[hutchibk]

Don't know if you have access to Tykerb down under yet, but if so, perhaps consider making a systemic change first, before radiation. That's what I did. I had 5 small mets and multiple punctates (pin prick sized seeds). We switched my treatment to Tykerb/Xeloda when I was dxed w/ my brain mets, and made a commitment to MRI every month for a few months to see what results we would get. My brain mets resolved and "went to sleep" for about 18 months with that treatment alone. Four of them decided to wake back up 18 months later, but the multiple punctates were wiped out by the Tykerb, so we then did IMRT targeted radiotherapy (similar to Gamma and Cyber, but my radiation onc likes it better having worked with all of them). It was 5 consecutive days of high dose targeted radiation and ZAP, they were gone never to be heard from again, except for the 5th rogue one which woke up a year later (last summer), which we zapped, now gone... I get a brain MRI every 4-6 months and all has been staying clear. We call it the whack-a-mole method. I am still on Tykerb, now with Herceptin and tamoxifen.

I chose this particular path in partnership and very close consultation of my oncologist and radiation oncologist working hand in hand. I was my onc's first patient on Tykerb, but he is sensitive to the desire to avoid WBR if possible... and I wanted to avoid WBR at all costs, if possible. I am THRILLED with the results to this point and wonder if other oncs have offered their patients this path as an option?