NSCLC Stage IV never scanned brain

Steve's NSCLC squamous stage IV to outer lung and a lymph node near aorta and abdomen. CAT scans and PET scan galore but not ONE doc has suggested an MRI or scan of the brain to see if it is moving there or at least as a base scan. Anyone else in this boat?

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Husband dx 7/21/11 with stage 1V adenocarcinoma. Scans every three months, but not one of the brain. We go back in Jan and I'm going to push for one.


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I just talked to my Doctor about this a month or so ago. I also asked so people on here what they thought, as you are doing. This is just my opinion, but my doctor ask me if I had any reason for wanting this done...meaning did I have any side effects that were concerning me....all I could think of was I was forgetful ( chemo brain) and that if it was in my brain I wanted to know. My doctor was willing to do the scan but I felt if I didnt have any side effects like not being able to remember to stop on Red light nad go on green (things like that) then maybe I should reconsider.
If I got it done and had it in my brain what would it change for me..... I already have stage 4 lung cancer. I guess we would do radiation. But I let my doctor guide me through this process. I just feel like he has been doing this for years and I have only been doing this for one year.
Again, this is my opinion, I hope this helps.

Take care

and yes I am still kicking cancers ass...:)

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I was dx this August with stage 4 nsclc with met to the ileac (hip) bone. My Onc wanted an MRI of the brain because the pet scan isn't effective for that. I had no symptoms whatsoever. My LC was found by a routine chest X-ray. Anyway, the MRI showed a met to the brain. It was very small, and it was treated with Cyberknife. I suffered no side effects, but I was fortunate that it was found very early. I will be having an MRI every three months or so to keep ahead of anything else that might develop, so it can be treated early if necessary.
I like the fact that my Onc is very aggressive on my behalf, not wanting anything to fall through the cracks. I wouldn't want to wait until there were symptoms, when whole brain radiation might be required.
I would humbly suggest that you seek a second opinion regarding an MRI of the brain. Good luck.


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i am doing a catscan with contrast today.. i cant do mri cause i hate them.. i had a catscan with contrast in aug all good.. petscan in oct was all good.. now i am doing another one this thursday.. i know in my heart it all will be clear.. calling all angels

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I am of course not a doc, but I am surviving and I have strong opinions on what will keep me that way. My Onc did a baseline MRI when I started Xalkori. I am pushing for an MRI every 6 months. The way I see it, if they catch mets early, even if you have several, they can use "cyber knife" or targeted radiation to clean them up. If you wait until you have symptoms and it has gone too far, your only choice is whole brain radiation, which you can only do once. This seems to me all about preserving options, strategic escalation so to speak. If you are not doing regular surveillance, then you can't be aggressive in your approach to treatment. I am a mature guy (58) with young children. I have every reason to fight to be here as long as I can. I vote for regular surveillance. Some Oncologists are relying on their experience to guide them in treating you. If their experience they rely on is 18 months or more past, it may not be valid any more.

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You mention in another post that you're not at a large or major cancer center. That's probably why an MRI wasn't done. It's part of the diagnostic protocol to do a brain MRI. Can you get to a major cancer center for a second opinion? And then ask to have one done.
Take care, Judy

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Nobody suggested it for my husband but I called the oncologist and asked him to add the brain scan back in June because my husband was complaining of headaches. Ask his oncologist for a brain scan.

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I was told they only do MRI if you have symptoms.
Besst D

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This question was something I didn't think of when my wife received the infamous Taxol + Carboplatin combination back in 1997, seven months after having an extrapleural lobectomy. Although the thoracic surgical oncologist was 100% successful, she left us with the knowledge that a second place a metastasis possibly could occur maybe the central nervous system (CNS) like the brain and/or spine.

However, metastases to the CNS was uncommon and rarely seen before the use of some present day chemotherapy regimens. Eleven months after completing her regimen, she developed a 3.5cm solitary cerebellar brain tumor. It was found via unenhanced/enhanced Cat Scan (later confirmed by an unenhanced/enhanced MRI), but that was only after she presented with headaches, dizziness, unsteady gait, nausea and vomiting.

No one suggested back then that these scans should be a routine follow-up after chemotherapy treatment either. Looks like today, they still are not advising it.


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I have outlined the initial work-up for lc many times:

Brain MRI w/triple dose contrast
CT w/contrast of Chest, Abdomen & pelvis
Bone scan
PET scan...maybe(in 13 years, I've never had none)

F/U MRI protocol is "iffy" and there is no established standard if original is negative. Since MRIs don't require radiation, I'd vote for every 6-12 months. Then again, no one has asked my opinion!


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There are guidelines for lung cancer treatment that the doctors have to follow . To order special test, without symptoms, your healthcare provider will have to approve them, if you want them to pay for it.

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