes 8/04
complete axillary dissection 12/04
herceptin/taxotere til progression (lungs) 3/05
xeloda w/out lapatinib trial 6/05
lapatinib/tykerb added 4/06
ended trial 8/06 due to progression
doxil / avastin 11/06-12/06 - wasn't working
navelbine/herceptin/avastin 12/06/3/07 - progression
gemzar/carboplatin/tykerb 4/07
mri shows extensive mets to bone in pelvic area 6/07
switched to abraxane (3 on/1 off) + tykerb 6/07
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