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PostPosted: 24 Aug 2015 01:48 
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Joined: 24 Mar 2013 02:28
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Treatment of Brain Metastases

Brain metastases (BMs) occur in 10% to 20% of adult patients with cancer, and with increased surveillance and improved systemic control, the incidence is likely to grow. Despite multimodal treatment, prognosis remains poor.

Current evidence supports use of whole-brain radiation therapy when patients present with multiple BMs. However, its associated cognitive impairment is a major deterrent in patients likely to live longer than 6 months.

In patients with oligometastases (one to three metastases) and even some with multiple lesions less than 3 to 4 cm, especially if the primary tumor is considered radiotherapy resistant, stereotactic radio surgery is recommended;

if the BMs are greater than 4 cm, surgical resection with or without postoperative whole-brain radiation therapy should be considered.

There is increasing evidence that systemic therapy, including targeted therapy and immunotherapy, is effective against BM and may be an early choice, especially in patients with sensitive primary tumors.

In patients with progressive systemic disease, limited treatment options, and poor performance status, best supportive care may be appropriate.

Regardless of treatment goals, use of corticosteroids or anti epileptic medications is helpful in symptomatic patients.

AMERICAN SOCIETY OF CLINICAL ONCOLOGY: 17th Aug 2015.

G Mohan.


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PostPosted: 24 Aug 2015 04:04 
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Brain metastases from whatever primary is a very cruel disease indeed. I have witnessed this in a close relative of mine. This is one time our minds start wondering about euthanasia as no treatment appears to offer any solace to either the patient or the dear relatives who look after them. It is extremely painful to see the way a patient suffers.


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PostPosted: 31 Aug 2015 14:30 
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Hi Mohan and Badri
In our overenthusiasm to treat such cases we are attempting to put some years to life rather than life into years.

UA Mohammed


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PostPosted: 03 Sep 2015 00:42 
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Hi Mohammed,

This is a very sensitive subject. For every person who thinks that it is cruel to prolong life in someone who is at the end stage of an incurable disease there is an equal no who think life at any stage is precious and we have no right to extinguish it.


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