[hutchibk]

I am stage IV for 6.5 years and have never had a brain met symptom. That said, I have had a total of 12 puntates (meaning pin prick size) and 6 brain spots (3-8mm) that were spread around in places that were not symptomatic. We were doing brain MRIs about once every 18 months until we saw nothing on CT/body scans but my tumor markers were going up. (I am one of those who is very sensitive to TMs, they have always told us where the new and small activity is).

So, with increasing TMs, we MRIed the brain, and found all these spots in 2007. It was 3 weeks after Tykerb had come on to the market. I eschewed WBR and tried Tykerb/Xeloda straight away with blessing of my Onc and Rads Onc, with the understanding that I would MRI again closely at one month intervals. After 3 months we could see that the Tykerb/Xeloda combination was working for me, so we let it do it's work. It made all the punctates go away and the 6 small tumors went to sleep entirely for 18 months. When the 6 small tumors woke up, we went straight away into high dose IMRT radiation "whack-a-mole" treatment which targeted each individual one (not WBR), and we have been able to remain clear since 2008. We monitor my brain right now with 3 month MRIs. (partially because outside of the brain (not a brain met) but in the boney skull, I have also had a spot show up behind my pituitary gland, and it has been IMRT high dose radiated also).

Had we waited until I was symptomatic, it would have been too late we are pretty sure.

So I am a proponent of regular MRI scanning... I cannot say how often for you, but in my case, my Onc was always very very mindful of the potential.