gamma knife effective for recurrent GBM?

catinthehat · New User Joined: 29 Jun 2009 Posts: 2

Hi, I've been told from the people treating my wife that there's no point in treating my wife with gamma knife radiotherapy as it's ineffective for her type of tumour. She had a grade 4 GBM that's been in remission for over 8 years.

I don't know for definite that her tumour had returned as she's had a bleed on the brain and the clot hides the source of the tumour so I'm looking into possibilities if we find out the worst. The size of the tumour if activated would be less than the 3cm max for gamma knife.

Is the specialist correct do you think or do you think gamma knife would be an effective treatment?

Want to hold off chemotherapy as a last resort. Was hoping gamma knife would give another 8 years reprieve.

Thanks,
G

brainman

Hi catinthehat. I am very sorry about your wife GBMIV. She is dealing with a very aggressive cancer!

I agree with the radiologist on the use of a gamma knife. A gamma knife is best suited for a relatively small and localized tumor or tumor bed. The problem with a GBM is that is in not like other solid tumors that are compact. A GBM is more like a cotton ball with little stands going out in all directions or worse like an octopus with testicles reaching out well beyond the body itself. If any radiation is used, whole brain is the only type that would be useful.

I would not hold off on chemotherapy. I do not mean to frighten you but this is the time of last resort efforts. Most people even with chemotherapy do not live more that 1-2 years. Without chemo, your wife is looking at months at best. I mother died just two months after her diagnosis. As always, consult with your wife's medical team before making any treatment decisions. I am just saying this is an extremely critical time and very important decision that will impact your wife's odds of living.

You and your wife are in my thoughts and prayers as you weigh your options.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
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catinthehat · New User Joined: 29 Jun 2009 Posts: 2

Hi brainman, thanks for your reply.

I understand that all areas would have to be treated and this may be difficult due to the kind of tumour but I was hoping that the area of enhancement would be small so could be treated effectively.

My question I suppose is how effective the radiotherapy would be second time around if all active cells were treated. Would the tumour respond in the same way to the radiation or would it have mutated to be more resistant?

She's had 8 years so far so the tumour must have been very susceptible to the radiation first time around.

Thanks,
G

brainman

Hi G. This comment would be true about any cancer anywhere... not just the brain. There is an establish life time maximum radiation that any give organ can receive. I am not sure what this limit is for the brain. However, if a person receives the maximum they cannot use radiation as part of any future treatment. This is a very important question for you to ask your wife's medical team in deciding what to do next. I am still not sure how much good it would do in the long run and that whole brain radiation might be better but that really depends of the size of the tumor. Often the core of the tumor is made of dead cells; that is something else that might limit the effectiveness of a gamma knife since those cells might already be dead.

Keep asking these very good and very important questions Smile

_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54

kenobewan · Regular Joined: 10 Jun 2009 Posts: 25

I agree with brainman, chemotherapy should be your first port of call.

I'd at least ask about the gamma knife, but it must also be a regular shape, eg circle or oblong, as well as less than 1 inch in diameter.

There may be other options. If they happen to have proton therapy available that may be possible, only 5/6 centers in US I believe do. So while she may have reached lifetime max, this does not necessarily exclude other treatments.

Hope this information is helpful, all the best!

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