Brain metastasis - experience with surgery

My wife has metastatic breast cancer (metastasis diagnosed in 2000). Upto now the metastasis has been confined primarily to bones. Last May, she had an MRI done of her brain which showed a lesion but was diagnosed as a benign meningionoma (confirmed by two sets of radiologists). She was complaining of headaches over the last couple of days, so we decided to do a head MRI as a precaution. The 'benign meningionoma' had more than doubled in size (now 4.5 cm x 3 cm x 3cm)and has oedema. They say for a tumour of this size, the only real option is surgery, which obviously scares us to death.
Is there anybody out there who has undergone surgery for brain metastasis? What has your experience been, and what was your post-operative treatment regime? Any advice, suggestions much appreciated.

Regards
Raj

Dear Raj,
I have brain mets, first dx with it Sept '02, almost 17 months ago. Altho I have not had a craniotomy, I have conversed at length with a gal who did.

She said it was not a very difficult nor painful experience for her. I think her tumor was slightly smaller than what your wife has. My friend always said that she was much more afraid to have GammaKnife or Stereotactic Radiosurgery because of the screwed on head frame. I have had three of those procedures and she thought I was the 'brave one'.

Ofcourse, I have always felt just the opposite!!!

Her recovery afterwards was not lengthy nor problematic.

Decadron will probably be an ongoing drug prescribed to your wife for some time because of the edema. For me, that has always been the worst of having brain mets because of the horrible side effects including insomnia. Sleep depravation really wears a person down when combined with everything else, physical and emotional.

It is a travesty that the doctors did not take this more seriously with the first brain MRI. I do believe I would be looking for different doctors now. My faith in the others would be zero at this point.

After your wifes surgery and recovery, I would also be pushing for a stereotactic radiosurgery to eliminate any remaining tumor and holding off on whole brain radiation. If she has had this tumor this long, without developing multiple mets, it would be a hard sell to me justifying the radiation of the whole brain. Even if another 3 small tumors are found with subsequent MRI's any of the focally directed radiation treatments would be sufficient.

Hope this has been of some small help to you both,
pattyz

Dear Raj,

I and my friend both had 3 cm tumors removed from the cellebellum portion of our brains. I was the first to have the craniotomy done and it really wasn't bad. I really didn't suffer much pain with it. Post surgery I had 10 days of Whole brain radiation which made me very tired but other than that not much to write about. My friend who experienced the same headaches that I did then had a mri and found out she had the same tumor but larger. She came through surgery and WBR just as well. Prior to surgery we both were put on Steroids to take down the swelling and also to prevent swelling following surgery and radiation. I think the steroids caused more ill effects than anything. Good luck to your wife and if she wishes to email me directly she can.

Dear Raj,

I and my friend both had 3 cm tumors removed from the cerebellum portion of our brains. I was the first to have the craniotomy done and it really wasn't bad. I really didn't suffer much pain with it. Post surgery I had 10 days of Whole brain radiation which made me very tired but other than that not much to write about. My friend who experienced the same headaches that I did then had a mri and found out she had the same tumor but larger. She came through surgery and WBR just as well. Prior to surgery we both were put on Steroids to take down the swelling and also to prevent swelling following surgery and radiation. I think the steroids caused more ill effects than anything. Good luck to your wife and if she wishes to email me directly she can.

A "benign meningioma" (if that's what it is)is not related to breast cancer, and is not a form of metastases. It is merely a locally growing tumour growth which has no risk of spreading to other parts of the body, and has arisen locally rather than spread from afar. It's adverse effects are secondary to pressure and oedema (e.g. headhache, nausea and vomiting) and other "local effects" from pressure exerted on nearby tissues. It has a much better outcome than breast cancer metastases as long as it is not pressing on vital structures e.g. those that impair automatic functions. Surgical removal, if possible, can improve enjoyment and quality of life, and is not usually associated with serious consequences if in an easily accessible region of the brain. Talk to your doctors about it. Good luck and be relieved that it's not mets.