The standard for treating brain metastases back in 1954 was whole brain radiation therapy. The intent of whole brain radiation therapy is to help deal with cancer that spread to the brains by treating the whole brain, all of it, with radiation.
When I trained in the ’80s, whole brain radiation remained the standard of care for brain metastases. I observed that the effects of the treatment were often worse than the disease itself with respect to the patient’s quality of life. Patients always had moderate to severe problems with brain function after treatment.
How bad was it? Let’s say if they could balance their checkbook prior to treatment, they weren’t likely to be able to after. Other negative effects included memory problems, being able to understand, and other changes in how they were able to think and do things prior to treatment.
The benefit of the treatment was that the patients could live a few months longer…but I always thought, and still think, that the downside was very significant.
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Fifty years later the standard for treating brain metastases is still whole brain radiation. What? How can this be true with all the advances in medical science over the last 50 years? How can this be true when treating brain metastases, using radiosurgical techniques with CyberKnife and other machines, is readily available?
According to the Wall Street Journal article, “Cancer Radiation Questioned,” 200,000 patients with brain metastases are subjected to whole-brain radiation therapy for brain metastases each year. Doctors at MD Anderson have recently investigated the outcomes after using whole brain radiation and…. surprise! They found a negative impact on brain function that was “more than they expected!”
This is not the first group of doctors who studied problem and found whole brain radiation an unsatisfactory treatment option for patients with brain metastases who were doing well otherwise — responding to other treatments, and would live for months or years if not for the brain metastases.
What alternatives are there? As I have said, treating brain metastases with radiosurgical techniques, such as with CyberKnife and other machines, is readily available and is not associated with the consequences of whole brain radiation.
I have helped hundreds of patients enjoy control of their brain metastases and excellent quality of life with respect to brain function for years while working with their team of physicians and keeping the cancer in other parts of their body in check.
However, to be fair, there are some patients for whom whole brain radiation could be the right treatment, and I do recommend it for those few patients that I consider it to be the best treatment option.
The treatment of brain metastases is another one of the many areas where radiosurgical treatment with the CyberKnife excels, and if you’re reading this, know that the procedure is available today for patients who have brain metastases.
Make it your mission to not let someone you love or know become one of the 200,000 casualties of over-treatment with whole brain radiation every year.