Advice for Brain mets

Hi Nick, 

I'm sorry to hear about your father. How many brain mets does he have? If less than 8 or so (I had 10), then some form of targeted radiation (Gamma Knife, stereotactic radiosurgery, Cyberknife etc.) is far more effective for long term control of the individual brain tumors than WBR. I would have thought targeted radiation combined with something more systemic like a braf inhibitor if he is braf positive, or some form immonotherapy would be a far better option that just to "wait and see".

Just my opinion though.

Good luck,

Ben.

Hi Nick, 

I'm sorry to hear about your father. How many brain mets does he have? If less than 8 or so (I had 10), then some form of targeted radiation (Gamma Knife, stereotactic radiosurgery, Cyberknife etc.) is far more effective for long term control of the individual brain tumors than WBR. I would have thought targeted radiation combined with something more systemic like a braf inhibitor if he is braf positive, or some form immonotherapy would be a far better option that just to "wait and see".

Just my opinion though.

Good luck,

Ben.

Hi Nick, 

I'm sorry to hear about your father. How many brain mets does he have? If less than 8 or so (I had 10), then some form of targeted radiation (Gamma Knife, stereotactic radiosurgery, Cyberknife etc.) is far more effective for long term control of the individual brain tumors than WBR. I would have thought targeted radiation combined with something more systemic like a braf inhibitor if he is braf positive, or some form immonotherapy would be a far better option that just to "wait and see".

Just my opinion though.

Good luck,

Ben.

I agree that stereotactic radiation (gamma knife, cyber knife) makes sense when you have only a couple of brain mets. Perhaps your father had extenuating circumstances that prevented that from happening.

I would talk with his doctor about either a trial that is focusing on brain mets–perhaps using Yervoy–or looking into the Expanded Access Protocol for Merck's anti-PD1 drug. They have rather loose criteria in that EAP for brain mets.

I don't think you have exhausted all the options yet, based on what you reported. It is very important that if all possible your father is being seen by someone who sees a lot of melanoma patients. They are most likely to be current on the latest and best treatment options.

Tim–MRF

I agree that stereotactic radiation (gamma knife, cyber knife) makes sense when you have only a couple of brain mets. Perhaps your father had extenuating circumstances that prevented that from happening.

I would talk with his doctor about either a trial that is focusing on brain mets–perhaps using Yervoy–or looking into the Expanded Access Protocol for Merck's anti-PD1 drug. They have rather loose criteria in that EAP for brain mets.

I don't think you have exhausted all the options yet, based on what you reported. It is very important that if all possible your father is being seen by someone who sees a lot of melanoma patients. They are most likely to be current on the latest and best treatment options.

Tim–MRF

I agree that stereotactic radiation (gamma knife, cyber knife) makes sense when you have only a couple of brain mets. Perhaps your father had extenuating circumstances that prevented that from happening.

I would talk with his doctor about either a trial that is focusing on brain mets–perhaps using Yervoy–or looking into the Expanded Access Protocol for Merck's anti-PD1 drug. They have rather loose criteria in that EAP for brain mets.

I don't think you have exhausted all the options yet, based on what you reported. It is very important that if all possible your father is being seen by someone who sees a lot of melanoma patients. They are most likely to be current on the latest and best treatment options.

Tim–MRF