Expert: Claes-Gustaf Nordquist, M.D. - 12/13/2008

Question
I'm 56.  Surgery/lumpecty/L lymph node dissection/1 positive node 5 cm. diameter. Clear margins. IDC 10/7/01.  Chemo TAC X 6 (3)weeks apart, them BID breast radiation over about 5 months.  Restaging MRI showed met on L1, 2o QD radiations to area cleared tumor but left compression frx.  Nov. 08 spasticity and visual/balance problems, MRI shows sx brain mets,  one 15 mm sitting on top of brain stem, inoperable, too low for gamma knife,  BID WBR started as only option.  3 dose packs prednisone, now on last cycle.  Due to the steroid, and a
"moon" face, I look like a female version of you, except I have a mohawk where the radaition didn't hit ro cause the hair to fall out.  Due to continued excrutiating back pain, I had a minimally invasive kyphoplasty for the compression frx.  Tried 2 monthly doses zometa before the brain tumor and don't think I'm going to resume because it caused so many side effects.  Breast Tumor was Triple Negative.  Doc took 3 biopsies L1 while doing kyphoplasty, just to be sure tumor is dead, and if not, set the stage for further radiation.  I am BRCA1 positive,E143X mutation as seen in an "Irish" strain.  Any food for thought you could add would be appreciated. I feel strongly that I have at least 20-30 years left of life if I can keep this foul disease from sucking my life dry.

Answer
Your brain tumors can mostly be treated with the GammaKnife too. The one that can not be reached with that method may be possible to hit with proton beams. Or maybe with the CyberKnife. That to me seems as better than conventional radiation therapy. But I have to add that even so your prognosis would at least be uncertain.