Brain MRI results

[GemmaG]

Hello everyone,
I had my Brain MRI last night. My onc called me this afternoon and results showed a tumor! I'm going to see the surgeon next Wednesday.
I've been dizzy for the past few days that's why my onc sent me for MRI.

[Joe]

Surgeon? I would highly recommend a radiation oncologist instead.

Regards
Joe

[StephN]

Oh, Dear Gemma -
Our hearts are with you as you face another tumor.
I know just what that initial shock feels like. Sort of a suspended feeling - like can this really be MY scan?

Hopefully you can have Gamma Knife or Cyberknife if it is just the one spot.
Many of us here have been treated this way and it is a breeze.

Since you are having symptoms with the dizzy spells, you will likely be put on the Dreaded Decadron, if you are not getting it already with the other treatments.

Feel free to ask all the questions you need to. You can beat this one!

[Believe51]

I will be thinking of and praying for you on Wednesday when you meet with the surgeon. Do you know how big it is? I also wanted to remind you that miracles do happen and I am praying real hard for you to receive one yourself!! Hang tough 'ole friend. Sending prayers and a giant hug to you right now. Keep positive and let us know your progress in this matter>>Believe51

[fullofbeans]

Sorry to hear Gemma, I hope that you can get the treatment mentioned above(by joe and steph). However it may not hurt in the meantime to take some boswellia (which is a cheap CAM ingredient) since in some case brain mets was "reversed" yes reversed!..and pray that it works for you too, why not for you too..

all my best wishes in these difficult time


D. F. Flavin1
(1) Foundation for Collaborative Medicine and Research, 24 Midwood Drive, Greenwich, CT 06831, USA
Received: 23 July 2006 Accepted: 11 August 2006 Published online: 26 September 2006
Abstract The complication of multiple brain metastases in breast cancer patients is a life threatening condition with limited success following standard therapies. The arachidonate lipoxygenase pathway appears to play a role in brain tumor growth as well as inhibition of apoptosis in in-vitro studies. The down regulation of these arachidonate lipoxygenase growth stimulating products therefore appeared to be a worthwile consideration for testing in brain metastases not responding to standard therapy. Boswellia serrata, a lipoxygenase inhibitor was applied for this inhibition. Multiple brain metastases were successfully reversed using this method in a breast cancer patient who had not shown improvement after standard therapy. The results suggest a potential new area of therapy for breast cancer patients with brain metastases that may be useful as an adjuvant to our standard therapy.

_______________________________

Boswellic acids and malignant glioma: induction of apoptosis but no modulation of drug sensitivity

T Glaser1, S Winter1, P Groscurth3, H Safayhi2, E-R Sailer2, H P T Ammon2, M Schabet1 and M Weller1

1Laboratory of Molecular Neuro-Oncology, Department of Neurology, 2Department of Pharmacology, Institute of Pharmaceutical Sciences, Hoppe-Seyler-Strasse 3, Tübingen, 72076, Germany

3Department of Anatomy, University of Zürich, Zürich, Switzerland


Steroids are essential for the control of oedema in human malignant glioma patients but may interfere with the efficacy of chemotherapy. Boswellic acids are phytotherapeutic anti-inflammatory agents that may be alternative drugs to corticosteroids in the treatment of cerebral oedema. Here, we report that boswellic acids are cytotoxic to malignant glioma cells at low micromolar concentrations. In-situ DNA end labelling and electron microscopy reveal that boswellic acids induce apoptosis. Boswellic acid-induced apoptosis requires protein, but not RNA synthesis, and is neither associated with free radical formation nor blocked by free radical scavengers. The levels of BAX and BCL-2 proteins remain unaltered during boswellic acid-induced apoptosis. p21 expression is induced by boswellic acids via a p53-independent pathway. Ectopic expression of wild-type p53 also induces p21, and facilitates boswellic acid-induced apoptosis. However, targeted disruption of the p21 genes in colon carcinoma cells enhances rather than decreases boswellic acid toxicity. Ectopic expression of neither BCL-2 nor the caspase inhibitor, CRM-A, is protective. In contrast to steroids, subtoxic concentrations of boswellic acids do not interfere with cancer drug toxicity of glioma cells in acute cytotoxicity or clonogenic cell death assays. Also, in contrast to steroids, boswellic acids synergize with the cytotoxic cytokine, CD95 ligand, in inducing glioma cell apoptosis. This effect is probably mediated by inhibition of RNA synthesis and is not associated with changes of CD95 expression at the cell surface. Further studies in laboratory animals and in human patients are required to determine whether boswellic acids may be a useful adjunct to the medical management of human malignant glioma.


________________
M. Winking1, S. Sarikaya1, A. Rahmanian1, A. Jödicke1 and D.-K. Böker1
(1) Neurosurgical Clinic, Justus-Liebig University Giessen, Giessen, Germany

Abstract Conventional malignant glioma therapy (surgery, radiation therapy and chemotherapy) does not yield satisfying results. The prognosis of the glioma patient depends more on the histological grading of the tumor and patient''s age than on the therapy. Especially the adjuvant chemotherapy failed to date to influence survival time in glioma patients significantly. To improve results in malignant glioma therapy additional therapeutic regimes are necessary. In an earlier study we were able to show a significant reduction on perifocal edema by an extract from gum resin (EGR) accompanied with a clinical improvement in patients with malignant glioma. Also a decrease of urinary LTE4-excretion as a metabolite of leukotriene synthesis in brain tumors was observed. Furthermore we had found a proliferation inhibiting activity of the extract form EGR, the boswellic acids in cell cultures.

The purpose of this experimental study was to elucidate the effects of the boswellic acids, which are constituents of an extract from gum resin on tumor growth in vivo. Female wistar rats weighing 200–250http://www.springerlink.com/content/r1278x2477201157/xxlarge8201.gifg were treated with the drug 14 days after inoculation of C6 tumor cells into their right caudate nucleus and randomization into 4 groups. The treatment groups received different dosages and were compared to a control group without any additional treatment. Survival time of the rats in the highest dosage group (3 × 240http://www.springerlink.com/content/r1278x2477201157/xxlarge8201.gifmg/kg body weight) was more than twice as long as in the control group (P < 0.05).

In a second experiment the inhibition of tumor cell proliferation was examined. The C6 tumor cells were implanted into the caudate nucleus. Drug treatment was started immediately after implantation and stopped after 14 days. The animals were sacrificed and the brains were examined microscopically. Comparing low and high dosage of EGR treatment a significant difference in tumor volume was detected (P < 0.05). The proportion of apoptotic tumor cells in animals with high dose treatment was significantly larger than in the low dose (treatment) group (P < 0.05).

These data demonstrate an influence of EGR in rat glioma growth and might represent a new therapeutic option on glioma treatment in man in future. Further experimental work on human gliomas is needed to definitively answer this question.

[LAURIE]

I am sending a big hug, we are here to support you!!!

[dhealey]

Dear Gemma,
Sending lots of prayers and hugs your way!

[lexigirl]

Dear Gemma,

I am sorry that you are dealing with this. I agree with Steph, you can beat this!

Hugs and Prayers,
Lexi

[Mary Anne in TX]

Oh, rats, Gemma! My prayers and best wishes are with you as you gear up to battle this spot that is trying to upset your peace and serenity. Please check out what is recommended and get The Best possible treatment to get you back to NED. Lots of love and huge hugs I'm sending your way. ma

[Joan M]

Gemma,

I'm sorry to hear of the scan results. A lot of women on this board have had brain mets and would be able to give you guidance.

Since you are in N.J., is it possible to get to the Cancer Institute of New Jersey if even for another opinion? It's near Rutgers University. Also, depending on where Dumont is (I'm not sure) you may have easy access to Philadelphia and New York too.

I'm praying for you.

Best, Joan

[Bill]

I'm sorry to hear about your MRI results, Gemma. You're in my thoughts and prayers. Like Joe said, consult with your radiation oncologist as well. Get a second and third opinion. True, we don't know the details of your tumour, but don't go straight to surgery. Best wishes, Bill

[Becky]

Dr. Lori Goldberg is at Fox Chase Cancer Center and Dr. Keith Fox is at the University of PA. Both are in Philly. Both are only medical oncologists though.

Dr. John Bauman is at the Medical Center at Princeton. He is excellent and has been voted Best Radiation Oncologist in NJ for the last 8 yrs in a row. There is also Cyber and Gamma knife at Overlook Hospital in Summit (I know I can get a name for you there or at Morristown General if you want since I am a volunteer for ACS and these hospitals are in my area).

Ask and you shall receive. Just let me know.

[GemmaG]

Thank you all so much for the love and support. I will see my onc on Friday for my weekly Herceptin/Gemzar. I'll ask why he referred me to the Brain Surgeon first.
He put me on Decadron 4 x day though.
My love to you all!

[Joe]

I found this today on another board:

Regards
Joe

[Faith in Him]

Gemma,

I am so sorry you are having to deal with this. I will keep you in my prayers.

Tonya

[jones7676]

I am sorry that you have to deal with this....I hope that you will see a radiation oncologist and a brain surgeon. There are options out there for you, be sure to check them all out.

[Vi Schorpp]

I'm sorry to hear about your news. Make sure you read the pdf Joe attached and search for more information on the search pull-down screen above. As we all know, knowledge is power. On a personal level just know that we on the board are rooting for you. Take care.

[GemmaG]

Hi Joe, Thank you so much for the info. I read and printed out the pdf info. Thank you all.
BTW, I got a copy of my results and disc. I went to the hospital and pick it up this morning. The report says; 1cm enhancing nodular lesion located within the high left frontal lobe gray-white matter junction associated with localized surrounding T2 prolongation effect-vasogenic edema. Finding compatible with a solitary metastasis.

I'll see my onc tom. I'm losing my voice and my feeling numbness in the tongue. Well, i've been having this numbness in the tongue for a few months now. I think way back in Dec. of last year.

Thank you again for all your love, prayers and support. We're all in this together. I hope to find the cure.

[Sheila]

Gemma
Keeping you in my prayers...please get more than 1 opinion...you are too young. Love the new picture....

[abitjaded]

Gemma,

Bless your heart.

Actually seeing a surgeon is a good sign. Neurosurgeons don't want to see you if they feel they cannot help.

I was sent for surgery first because the tumor was easy to resect. If they can get it through surgery and "mop up" with radiation, why not?? The statistics are better in your favor if they can cut it out first. Makes sense, no?

My tumor was also single, bout 1 cm, but it had a huge cyst that was causing symptoms. Getting your tumor out may get rid of the "long term symptoms" and getting rid of the edema my get rid of the recent problems. My tumor was causing left hand weakness, which is gone, and all my edema was causing all sorts of nutsy things, also gone.

I was terrified when they did my craniotomy, but they got the tumor and all my symptoms went away. I was out of the hospital five days after the surgery.

Started WBRT two weeks later. One month out from the completion of that and I have no obvious symptoms!

If the surgeons can get it and you do not have to have radiation follow up, you can keep (at least most) of your hair!!! I then went to a hairdresser who artfully arranged my hair to cover the shaved areas. So good for your ego.

Carla

[StephN]

Dear Gemma -
Just wondering how the appt with the neuro went.

Often they work in teams that include a radiation oncologist, who you can ask to see if it is not suggested.

With only one tumor you may not need at have WBR. They will follow you up closely on your brain from now on and if anything new does pop up, it will be dealt with in a flash.

You will be in a new followup loop just for your brain.

[lilyecuadorian]

Gemma can you ask your doc about Novalis ???
read this ...
http://www.neurosurgery.ucla.edu/body.cfm?id=408

[karen z]

Gemma,
I am very sorry that you are having to deal with this problem. I agree with others to get more than one opinion and read the information that has been sent along. Please stay strong and know that we are here for you. Please keep us posted as you decide what treatment to pursue.
I loved your last picture as well as your new one. Please know that you are in my thoughts and prayers. Stay strong- you can do what you have to do.
karen

[CindyE]

I will be praying for you and send up many good thoughts. Take care and feel strength knowing many others are here for you as you battle this.

Cindy

[GemmaG]

Hello,
My appointment with the brain surgeon is on the 25th of june and with the radiation onc is on the 26th.
Pls. keep the prayers going.

Lots of love, hugs and kisses,
Gemma

[caya]

Hi Gemma,

Sending prayers from Canada. Please keep us posted after your appointments this week.

all the best
caya

[GemmaG]

Hello everyone,
My appointment with the neurosurgeon today went very well. He was very good and thorough. My sister and my bestfriend came with me and we were armed with questions! He was very impressed with our knowledge, Thanks to Joe! and to all of you here in this heavenly site.
We discussed surgery and WBR;Radiosurgery and WBR.
I will meet with the radiation onc tomorrow and discuss more options.
I think I'm more comfortable with surgery "crani" take the tumor out of my system and do the WBR two weeks later.
I'll also have an appt. for a second opinion on Monday.
OMG! these decadron are keeping me hyper! haah!haah!

Will post more tomorrow about my appointment with radiation onc.

My love and kisses and prayers,
Gemma

[GemmaG]

I've met with the neurosurgeon two days ago. Today I went to see the radiation oncologist. They gave me two options; 1) Whole Brain Radiation (WBR) and RadioSurgery; 2) Surgery and Whole Brain Radiation (WBR).
The radiation onc and the surgeon said both are good options but they're kind of leaning towards the RadioSurgery because it is less invasive. On my part, I'm more comfortable with the surgery craniotomy. I just want the tumor out of my system then do the WBR two weeks later.
I'm so terrified and couldn't make up my mind. I will make a decision tomorrow after my chemotherapy in the morning and get some more opinion from my oncologist.
It's been like a rollercoaster ride for me it makes my head spin non stop! I just want to wake up one day that everything is just a bad dream.
I'm swelling like a balloon. This dreaded Decadron is keeping me up all night.
I'm worried about this brain tumor and I feel like I'm losing the battle. Please keep the prayers going. My kids are too young to lose their mother.

[CindyE]

Gemma,

Thank you for the update. I will be praying for the best treatment possible for your situation. May God provide you strength and courage as you battle this newest tumor. Keep the faith, miracles are possible and God will be with you every step.

Take care,

Cindy

[sassy]

Gemma,

I wish you would wake up tomorrow and find all this a bad dream, but since that most likely will not happen, I will keep you in my thoughts and prayers. We are all with you and will be here whenever you need us.

[Sherryg683]

May God give you the strength and courage to get through all this. I will pray for you. I am so sorry you are having to go through this..sherryg683

[karen z]

Gemma,
Thanks very much for the update. Please know that I am thinking of you and know how difficult the treatment decision is. If you are still undecided, you know that you can get more information and please do that rather than go into something not feeling good about it. Stay strong and remember that we all know that you can do this. Sending up prayers for you today.
karen

[StephN]

Dear Gemma -
From what you have posted about your brain met, I am wondering why they want to proceed with whole brain radiation after radiosurgery at this point???

There is a statistic that I found that has held true for me and others here: If you are HER2 positive, have three or less brain mets that can have Gamma Knife, you have a 91% chance that these will be isolated mets and successfully treated. I had two mets.

That is an older study and you may find newer ones that support not needing WBR for a solitary met.

I was able to wean from the Decadron in three weeks after my Gamma Knife. That stuff really wreaks havoc with a person in many ways!