Expert: Claes-Gustaf Nordquist, M.D. - 8/5/2009

Question
Hi, My Mother was diagnosed with Malignant Melanoma of her brain about 1 month ago. She underwent 13 treatments of whole brain radiation, in hopes to shrink the tumor to make it eligible to attempt gamma knife. She had all 13 radiation treatments and they are waiting to scan her again for 4-6 weeks to see if the tumor shrank at all. The waiting is making us very anxious, as she seems to  be getting worse, she is very tired and has very bad headaches. She is currently on steroids to control the brain swelling, however when they tried to taper her off of these she quickly got very weak so had to be put back on them. We have never been given any answers as to prognosis, and is it normal to wait 4-6 wks after the radiation to do another MRI? We feel as though if she's in pain and getting weaker, shouldn't she be scanned again now to just see if the radiation did anything? We feel as though we are just sitting here waiting when things could be getting worse. Any information on this would be helpful. Just from research on the internet the prognosis for melanoma in the brain seems to only be months, therefore we feel like waiting 4-6 wks is too long.

Answer
Well, hopefully her radiation therapy will work. And it takes actually weeks before the effect can be evaluated. But unfortunately I can not promise that since malignant melanomas are usually not very sensitive to radiation therapy or chemotherapy. GammaKnife treatment may work though provided her tumors are not too big or too many but even so I can unfortunately not promise a cure since her malanoma is now a stage 4 malignant tumor with a bad prognosis. If her treatment is not successful her remaining survival time can probably at most be measured in months. I'm sorry I have nothing better to tell you!