AboutJuliet Seigle, MD Expertise I am a fully trained radiation oncologist and can answer many questions about cancer and its treatment. I can't answer questions about specific chemotherapy agents. I have also worked in general medicine and emergency medicine, so I can give advice about these areas as well. I would like to do this based on my very positive experience with one of your experts (real estate).
Experience I currently am working as a radiation oncologist in the DC metropolitan area. I have done research and given talks on neurooncology (tumors of the nervous system) at national meetings. I have been trained in use of a new technology, the CyberKnife. I was emergency physician at a busy communicty hospital (Calvert Memorial Hospital) in Maryland for 3 years (1989-1991).
Organizations ASTRO (American Society of Therapeutic Radiation Oncology)
Education/Credentials Georgetown University Hospital: fellowship radiation oncology 2005-2007
Georgetown University Hospital: residency radiation oncology 1991-1994
Georgetown University Hospital: residency neurosurgery 1984-88
Awards and Honors Award for best abstract - CyberKnife Users meeting 2005 (topic: chordoma)
ASTRO research award $30,000, 1993
Question Dr. a 'lifelong friend ' of mine recently had a stroke.
It occured in the rear part of the brain that deals with vision, etc.
He has recovered without neurological problems:
HOWEVER; in searching for the cause of the stroke this is what has been discovered :
The hemorage in the brain was caused by a "metatastic melanoma".
A CT scan of his lungs has now unearthed two small nodes that have been tested by needle biopsy and were found to contain "malignant melanoma" cells.
Does this mean that he now has what we lay persons call "lung cancer"? and perhaps brain cancer as well?
Does this mean that he had an unknown (to him prior) malignant skin tumor that spread cancer cells?
And if so, would these cells have gone first to his brain, created a tumor there that bled (and caused a stroke) and then travelled to his lungs as a very recent result?
Or did the reverse path perhaps occur?
Regardless; could you please explain for me, to the best of your ability, just what this is all about and just what has/is occuring to my friend?.
What can or will likely be done for treatment?
Is there a chance that the brain hemorage killed the tumor cells in that area?
What is the long-term outlook and available method(s) of treatment for him now?
I have extremely few 'life-long' friends.
We are both in our late 50's. He has a history of smoking (both cigarrettes and canibus (pot) going back to his teen years I may mention.
I have just recieved this news from a relation of his and have to travel soon to see him.
I wish to gain some advance knowledge and insight first.
Please reply if you can and be as graphic and descriptive as you can....Lay it all on the line please.
You will not frighten nor upset me....I already am!
With most humble gratitude; Frank
Answer I am so sorry - your friend's situation is very, very serious. It probably started in the skin and then moved to the lungs and then to the brain. The most accurate way to describe it is 'melanoma metastatic to lung and brain.' Bleeding virtually never kills all the cancer cells. Does he have only one brain tumor (the one the bled)? If so, he should be evaluated by a neurosurgeon (a single brain tumor can sometimes be removed) and a radiation oncologist (for treatment with radiation). A medical oncologist (chemotherapy specialist) will make suggestions about which medications will work best in his case. The good news is that the treatments are getting better, with fewer side effects. Unfortunately, once melanoma has spread this far, it is rarely curable and is very likely to come back again at some point. Melanoma is notorious for causing the type of bleeding into the brain that your friend had; it also is notoriously unpredictable in its behavior. That is, he may be able to go years without a recurrence.
