Any one with experience of brain mets? - OPA Palliative Ca...

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Any one with experience of brain mets?

JohninKent profile image
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Is there is anyone here with first hand experience of treatments offered and their effectiveness?

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JohninKent
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I have always been confused by the long names that various types of brain tumours have.

I know that there is sometimes some discussion on the Macmillan site:

community.macmillan.org.uk/...

And do try our helpline on 0121 704 9860 or the Macmillan helpline 0808 808 0000

JohninKent profile image
JohninKent

Thanks, Alan. I have been looking at the group, Brain, secondary cancer on macmillan. Though it is in my brain it is still oesophageal cancer. I thought I post here as well because if nobody actually posts it will never take off. I have found out most of the info I need about the treatments. My concern is that the MDT is meeting tomorrow and I am worried about what my options are if they don't come to the decision I am hoping for. I think I meet all the criteria but until I hear it is a worry.

John

JohninKent profile image
JohninKent

I am pleased to say that they are going to do the treatment that I want.

Dear John

That is good news.

I contacted Cancer 52, an umbrella group for less common cancers, and they advised that 0808 800 0004 might be worth a ring - the information line for the Brain Tumour charity. thebraintumourcharity.org

All best wishes

Alan

The Brain Tumour Charity have also passed on to me some information on Stereotactic Radiotherapy that you may be interested in. This type of treatment is commonly used with brain metastasise as it does not radiate the whole brain with a large does of radiation and can therefore be used on more than one tumour. I have copied and pasted this from a .pdf file so please forgive the formatting. I do not know whether this will be relevant to you or not.

Stereotactic radiotherapy or SRT is a type of

radiation treatment - it delivers radiation

beams in a highly focused way to the site of

the tumour. Targeting the tumour in this way

limits the intensity of radiation delivered to

healthy tissue and aims to give fewer side

effects than conventional radiotherapy.

It is important to realise, however, that SRT

delivers a low level of radiation to more of

the brain. There are two main types of SRT:

stereotactic radiosurgery (SRS), where all

the treatment is given in one session, and

fractionated stereotactic radiotherapy

(FSRT), where the treatment is given over

multiple sessions.

How does SRT work?

Stereotactic Radiotherapy differs from conventional

radiotherapy only in the way it ‘localises’ the tumour - it does so

by ‘stereotaxy’. Whilst conventional treatment uses marks on

the patient’s skin or radiotherapy mask, in stereotaxy, a separate

frame (co-ordinate structure) is fixed rigidly to the patient and

this is used to locate the tumour. The box is fixed in one of two

ways: either it is firmly fixed to the skull (in which case a local

anaesthetic is given) or it is fixed to a face mask. Either way,

SRT will not be painful.

The advantage of SRT is it a more accurate treatment.

Treatment is delivered from many different angles around the

head aimed at the tumour. Where all the points meet and

overlap at the site of the tumour, they create a high dose of

radiation, and therefore destroy the tumour cells. Since

stereotactic treatment is more accurate than conventional

radiotherapy, higher doses can be given or fewer treatments

may be necessary.

Often only one high dose of treatment is needed - this is called

Stereotactic Radiosurgery (SRS). Conventional radiotherapy,

split over several sessions, can also be given using the same

technology. This is called fractionated Stereotactic

Radiotherapy (FRST).

The planning stages

Fractionated Stereotactic Radiotherapy (FRST)

It is very important that the radiation beams are aimed precisely

so that they target the tumour cells, rather than healthy cells.

To achieve this, various specialists (including radiographers,

radiotherapy physicists and technologists) work together as part

of a planning team to plan your treatment. To help keep you still

and in position during SRT, you will wear a mask that is tailormade

to fit your individual head-shape (see fact sheet on

Radiotherapy for more detail on the making of the mask).

Wearing the mask, you will have an MRI or CT scan (see fact sheet

on Scans for more information), which will help the specialists plan

your treatment. The specialists will work out from the scans

exactly where the tumour is and how to aim the beams. You will

often be asked to return to the planning team to have the

positioning checked before proceeding to treatment.

Stereotactic Radiosurgery (SRS)

Whilst some departments will use a mask as described above,

others will use surgery (known as invasive fixation) for SRS.

This comprises a series of four pins that are screwed a small

distance into the skin under local anaesthetic to hold the

stereotactic frame. They remain in place throughout the

scanning, planning and treatment delivery phases and are

removed at the end of the day. The planning is otherwise

much as for FRST.

The procedure

FRST

During the FSRT treatment itself, you will need to wear your

mask and be positioned on a treatment table. The localiser

box (which helps to locate the tumour) is attached to the mask

and the treatment is set up. This usually takes just a few

minutes, but can take longer if the treatment is complex.

Before the treatment begins, medical staff will leave the room,

but they will be able to see and hear you and you will be able

to hear them.

The treatment is given by a machine called a linear accelerator.

This gives numerous beams of radiation from different angles.

The beams all intersect (cross over) at the tumour, where they

create a high dose of radiation and destroy the tumour cells.

SRS

Treatment with Stereotactic Radiosurgery is much the same

as FSRT except that the treatment is given in just one session.

This is likely to take longer and may even take up to 4 hours

depending on the technology used (see overleaf).

After treatment

It is very common to feel tired for a few days after SRT. Some

people experience feelings of nausea, dizziness or faintness

directly afterwards, however, this is very uncommon. You will

be allowed to go straight home after treatment, but should

arrange transport so that you do not have to drive.

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JohninKent in reply to

Thanks for this Alan. It is stereotactic radio therapy I am going to have. I was worried that as I have active cancer elsewhere they may have only considered WBRT which I did not want. I am meeting with the neuro-oncology team for the first time on Monday so I should find out soon exactly what the treatment will be and when. I was very worried when I found it had spread but I am now more relaxed about the future. Thanks again for posting the information.

John

Dear John

I just realised that there is a second page!:

Other types of SRS/SRT

The information in this fact sheet focuses on Linac based

delivery of SRT. Linac means that the treatment is delivered

using equipment called a linear accelerator. Other

technologies that work in similar ways are available.

These include:

Gamma Knife (Stereotactic Radiosurgery)

Rather than being an actual, physical knife, Gamma Knife is

named after the machine that administers it. Gamma Knife

is a type of SRT that uses gamma radiation to target and treat

the tumour. It normally offers only Radiosurgery. The

machine looks quite different to a linear accelerator but

the preparation, delivery and outcome are similar to SRS

on a linear accelerator.

Cyberknife (Stereotactic Radiosurgery)

Cyberknife is also named after the machine it uses. It has a

robotic arm that tracks the location of the tumour and any

movements the patient makes and adjusts its positioning

before delivering beams of radiotherapy. Treatment usually

takes around 30-90 minutes and requires 1-5 sessions.

What’s the difference between

Stereotactic Radiotherapy

and Radiosurgery?

Stereotactic Radiotherapy and Radiosurgery are both painless,

non-invasive techniques (i.e. don’t use surgery) that use

radiation beams targeted at the tumour in a very precise way.

Stereotactic Radiotherapy may deliver the treatment over a

series of sessions (called ‘fractions’), whereas Radiosurgery

tends to deliver it in a single session. It is important to realise

that Radiosurgery is only appropriate for certain types and

sizes (i.e. smaller ones) of brain tumour. Whilst FRST is

applicable to a wider range of tumours, there are, again,

limitations to the usefulness of this technique. Your doctor

will advise you about this.

What side effects can I expect?

It is common to feel tired after treatment. You may also feel

sick, dizzy or faint directly after treatment. These side effects

are generally short-lived. If you experience side effects that

you are concerned about, speak to your doctor.

Why is the word ‘knife’ used?

Despite the word ‘knife’ appearing in the names ‘Gamma Knife’

and ‘Cyberknife’ there is no actual knife used. The name was

chosen because the neurosurgeon who invented it, Prof. Lars

Leskell, felt that the treatment allows such precision, similar to

a surgeon’s scalpel.

Will the treatment hurt?

No, both Stereotactic Radiotherapy and Radiosurgery are

painless. There is no need for a general anaesthetic. You may,

however, need to wear the localiser frame for several hours,

which can be tiring.

How many sessions of treatment will

I need to have?

This depends on your treatment plan, which will be tailored to

your individual needs. Typically though, SRT can take around

6-25 treatment sessions or doses, whereas Radiosurgery is

given in a single session.

What are the benefits of SRT

and Radiosurgery?

SRT and Radiosurgery deliver radiotherapy beams from

various angles in a very precise manner targeted at the

tumour cells,. Where they overlap at the site of the tumour,

the dose of radiation is high and destroys the tumour cells.

As the radiation is only high enough to destroy cells where all

the beams cross, surrounding healthy tissue remains relatively

unaffected. This means that people generally experience

fewer side effects with SRT and Radiosurgery compared to

conventional radiotherapy.

Is SRT suitable for all types of

brain tumour?

While SRT is suitable for a range of different brain tumours, it

is not suitable for them all as precise localisation in this way

may carry no advantage. Your oncologist will be able to talk to

you about SRT and whether it is a suitable option for you.

Hi john, my brother had stage 4 oesophagus cancer which then went secondary to his brain. He was perscribed dexamethasone steroids which controls the headaches...he had a weeks treatment of radiotherapy which he managed quite well..Unfortunately my brother's cancer went to his blood stream, then bones and he ended up with clots on both lungs:( . My brother sadly passed away last month aged 49.. I seen your post and felt I had to ask how you were getting on ?

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