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Joan M · 10-06-2008, 08:06 PM

Hi Barbara,

Thanks for your response. I hadn't realized that you have also had a brain met.

The surgeon I consulted with also said that the surgery would not be difficult. She said it's in a good place. Also, she uses MRI imaging for guidance. That is, dots are placed on my forehead and I go through the MRI scanner and the resulting image maps out the best route of the surgery. Ahe also said that I could probably go back to work in two weeks if I wanted to.

I had sent a few PMs to HER2+ sisters (and brothers, and husbands of survivors) who I know have had or are dealing with brain mets.

I want to share their responses:

From Joe:

Although you are still a candidate for Gamma Knife.

You should look into fractionated radio surgery or Cyberknife. Both of these treat the tumor over several sessions and can treat larger tumors.
I would seek other opinions.

http://www.irsa.org/CentersOfExcellence/NewYork.html

From Brenda:

All of mine (5 of them) were considered in 'good spots' I suppose. That could be because none of them had any swelling around them and the largest one was 10mm - so it could just be that they weren't big enough to 'threaten' anything congnitively or motor- skills-wise.

That said, none of mine were in 'great spots' for surgery, but then due to the size of them, that wasn't a necessary consideration anyway.

I hope this helps. Also, I did IMRT treatment as opposed to Stereotactic, Cyber or Gamma.

From Flori: Flori said her tumor was small, only 13 mm.
___________________________________

I'm due to meet with the rads onc tomorrow. I believe they also use IMRT, as Brenda notes, a micro multileaf collimator system. And, Joe, thanks for reminding me about being able to use a fractionated treatment for larger tumors.

Joan

10-06-2008, 08:06 PM	#3
Joan M Senior Member Join Date: Oct 2007 Posts: 1,851	Hi Barbara, Thanks for your response. I hadn't realized that you have also had a brain met. The surgeon I consulted with also said that the surgery would not be difficult. She said it's in a good place. Also, she uses MRI imaging for guidance. That is, dots are placed on my forehead and I go through the MRI scanner and the resulting image maps out the best route of the surgery. Ahe also said that I could probably go back to work in two weeks if I wanted to. I had sent a few PMs to HER2+ sisters (and brothers, and husbands of survivors) who I know have had or are dealing with brain mets. I want to share their responses: From Joe: Although you are still a candidate for Gamma Knife. You should look into fractionated radio surgery or Cyberknife. Both of these treat the tumor over several sessions and can treat larger tumors. I would seek other opinions. http://www.irsa.org/CentersOfExcellence/NewYork.html From Brenda: All of mine (5 of them) were considered in 'good spots' I suppose. That could be because none of them had any swelling around them and the largest one was 10mm - so it could just be that they weren't big enough to 'threaten' anything congnitively or motor- skills-wise. That said, none of mine were in 'great spots' for surgery, but then due to the size of them, that wasn't a necessary consideration anyway. I hope this helps. Also, I did IMRT treatment as opposed to Stereotactic, Cyber or Gamma. From Flori: Flori said her tumor was small, only 13 mm. ___________________________________ I'm due to meet with the rads onc tomorrow. I believe they also use IMRT, as Brenda notes, a micro multileaf collimator system. And, Joe, thanks for reminding me about being able to use a fractionated treatment for larger tumors. Joan __________________ Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!! Last edited by Joan M; 10-06-2008 at 08:14 PM..