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Old 06-09-2007, 11:32 AM   #21
pattyz
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Lu ann,

I was and have remained of the same opinion for myself: No WBR!

With my second dx of brain mets (six months after the first two were treated with SRS) there were 14 newbies scattered throughout my brain. In cerrebellum as well as one on my pon/brainstem.

I was lucky in that all were under 1cm and I remained nearly asymptomatic. My choice was for a series of focalized rad tx's. We treated in batches of 4 twice. Going after the largest, most potentially dangerous, first.

The final six were done with two CyberKnife tx a few days apart.

This was over the course of a year+! So, depending on the size of yours and locations, and nerve! you could do this as well.

Yes, I've now 'used up' my total rad amount, too, as it is cumulative... but, I have had miraculous luck with Xeloda/Temodar for my current 8 brain mets... nearing two yrs of that combination.

My first dx with brain mets was in Sept. '02. I had the support of my partner (in every appt I had) for my decisions. I think this helped get the treatment I wanted. For the most part, I was calm and clear as to my choices, so I didn't sound like a raving idiot! That may have helped, too.

If you still get 'no' for an answer and are ok with the wait, try for a third opinion...

Wishing you very good luck in pursuing the course of treatment YOU choose for yourself, with much hope of long lasting results.

hugs,
pattyz
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Old 06-09-2007, 07:54 PM   #22
Lala
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Lu Ann
I sent you an email. You are in my thoughts and prayers.

Hugs to you,
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DX Fall06 Brain mets, Brain mets gone Spring 2007
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Old 06-09-2007, 09:01 PM   #23
MCS
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Oh Lu Ann,


such much fear and unknown. Just be as well informed as you can be even if it scares the hell out of you. information gives you power over your decsions and ability to handle whatever my come

I will think about you. please post as you've said so that we can be with you in spirit

MCS
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Old 06-12-2007, 10:07 PM   #24
lu ann
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still working on second opinion

My husband spoke to my rad. onc. yesterday about our concerns. She spoke to the head of the dept. today who agreed that my best course of treatment would be whole brain rad. at a mild to moderate dose. The most severe side effects I would have would be fatigue. I can't imagine being more tired then I already am. I will have to start wearing depends to bed, incase I don't wake up to go p. I usually am up every 2-4 hours at night to go.

We heard from C.T.C.A. about our insurance being accepted. Someone will be in touch to go over things with us further. I need to know from another provider what treatment they think is best.

I will keep all informed
Love, Lu Ann

P.S. I forgot to add. My husband asked my rad. onc. my prognosis. She replied that I am a hard case as my cancer is growing at a very slow rate. She said my body responds well to rad. tx. and along with chemo I could live a long time. I just don't want to be miserable in the meantime. Quality of Life is Sooo Important.
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Old 06-12-2007, 10:16 PM   #25
Lala
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Lu Ann

You remain in my thoughts and Prayers.
Hugs to you
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DX Fall06 Brain mets, Brain mets gone Spring 2007
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Old 06-13-2007, 03:09 PM   #26
MCS
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Lu Ann

Yes try to touch base with joe or Christine. I am shaking my head as I read your threads. Hang tough. Ok. We are all thinking of you and your daughter

Lots of love

MCS ( maria)
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Old 06-13-2007, 03:21 PM   #27
Esther
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Lu ann, I received SRS treatment at Cedars Sinai in LA, and The MD"S there said I could always have WBR in the future. Having targeted rads does not preclude the option of WBR.

I would get a second opinion from a major cancer center on this, because I don't believe their information is correct. SRS does not rule WBR in the future if needed.
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Old 06-13-2007, 04:36 PM   #28
Barbara H.
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Lu Ann,
I would get a second opinion. I was also told to get WBR and refused. That was three years ago. Good luck and keep us informed.
Thinking of you.
Barbara H.
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Old 06-14-2007, 03:53 AM   #29
rentrac
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second opinion

Dearest LuAnn,
I don't know much about Ohio geography, but have you considered the Cleveland Clinic for a second opinion? They are world renowned, and even if they aren't very close, they should be an excellent source for an opinion. I've been going to UNC for my second opinions; I call them my Greek Chorus. They are too far away for me to consider them for providing my immediate care, but they're on top of all the latest treatments and research. Consults from these big centers include review by experts in all relevent fields - radiologists look at the imaging studies, radiation oncologists, pathologists, oncologists, etc. It paid off for me in unexpected ways: a sharp eyed radiologist noticed something on the very edge of a neck-to-thigh PET and suggested an MRI of the brain. Thanks to him, we found 2 brain mets and at a size small enough to allow Gamma Knife. I had no obvious symptoms at the time, and probably would not have for another couple of weeks.
Know you are in my thoughts and prayers.
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Old 06-14-2007, 05:01 AM   #30
Joe
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Luanne,

Feel free to call Christine anytime. I will email you our phone number. Here is a link to Gamma Knife "Centers of Excellence" in the midwest.:

http://www.irsa.org/midwst.html

You may also wish to get a second opinion from Dr. Keith Black's grou[ at the Maxine Durnitz Neroulogical Center in Los Angeles. De. Black is perhaps the nation's best neurosurgeons in the US.


Regards
Joe
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Old 06-14-2007, 12:20 PM   #31
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LuAnn - another perspective from someone with brain mets...

We found my brain mets in April on MRI. I have no symptoms at all from the mets. There were two that were 9mm (one in the rt celebellum area and one in the rt parietal area) and several punctates, which look like the period at the end of this sentence. At the time, my docs went back and forth and finally agreed that WBR would be the prudent way to go. We also knew that we were switching my drugs to Tykerb/Xeloda. I was not ready for WBR, didn't think that is what I wanted to do at that point. I was leaning towards the targeted 'whack-a-mole' method, wanting to save WBR for last resort down the road. So, I asked my onc and rads onc if they were comfortable with us doing 'watchful waiting' for a month or 6 weeks to see what the Tykerb/Xeloda might do. They agreed that it would be a reasonable way to approach it. So that's what we did. I had an MRI last week, and it showed that there was no growth at all of the brain spots. They had remained completely stable on the Tykerb/Xeloda, and that one of the 9mm spots was less enhanced, which the radiologist said was a positive thing. Along with that great MRI result, my tumor markers fell from 37.5 to 17.5. My onc and rads onc both agree that we can continue 'watchful waiting' for another 6-8 weeks and do another MRI before we make any other decisions....
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 06-14-2007, 06:00 PM   #32
Ceesun
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Thumbs up

Luann, I am thinking of you and hoping for a positive result. I am glad and encouraged to hear that some of our sisters are doing well dealing with brain mets. YOU WILL Too! Ceesun...Cathy
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Old 06-23-2007, 08:32 AM   #33
rentrac
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Lu Ann,
Thinking through options and then waiting for the next decision can be agonizing. Just wanted you to know you're in my thoughts and prayers daily. Let us know how you're doing.
Warmest wishes,
Rentrac
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Old 06-23-2007, 10:12 AM   #34
Adriana Mangus
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brain mets

Lu Ann:

How are you? Have you talked to Steph from Seattle? she has experienced this type of procedure; she's really nice and knowledgeable about this whole thing. I will keep you in my prayers....
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1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 06-24-2007, 08:03 PM   #35
Soccermom
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Dear LuAnn,
Just wanted to let you know that you'll be in my thoughts and prayers. Hoping that you are able to find the treatment that nails those mets!

Marcia
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Old 06-24-2007, 09:25 PM   #36
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I second what Joe says about Dr. Keith Black. He was one of the neuro-surgeons I consulted when I was first panicked about my brain mets in my cerebellum in January 06. I chose to receive my brain mets care there.

He is brilliant! He thinks outside the box, and explains his opinion and just gives you his opinion straight out. He is also an incredibly talented surgeon.

My success in dealing with my brain mets, and as of last Wed being able to say I am NED from 3 lesions in my brain, is due in large part to Dr. Black's phenomenal team at Cedar-Sinai's Maxine Dunitz Neurosurgical Institute.

Also Dr. Black and his team are all active in their particular hobbies, Dr. Black skydives and mountain climbs, Dr. Yu skiis, etc. They understood my need for a high quality of life continuing the sports I love. Just weeks after surgery to remove a lesion in my cerebellum this March, Dr. Yu cleared me for spring snow skiing. Now that's an understanding surgeon!!!

Last edited by Esther; 06-24-2007 at 09:29 PM.. Reason: adding more information
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Old 06-30-2007, 04:44 AM   #37
lu ann
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I havn't been on board for the last 2 weeks. I was admitted to the hospital with double vision June 14 and I started WBR the following day. I have 5 more treatments. So far, so good. I know the fatigue will be coming, although I sleep all the time now. The double vision is just about gone. I don't know if it is the tx. or the decadron, but I'll take it. I fell last week from being dizzy and I don't want to do that again. My knees just buckled down underneath me. Thank you all for your cares and concerns. I will be in touch to let you know how things are going. Both my rad. and med. onc. say it's hard giving me a prognosis as my cancer is growing very slow. I guess that is a good way to think about it. Take care and God Bless You. Love, Lu Ann
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Old 06-30-2007, 06:43 AM   #38
Lala
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Lu Ann
You are in my thoughts and Prayers. I hope you are feeling better soon. Hang in there, Hugs to you!
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Old 06-30-2007, 07:09 AM   #39
cafe1084
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Sometimes, when we are at our weakest, that's when our true strength emerges. I'm praying and pulling for you, too.

Steph C
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Old 06-30-2007, 09:56 AM   #40
Soccermom
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Lu Ann,
Sending you strength and love from Mississippi. Wish there was something more...

many warm hugs,marcia
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