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Brain Tumors/radiation necrosis

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QUESTION: My husband has small cell lung cancer with two met to the brain. surgery to remove the brain tumors was done Jan 2012. radiation was done to the tumor bed 3 days after surgery. chemo and chest radiation was the next treatment.whole brain radiation followed. all treatment stopped by June 2012.Dec 2013 had grand mall seizure, went on seizure meds and steroids. had surgery in May 2013 which removed necrosis. symptoms returned Dec 2013, another surgery in Feb 2014. doctors said no new tumor was found at each surgery just necrosis. my husband again has cognitive issues, gait problems severe memory loss and is very confused. urine incontinence also. seems as if he is melting before my eyes. the doctors say he is NED the necrosis is his only problem. steroids were terrible for him and only slightly relieved symptoms in 2013 before surgery. he is scheduled for MRI in three days. Is there a treatment that could help him or is this the beginning of the end? what will be next? what questions should I ask his doctors next week after the MRI? we thought the cancer was scary, this necrosis is just as horrible. is there a treatment? after each surgery poeces of my husband personality do not return.

ANSWER: Your husband has had a small cell lung cancer that has spread to his brain. That makes it a stage 4 (IV) lung cancer which is the worst stage possible. Such a cancer is by definition at present incurable and lethal. Treatment can only to some extent prolong survival with some probability and also with some probability temporarily decrease the symptoms. So unfortunately this is most probably the beginning of the end. That no cancer was found after surgery does not change this evaluation. The MRI can only show the progress of this process. I am sorry I have nothing better to tell you!

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

QUESTION: had the MRI and it showed a brain bleed , surgery was done and now all the symptoms are GONE. they also biopsied the fluid where the brain bleed was and it came back NO CANCER. my question is  what symptoms will he have from the necrosis when it was the end. are there any treatments for the necrosis?

Answer
No not really. What is dead is dead. Necrotic tissues are dead tissues. Unfortunately in this situation the risk that his cancer will come back is very big, almost a certainty. I am very sorry to continue to be the bringer of bad news. But you have asked me straight questions and such questions deserve straight honest answers. And these are the only honest answers I can give you.


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Brain Tumors

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Claes-Gustaf Nordquist, M.D.

Expertise

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

Experience

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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