Stereotactic Radiosurgery, what side effects?

My friend (diagnosed 6/08,Stage IV NSCLC), aged 61, is still in treatment but is running out of options.

Initially she was treated with chemotherapy approx. 6 mos. and then she was on Tarceva for 13 months. In November 09 most of the cancer had resolved and the primary tumor was actually removed using the VATS procedure and we were hopeful the Tarceva would continue to maintain control. Alas that was not the case and in December It was found she had developed numerous small brain mets. She was treated with WBR for these (no one explained the wbr caused terrible side effects from steroids and burns). The cancer in her lung progressed in January and Tarceva was stopped. Shortly thereafter much pain began and she was given a fentanyl patch and morphine.

She began Gemzar in February. Two days after the Gemzar infusion she was in terrible pain, barely able to speak and unable to get up. Her hands and legs were swollen and blotchy red. She had a fever of 101.9 and ended up in the hospital for a week. Her oxygen level was 80 percent and she has been on oxygen ever since. She survived all that and has improved but needs much help with the daily functions of living.

A recent MRI shows she has four new brain mets that can be treated with Stereotactic Radiosurgery and she wants to persue this treatment. Yesterday her onc told her that more chemotherapy would not affect the brain mets and likely increase her neuropathy and quality of life. He does recomend the focused brain radiation.
The oncologist agreed she could try the Tarceva again since it sometimes will work a second time after a break. He is increasing the dosage from 150 to 225.

What side effects can be expected from the focused radiation and are there any suggestions about the rest of her story? I have researched the clinical trials having to do with tarceva resistance and for one reason or another she doesn't qualify.

My friend is eating very little and sleeping alot. However she is still very much a part of this world wanting to have a yard sale, take care of her plants, watch television and read. We even played cards last week.
Thank you. I appreciate your knowledge and suggestions.

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Your friend is so lucky to have you. My beautiful (I mean she is absolutely beautiful inside and out) 64 y/o mom(my best friend) was recently diagnosed January '10 with stage iv lung cancer with 2 brain mets and a spot on her spine. She received the stereotactic radiation to the 2 brain mets and then less than a week later she started her chemo. We go today for her 2nd chemo treatment. They have not done a mri to see if the sterotactic radiation worked but they will once she receives her third chemo treatment. My mom is already so thin and so weak. I was wanting to know what did the start your friend on initially and how has she done. Right now at the point where my mom is I would like to get her to the 2 year mark. I just said a prayer for your friend and wish her all the best. If you are like me, you research and try to find the answers to try to save her. My thoughts are with you and her.
Jeri

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Thank you Jeri for your reply. We feel very blessed to have this much time but of course we want more. Linda was diagnosed in June 08, began avastin, alimta and carboplatin on July 20. She did well on this combo and after the second treatment It had reduced the tumor by 50% and lymph nodes by 30%. But by November 08 it lost its effect. And again in 12/08 Linda was in very bad shape. That is when she began Tarceva, a targeted treatment that is in pill form and usually most effective in people who smoked very little or never-smokers. Linda was back to her old self for a full year. It was wonderful indeed.
What side effect has your mom had from the brain radiation? Thanks again Jan K.

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Jan,
I've never had a brain met, but I had TomoTherapy for a spinal met. Please Google TomoTherapy. It is quick, efficient and very precise. I had no side effects or damage to healthy tissue. Please request an appointment at a TomoTherapy Center. Cyberknife is also good, but can have side effects.
Charlene

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Thanks Charlene, I will do that. That is good to hear since WBR was horrific for her.

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I had Novalis TX sterotatic radiosurgery for a stge 3 lung tumor. After two years of four chemo and 40 IMRT radiation treatments that did nothing, I had five daily treatments of Novalis TX and the tumor is now gone. The radiation oncologist started this type of treatment in July 2009 and his patients have had very few side effects, fatigue being the most common. I also had joint aches which could have been from all the previous chemo. He also said most side effects resolve within two or three weeks after treatment ends. If you have multiple tumors, they work on one at a time but can zap the next one right after they finish the first. I would HIGHLY recommend this treatment, and only wish I would have had it sooner. I finished in November 2009 so have only had one PET with No Evidence of Disease so far, but am very hopeful with the help of this radiosurgery option!

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Thank you Suzanne. That certainly is encouraging.

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Jan, I also had Novalis on 2 Stage IV lung mets and an adrenal mets with no side effects in 05 TomoTherapy is a newer treatment but both are preferable to any other radiation. Please , no WBR
Charlene

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My mom had several steriotactic raidosurgery treatments. Some fatigue, might have been slightly more forgetful. But maintained a great quality of life. Wishing all of you the best. My mom survived 9 years from diagnosis and really had a normal productive life until the last 9 months of her life. There is hope ...

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Jan,
Mom's mets were on her visual cortex so it effected her vision from the swelling (hopefully) just a little. She also said everything tasted funny and smelled funny. I pray all goes well with her. Thank you so much for your information. Mom is on alimta and carboplatin. They could not do avastin because of possible bleeding in the brain and they had just done the radiation. I pray avastin is next...I here good things about it.
God speed!
Jeri

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