Expert: Claes-Gustaf Nordquist, M.D. - 2/10/2012

Question
My mom (67 yrs old) was recently diagnosed with metastatic brain cancer based on an MRI.  The primary care physician described the radiology report as: multiple lesions (unclear but maybe up to 12) in the left and right hemisphere and cerebellum with the largest in the left hemisphere at 2.5 cm diameter.  We had subsequent CAT scans, X-ray, and blood test to determine the source os the cancer.  All the test came back normal or negative which was conveyed as good news since there was not a primary cancer to also contend with.  However given the description of the cancer in the brain and the prognosis I have thus far found online I am very concerned about the future success of treatments.  Can you share what prognosis I should be prepared for as an expected case as well as questions I should ask the oncologist during the appt next week?  Thank you so much for any advice and guidance.

Answer
Unfortunately you are correct. The fact that her primary cancer has not been found can hardly be described as good news since it still must exist somewhere given her MRI scan (with this number of lesions it can not be a primary brain tumor instead it must be a cancer somewhere else that has spread to her brain). And the bad prognosis of a cancer that has spread to the brain is also not changed. So even with full treatment (radiation therapy of her brain and chemotherapy) her prognosis is unfortunately very bad. I expect her remaining survival time even with full treatment to be at most measured in months. I'm sorry I have nothing better to tell you!

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