Expert: Claes-Gustaf Nordquist, M.D. - 11/13/2011

Question
QUESTION: My 72 year old father had melanoma removed from his arm two years ago. They also removed the lymphoid from under his arm and found no cancer.
Two weeks ago my father had a melanoma tumor the size of a small golf ball removed from his brain (front right lob)
My father also has early dementia.
My question regarding should my father do the radiation to the brain or not? We have been told if he does not do it, he has a 90% chance of the cancer coming back. If he does do it, he has a 30% of the cancer returning to the brain.
We realize from what we have been told the cancer will most likely come back and my father could have 6 months to a year to live. All depends on when and where the cancer comes back.

Some questions I have are:
1. Will radiation prolong my father's life? If so - for how long?
2. Will it shorten his life if he doesn't get radiation?
3. Will radiation make my father's life more comfortable - the time he has left?
4. What are the side effects, besides tiredness?

Any help and information you can give me would be greatly appreciated.

Thanks,

Kip

ANSWER: I'm sorry to read about his - and your - problems! Unfortunately I think his risks have been underestimated. The risk that his melanoma will come back to his brain if no treatment is given is even bigger than the stated percentage - it is almost a certainty. And even with treatment it is almost as high. The possible main difference is that it may come back somewhat later and maybe somewhat slower. So 1. Maybe but probably not very much. 2. Maybe. But the difference will probably not be big. 3. Perhaps, but the treatment has side effects. Those can also be treated but also that treatment has side effects. 4. Whole brain radiation therapy usually causes brain swelling with several neurological symptoms. That can be treated with corticosteroids (cortisone) but that too has side effects. So unfortunately I can not offer much hope! I'm sorry I have nothing better to tell you!



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---------- FOLLOW-UP ----------

QUESTION: We ended up not doing the radiation. My father lived just over 5 months.
He passed away on May 9th. We made his last few months as comfortable as possible. He went into a deep sleep, stopped eating, and drinking. His body basically shut down, and 5 days later he passed away. It was a very peaceful way to go.

Answer
Thanks! I'm sorry for your loss but unfortunately it was unavoidable! You probably made the right decision!




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