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Sandy in Silicon Valley · 10-20-2007, 08:42 AM

Hi, Debbie -

Depending on what the brain MRI today shows, if the two spots that showed on the CT scan are indicated on the brain MRI, you'll likely be given the option of SRS (stereotactic radiation surgery: GammaKnife, CyberKnife, XKnife, Novalis).

SRS is very easy and non-invasive - one or two out-patient sessions, maybe an hour each. They involve sending very low-rads beams, computer-guided, aimed at the spots from numerous places around your head, which are too weak to cause any damage to your skin or healthy brain cells on the way in, but when they all meet at the spot, they zap/fry whatever cancer cells are there.

I've had 3 different CyberKnife procedures, and they were all easy. The MRI itself is noisy and enclosed - I don't happen to suffer from claustrophobia, so only the noise & staying still bothers me, and I take an Ativan beforehand. Some of the SRS treatments require a mask that is "bolted" to your head to keep you still during the procedure - and I've heard that the bolts can leave temporary dents and a pressure headache - nothing too serious. CyberKnife involves a foam mesh mask that is custom-made for each patient, and snaps onto a neck pad - no bolts, no headache.

If SRS is in the cards for you, you might want to ask your onc about going on Tykerb (Lapatinib) - a dual kinase inhibitor that patients on Herceptin are eligible to take - its advantage is that it is a small molecule, and considered to be able to pass through the BBB (blood-brain barrier). It also goes to the CENTER of the cancer cells, rather than the outside membrane, as Herceptin does. I've been taking Tykerb, along with Herceptin, since July 1 of this year. I have experienced some side effects - diarrhea and an acne-like rash and itching, but if it works to prevent further brain mets from developing, I consider it well-worth the side effects.

Hoping that the brain MRI does not indicate bc brain mets, but if it does - about 25-30% of HER2neu+++ patients develop brain mets, and they are quite treatable.

(((hugs)))
Sandy in Silicon Valley

10-20-2007, 08:42 AM	#7
Sandy in Silicon Valley Senior Member Join Date: Aug 2007 Location: Silicon Valley, CA Posts: 76	brain scan results will determine next step Hi, Debbie - Depending on what the brain MRI today shows, if the two spots that showed on the CT scan are indicated on the brain MRI, you'll likely be given the option of SRS (stereotactic radiation surgery: GammaKnife, CyberKnife, XKnife, Novalis). SRS is very easy and non-invasive - one or two out-patient sessions, maybe an hour each. They involve sending very low-rads beams, computer-guided, aimed at the spots from numerous places around your head, which are too weak to cause any damage to your skin or healthy brain cells on the way in, but when they all meet at the spot, they zap/fry whatever cancer cells are there. I've had 3 different CyberKnife procedures, and they were all easy. The MRI itself is noisy and enclosed - I don't happen to suffer from claustrophobia, so only the noise & staying still bothers me, and I take an Ativan beforehand. Some of the SRS treatments require a mask that is "bolted" to your head to keep you still during the procedure - and I've heard that the bolts can leave temporary dents and a pressure headache - nothing too serious. CyberKnife involves a foam mesh mask that is custom-made for each patient, and snaps onto a neck pad - no bolts, no headache. If SRS is in the cards for you, you might want to ask your onc about going on Tykerb (Lapatinib) - a dual kinase inhibitor that patients on Herceptin are eligible to take - its advantage is that it is a small molecule, and considered to be able to pass through the BBB (blood-brain barrier). It also goes to the CENTER of the cancer cells, rather than the outside membrane, as Herceptin does. I've been taking Tykerb, along with Herceptin, since July 1 of this year. I have experienced some side effects - diarrhea and an acne-like rash and itching, but if it works to prevent further brain mets from developing, I consider it well-worth the side effects. Hoping that the brain MRI does not indicate bc brain mets, but if it does - about 25-30% of HER2neu+++ patients develop brain mets, and they are quite treatable. (((hugs))) Sandy in Silicon Valley __________________ 1992 - age 44/ ER-/PR+ Stage II dx - mastectomy, CAF x 6 cycles; Tamoxifen 1997 - BRCA1 mutation dx'd 1998 - ovaries removed 1999 - off Tamoxifen, on Arimidex 2003 - dx'd Stage IV - lymph nodes & lungs. ER-/PR-/HER2neu+++. Tx: Herceptin & Taxotere (6 cycles). 2005 - 2.9cm x 3.6cm brain tumor. Craniotomy, CyberKnife. 9 mo. staph aureus infection at incision site - 2nd craniotomy. Two small brain mets CyberKnife'd. 2006 - revisit Xeloda - dosage lowered to 2500mg/day, 5 cycles. 2007 - "spot" dx'd on qtrly brain MRI - same location as CyberKnife 7/05. > by 2-4mm per quarter - - radiation injury or re-growing cancer? Tykerb added to Herceptin - July, still "watching & waiting". Otherwise, fully functional... "The majority of people are not only afraid of holding a wrong opinion, they are afraid of holding an opinion alone." Kierkegaard