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Hello,
So much depends on the agressiveness of you particular bc, time to recurrance from orig. dx, any other mets ie. controlled, number, non-responding, and overall health and being symptomatic. Then there are the unknowns.
In 2002, after my initial two brain mets were treated with Stereotactic rads, the six month MRI showed an additional 14 brain mets. Those I had treated in small batches over the course of a little more than a year. All done with focalized rads. I am one who has continued to refuse WBR.
At this juncture, I have recurrance of multiple brain mets dx'd in Sept. In the past I was nearly asymptomatic, which was one of the MAIN reasons I was able to deal with the mets this way. These new mets had me dizzy 24/7 with 'tipping over' events.
However, I have been told that any more focalized is not an option because of the overlapping multiple rads. And that WBR is (was) the only option left. But even that would come with even higher risk of permanent damage now....
My onc and I came up with a chemo combo tailored just for me because of the research I've done and shown him. I started Temodar/Xeloda in Sept. and within days I thought my dizziness was lessening. I was right. So, for the past five months I've continued on this combo. My Mri's showed (twice) nearly 50% shrinkage and the last showed stable with no new lesions.
The most problematic mets were on my brainstem/pons and cerrebellum. I've had recurrance in both places, but now they are very very small and stable. But, I really don't know how long I will continue to respond to this tx.
My next step would be to try for the Lapatinib trial.
That said:
If you are symptomatic, as you say, there is reason to act quickly to avoid permanent damage. I would insist on RSR13 efaproxiral in conjunction with the WBR. There have also been studies done using Temodar in smaller doses during the course of WBR. The longer courses using smaller daily fractions are more to my 'liking' if it were me...
Decadron is the 'drug from hell' we all agree, yet it does it's job.... trust me when I say we empathize with you!!
I don't want to over tax you with info, so will end now. Hope this has also given you some supportive info. If more questions, just ask.
pattyz
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