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Suggest Treatment For Small Cell Lungs Cancer With Brain Metastases

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Posted on Fri, 16 May 2014
Question: I am looking for second opinion for my Father in Law who is diagnoses non small cell lungs cancer with brain metastases Stage 4. He has taken full brain radiotherapy a few days before. He is able to walk now and can go to wash room with little help. We are worry about cancer to spread other parts of body. One doctor/hospital suggested to start chemotherapy and 2nd doctor/hospital suggested not go with chemotherapy. I have all reports from all doctors/hospitals. I am looking for 2nd opinion from Doctor who is expert in lungs cancer and can read all reports and give suggestion what should we do in this situation.
doctor
Answered by Dr. dr. Jawahar Ticku (28 hours later)
Brief Answer:
he needs to undergo adjuvant chemotherapy

Detailed Answer:
Dear XXXX

I have seen the uploaded reports.

Your father has brain metastasis the most vulnerable part of the body for which he has received Radiotherapy. It is good that your father is presently in good condition but recurrence is the rule either local or any other site of the body.

To maintain the remission of his disease he needs to undergo adjuvant chemotherapy which will take care of brain metastasis as well as metastasis in other parts of the body. There are good drugs available which cross the blood brain barrier to produce a good remission effect.

In adjuvant setting you need less drugs which may not have serious side effects, though advised by other doctor not to have it. To maintain the longer duration of wellness chemotherapy is the only option.
XXXXXXX ji, please follow the advice of the doctor who is in favour of it.

Truly,
Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. dr. Jawahar Ticku (36 hours later)
Thank you for your expert opinion. Much appreciated. His general health and diet is improving every day after radiotherapy and like you said we will talk to the doctor who suggests chemotherapy. Please answer our following questions

1. What particular adjuvant Chemotherapy regimen do you suggest for my father in law which can take care of Lung Cancer and Brain metastasis at the same time?

2. After Whole Brain Radiotherapy, is there any treatment such as Gamma Knife or any other treatment option that we can use to specifically target and reduce brain metastasis?

3. Father in law was tested negative for EGFR mutation. I searched on the internet, there is another test of ALK mutation. Is it advisable to have that test done as well. We don't want any stone to remain unturned.

Thank you
doctor
Answered by Dr. dr. Jawahar Ticku (11 hours later)
Brief Answer:
NSCLC lung Cancer

Detailed Answer:
Dear XXXX
Thanks for reverting and further queries.

Adjuant chemotherapy can be single drug or combination of drugs.The treating doctor will prescribe it after he physically assesses the patient.

Gama knife radiation has role only if a small residual foccus is left in the brain after radiotherapy. If all the metastasis have disappeared the Gama Knife has no role.

Regarding EGFR and ALK mutation tests they are done to find if a particular drug is needed. They come under the group of Targeted therapy. These drugs are to be kept in reserve and used if the real need be there. At this moment only conventional drugs need to be used.

Last but not the least as per my personnel experience Immuno modifying herbal drugs should be thought of which can be used singly or along with a single chemo agent. They give long lasting remission and good sense of well being. I recommend you to search for Wheat Grass capsules and Phycocyanin.
Truly,
Dr. J. Ticku
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. dr. Jawahar Ticku

Oncologist

Practicing since :1979

Answered : 490 Questions

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Suggest Treatment For Small Cell Lungs Cancer With Brain Metastases

Brief Answer: he needs to undergo adjuvant chemotherapy Detailed Answer: Dear XXXX I have seen the uploaded reports. Your father has brain metastasis the most vulnerable part of the body for which he has received Radiotherapy. It is good that your father is presently in good condition but recurrence is the rule either local or any other site of the body. To maintain the remission of his disease he needs to undergo adjuvant chemotherapy which will take care of brain metastasis as well as metastasis in other parts of the body. There are good drugs available which cross the blood brain barrier to produce a good remission effect. In adjuvant setting you need less drugs which may not have serious side effects, though advised by other doctor not to have it. To maintain the longer duration of wellness chemotherapy is the only option. XXXXXXX ji, please follow the advice of the doctor who is in favour of it. Truly, Dr. J. Ticku