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Brain Tumors/Treating lungcancer mets to brain

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Question
A family member has lungcancer, adenocarcinoma nonsmall celled type. It has metastized to the brain and a large tumor was recently removed woth surgery, craniotomy. It went well but the mr scan showed 9 tiny mets, smaller than 1mm.  

Is it an adviseable idea to treat them with stereotactic beams? If not, why? What could be the downside for treating this number of mets?
I wonder, because some hospitaæs only wants to treat 3 mets and others up to as many as 16 or even more at the time.

If she was to undergo whole brain radiation, would this be more adviseable? If not, why? And if yes, could this actually cure the mets?

I have heard about some severe cognitive side effects showing up after some months from wbr. How many actually gets them? And how much radiation seems to be the limit to avoid any cognitive dysfunctions and memory impars?

What is the teqnique to be usedto avoid radiating the brain stem and hippocampus and would this method be able to keep the cognitive imparments away?

Many kind regards
Cecilia

Answer
Du kan godt skriva till mig på dansk!It is not just a matter of how many mets there are. It is also a matter of where they are located. Without knowing that I can not say if stereotactic beams are possible or better than whole brain radiation. The situation is not evaluable without knowing that. No treatment known at present can with any certainty cure these mets. What is possible is to extend survival time and any symptom free priod.It is difficult to know what is radiation effect - if any - and what is the effect of reemerging tumour growth. Since the treatment can anyway only gain some time any long time side effects are in my opinion not of much interest. Even with treatment we are - at present - discussing survival times measured in months.


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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and specialist in radiation therapy and medical oncology. I have a long time experience of these tumours.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy, educated and trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 . I have no restrictions on the number of questions there. I also answer questions about Oncology (General Cancer), General History, Military History, Breast Cancer, Colon Cancer.

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Doctor of medicine, specialist in medical oncology & radiation therapy.

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