Expert: Claes-Gustaf Nordquist, M.D. - 2/4/2009

Question
my mother is 63, had lumpectomy on her left breast 4 years ago followed by radiation.  In october of 08 she had a compression fracture in her back and was diagnosed with metastatic breast cancer having gone into her bones.  They, through CT scan have found lesions in her liver as well, all but one sub-centimeter, it being 12mm.  This past week she has had very bad headaces and is seeing double.  I have done some research and wonder if it is cancer in her brain and/or eye?  what do you think?

(She has been having hormone theropy and IV Zometa since the fall and her doctor wants her to do chemo now.  Mom isn't so sure.  She is seeing a naturopathic dr. also.)

Also, her oncologist said that if she does chemo she will have an 80% likelyhood of having her cancer go into remission.  I have found nothing close to that positive prognosis on the web.  What do you think?

Answer
If her cancer has NOT spread to her brain it MAY be possible to control her cancer at least for some time with chemotherapy, but at present it can not be cured in that situation. But I can not guarantee anything and I do not like to promise more than I can keep. She should have an MRI brain scan ASAP in order to check if her cancer has indeed spread to her brain or not! If it has our ability to help her has been significantly decreased. It may be possible to give her rather effective radiological therapy to any brain lesion there - if not too big - with the GammaKnife or with proton beams. Surgery may also be an option but conventional radiation therapy can only give temporary relief. However even with the best therapy her prognosis would be bad in such a situation. However I have NO faith whatsoever in ANY "alternative" treatments!

If you read through my answer carefully you will notice that I have addressed BOTH questions that you asked 1. If her cancer has spread to her brain or not which can not be answered without an MRI scan of her brain which means that it is possible (otherwise no need for the scan) but not sure (must be confirmed by the scan). And 2. Her prognosis which I have stated to be bad - whatever the results of any further tests. Which means that I do NOT share the positive outlook of her dr. So BOTH questions have indeed been answered. It may be possible to control her cancer to some extent and for some time but that is unfortunately all.