Chemo vs WBR

[pleodorina]

My brother, 50 years old, has Stage IV NSCLC (adeno);diagnosed September 2013; inoperable; no relevant mutations. He had undergone radiation to lung and several rounds of chemo (Carboplatin, Taxotere, Cisplatin, Gemzar). He also had surgery to remove one brain met (January 2014) and one kidney (May 2014)… CT scan in December showed no mets outside lung and lymph nodes….

He started Tarceva this January but it seems it did not work as the cancer spread to brain…. 9 mets were identified in the initial MRI 2 weeks ago but the subsequent MRI right before yesterday’s gamma knife procedure (which removed 7 mets) evidenced numerous other tiny/small tumors spread all over the brain….He has been in relatively good condition (eating well, no weight loss) until these new mets emerged (which affected his walking and reading ability)…. He is fine now again…

My question is: under these circumstances what would be the preferred strategy? To first do WBR (knowing that meanwhile and several weeks after he won’t have chemo, thus new mets will likely occur) or start chemo for a few rounds (knowing that meanwhile the brain mets will likely grow in size; his cancer cell type is very aggressive)….

Thank you for any opinion/insight….

[pleodorina]

Thanks for you reply and wishes.
All the best to you too.

[pleodorina]

Many thanks for your reply....
Best wishes to you too.

[rumpled]

Sadly, we are a patient support forum, so we cannot really answer the specific issues that  you put out. I do hope that your brother gets the care he needs and the second opinion that you seek!

[japdip]

This question needs to be put to your Brother's Oncologist ..... We here, especially over the internet do not have the capabilities to deal with such complicated concerns. If you and your Brother are not happy with the advice of your Oncology Team then you could seek a second opinion. I doubt at this stage of disease you would find any additional advice or recommendation. I believe there is also a Chemo or Oncology Community or Forum on the website where you might also post. I must say again though that this is a matter for a Medical Specialist in the Oncology Field.  Best wishes to you both.    Kindest regards ...