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Oncology (General Cancer)/Metastatic Malignant Melanoma

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Question
My Father was just told he has stage IV metastatic malignant melanoma, which had formed multiple legions in his brain.  They are starting with 10 days of Whole Head Radiation. He is not a candidate for the cyber knife because there are too many spots.

He did not ask the doctor how long he should expect to live, and that is a pressing question for most of us supporting him.
Also, with the whole head radiation treatment, what types of changes to his quality of life should we expect? Are there supportive care options that can help?

Thank you for your help.

Answer
Whole brain irradiation may buy a little time, but cannot cure him.  Often, with melanoma the amount of radiation that the brain can tolerate is not enough to really kill the tumors.  That being said, unless he is very elderly, I'd consider having the radiation.  There are risks to whole brain radiation, including sudden events like bleeding into one of the tumors, to more gradual problems like the loss of brain function over time.  However, I don't believe he will live long enough to have the second kind of problem.  Supportive care should be involved at this point, so that intervention can be introduced gradually, rather than at the last minute.  I would suspect he may have 3-6 months with whole brain radiation, depending on his response, and depending on where else he has disease.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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