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Is Chemotherapy Advisable When Having Brain Lesions?

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Posted on Tue, 5 May 2015
Question: Hello, my name is XXXXXXX my wife has brain lesions (5). we are going for second mri and hopefully the lesions have reduced in length and hopefully disappeared. if they have not improved and hopefully not increased in # should we continue with chemo. the lesions are located at the base of brain right side and at frontal lobe the largest one is 2.9cm
doctor
Answered by Dr. Vivek Chail (18 minutes later)
Brief Answer:
Chemotherapy as per protocol, follow up MRI is most important right now

Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.

I have read through your query in detail.
Please find my observations below.

1. I have worked at a cancer institute and come across many patients of SCLC having brain metastasis like your wife. The follow up MRI in these cases holds the key to continuation of treatment and any modification as per disease remission and progress. Your wife is having Extensive-Stage Small Cell Lung Cancer as the disease has spread beyond the lungs.

2. Chemotherapy using single or combination medicines are best suited for brain lesions and works in most people. Chemotherapy is given under supervision of the oncologist. You have not mentioned the drugs being given, however it is important to continue the chemotherapy as per the protocol suggested by the oncologist.

3. Should the brain lesions increase further in size and number, then second line of chemotherapy agents might have to be started to treat brain lesions in SCLC.

4. Radiation therapy is also recommended in combination with chemotherapy to suppress the brain lesions. Radiation therapy is recommended for treating lesions in the brain, spine, bone, or other parts of the body where the cancer has spread, as palliative therapy to relieve symptoms and improve quality of life.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (36 minutes later)
yes understood thank you we have had the radiation and chemo for the lung cancer and it worked lung cancer is no longer their in lungs had been clear a few months then dr ordered an mri on brain and that's when we found lesions she prescribed steroids. dexamethalone 4mg know twice a day. anti-depressant 150 mg 2 day. we have already done pct. Can lesions be cleared with the chemo?
doctor
Answered by Dr. Vivek Chail (16 minutes later)
Brief Answer:
Lesions in brain can be completely cleared in 1 out of 10 SCLC patients

Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.

1. Medical research shows that in case of SCLC with brain lesions, 75 percent to 85 percent of patients show initial response to treatment.

2. In the group showing response the lesions are completely cleared in 1 out of 10 patients. The other 9 patients will have partial response. Complete response if difficult in those with multiple brain lesions.

3. PCT has a limited role in treatment of SCLC and is usually done as a part of follow up.

4. A patient of SCLC with brain lesions not clearing completely might have a survival of up to 2 years. Combination radiation and chemotherapy can be given as a last resort to clear the lesions.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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Is Chemotherapy Advisable When Having Brain Lesions?

Brief Answer: Chemotherapy as per protocol, follow up MRI is most important right now Detailed Answer: Hi XXXX, Thanks for writing in with an update. I have read through your query in detail. Please find my observations below. 1. I have worked at a cancer institute and come across many patients of SCLC having brain metastasis like your wife. The follow up MRI in these cases holds the key to continuation of treatment and any modification as per disease remission and progress. Your wife is having Extensive-Stage Small Cell Lung Cancer as the disease has spread beyond the lungs. 2. Chemotherapy using single or combination medicines are best suited for brain lesions and works in most people. Chemotherapy is given under supervision of the oncologist. You have not mentioned the drugs being given, however it is important to continue the chemotherapy as per the protocol suggested by the oncologist. 3. Should the brain lesions increase further in size and number, then second line of chemotherapy agents might have to be started to treat brain lesions in SCLC. 4. Radiation therapy is also recommended in combination with chemotherapy to suppress the brain lesions. Radiation therapy is recommended for treating lesions in the brain, spine, bone, or other parts of the body where the cancer has spread, as palliative therapy to relieve symptoms and improve quality of life. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek