Brain MRI treatment question

[Midwest Alice]

I will have a brain MRI April 21 at M D Anderson. I can expect three different outcomes, clear (which is what I hope and pray for) small mets, or large tumors. I fly down with a friend for three days.

I need to have some kind of idea or time frame on the last two outcomes. If I would have to have gama knife of surgery I think I should come closer to home, St. Louis, Nashville, Louisville. How often do you have to go in to have your treated area looked at after one of these procedures?



I want to see Dr. Cristafanilli every three months and have my treatments (Herception and regular stuff) done here. Otherwise more than three months will get very expensive. But what about big stuff?

This is very confusing. Please anyone with experience that may help me think this through let me know.

[Joe]

Alice,
Treatment will depend on the size and number of tumors, if any. Generally Gamma Knife can treat tumors >3 cm. and usually only if fewer than 6.

Whole Brain Radiation is used if you have many tumors.

I do understand that Cyberknife (http://her2support.org/vbulletin/www.accuray.com)can treat larger tumors.

There are several practitioners of Gamma Knife in the Knoxville area: Centers of Excellence (http://irsa.org/CentersOfExcellence/UnitedStates.html).

You may wish to visit the CNS section of this website for re information: CNS Tumors (http://her2support.org/index.php?option=com_content&task=view&id=44&Itemid=67)

Regards
Joe

[Midwest Alice]

Thanks Joe, I went to these places and found lots of helpful information. Just wanted to come back and tell you thanks.......now back to my research.

[Joan M]

Alice,

I had both surgery and stereotatic radiotherapy.

After the surgery, the sutures were removed in one week. Then it took six weeks of healing before radiation, but there was prep before for the treatment.

Radiation was five doses given over a week's time. However, I needed a brain MRI before that and also to get fitted with a mask that held my head down, and then there were two simulations before the actual treatment, as well. Scheduling for these procedures went on over a few weeks.

My tumor was just short of 3 cms and therefore a little too large for effective radiation treatment alone, according to the surgeon and and radiation oncologist, who suggested that I do both for better control.

But hopefully you will get a clear scan and won't need any of this.

Joan

[jones7676]

I certainly cannot offer you advice - but I hope you find whatever is right if you do have a challenge.

I am hoping you get an all clear!

I too will be checking out additional sites listed by Joe.

Good luck to you and thanks to Joe too.

[hutchibk]

Gamma and Cyber are one visit treatments, I believe. A main difference between the two is that for Gamma, your have a halo screwed into your skull. For Cyber, I believe that you are snapped onto a table in a head frame.

I had treatment for 5 brain mets (ranging in size from 1mm - 10mm) in Sept. My radiation onc preferred to use IMRT (intensity modulated radio-therapy) which worked wonderfully, they have all disappeared. I went in for 5 days in a row and he mapped out a treatment plan that was 19 different angles of beams on each of the 5 spots for five days (with a weekend break between day 3 and 4). Each visit took about 15 minutes. They created a head frame that locked my head and shoulders down to the table keeping me perfectly still.

Best of luck with your MRI... I love Dr. Christofanilli - I have talked to him a couple of times at 3 different conferences. He's top notch.

[Believe51]

Yes, the Gamma is a one day affair and is screwed into your head. Although this does not sound too appealing, it was bearable per Ed. The next few days of healing allows these sites to drain and feel quite numb, with a little headache. Again, bearable. He did need to have WBR since the first set of mets was 'salted' like you sprinkled the shaker over his brain. The WBR worked wonders and allowed us to get rid of the for the most part. Again, he had little choice about this decision and we wished we could have avoided that altogether. The first Gamma he had was for 10 mets all under 9mm but this is not the normal amount. They do like to remain Gammering under 6 mets, 10 is a lot of work but he needed to take those risks. It was a long day for him that time because his spine would not allow him to lay that long consecutively. Ed was there from early morning until very late night, this is not the norm either. For the most part, the second Gamma went well and rather quickly with his 5 mets, home by 6pm. There were 5, of them 3 were new, one might have been a met and the 5th was a previous met the doctor thought was 'angry' (still laughing at that). Both Gamma's were productive in producing the results we needed. The worst part of much of this was the reactions to the Decadron.

As a caregiver, witnessing both procedures, I felt comfortable with the research done, the GammaMan himself, but especially the results. This is a very scary thing to hear the words 'brain' and 'radiation' in the same sentence. In fact, it stinks!! In your situation the same will hold true. You will working with a respected and top notch doctor/facility. You are doing your research, gathering knowledge and ammo. I have complete confidence that things will work out wonderfully for you, Alice. You are always in my prayers and I embrace you as you move forward with your quest.

Keep your spirits up and remember you are not alone. We are following right by your side and will see you through this. I have faith that whatever you chose it will be the best solution for you. Most of these brain procedures produce miraculous results for many. And please note....the brain is an amazing organ. It is strong and vibrant, responds well to radiation and heals great! Whatever you chose it will be a decision that was well thought out.

Saying a special prayer for you right now. I am also sending positive healing thoughts your way. Be confident in the doctor, procedure of choice and your final decision. Things will work out from there. It will all fit together like a puzzle.>>Believe51