Brain Cancer

[GK50]

Need to know on how does the reduction of a malignant tumor in the brain happen post gama knife surgery. A close relative of mine had a gama knife surgery done post which within the next three months the lesion was reduced to half its orignal size. But in another two months it has again increased by a few mms though not to its original size. The doctor says that it would reduce again and has kept her on medications. Wanted to know if this is correct.
Is this normal post gamaknife surgery

[vprincess1928]

GAMMA KNIFE VERSUS CYBERKNIFE TREATMENT FOR BRAIN TUMOUR FOR THE FOLLOWUP CASE OF CARCINOME PHARYNX, FURTHER MRI SHOWS My brother is in trouble.
He was diagnosed with Lymph node cancer and nasopharynx .
Since two he is suffering from cancer on the Temporal bone area.
Chemo and radio therapy was done since the diagnosis.
After the last surgery 10  months back, Some fluid kept coming out from the hole punctured in the left  temporal bone just above affected side.
it stopped after 2 months, we were inclined to get the homeopathy treatment for last six months. before this and during this period , problems like stiffness in the face Muscles, caused  the Speech problem and he developed Vision loss , hearing losses.
I request you to guide us for the treatment, whether the accuray's Cyber knife treatment shall be a benefit for my brother.
Any information if required, pls respond back at the earliest.

NOW HAS DEVELOPED LARGE LOBULATED HETROGENEOUSLY  ENHANCING LESION WITH LEFT TEMPORO PERIETAL REGION WITH SOLID AND CYSTIC COMPONENT MESURING TOGATHER 70X82XX61 CM AND CYSTIC COMPONENT IS EXTENDING TROUGH CRANIOTAMY DEFECT EXTRA CRANIALLY IN THE LEFT EMPORAL REGION. ALSO INVLVING LEFT CAVERNOUS SINUS WITH THE MASS EFFECT.
COULD YOU PLEASE SUGGEST US THE BEST FOR MY BROTHER.

[GK50]

Thank You Dr for your help. Would also appreciate your advice as to wether the current line of treatment is the best possible , or are there any better options to treat the same?

[Fernando Roque, MD]

Hi.  From the additional information you posted, it seems that your relative's recurrence of weakness is coming from the excessive edema surrounding the mass, not mainly from the enlargement of the mass itself.  The edema can exert a "mass effect" and can cause the tumor to behave as though it's larger than it actually is. That's why your neurosurgeon said the size is "still fluctuating and can still reduce".  I think he's hoping that the edema will subsequently subside with the medication.

[GK50]

Thanks for your revert. She had original case of Overy cancer for which she was operated and underwent 3 pre surgery and 15 post surgery cycles of Chemo. Post which she was confirmed as cured for that, however she had developed a lesion in the right frontal lobe which was effecting her left side of the body. She underwent a gama knife surgery, post which she was given steroids and Valporin. She was recovering well for around three months . Her 1st three monthly checkup showed a great reduction in the lesion. However 2 months later she started feeling a weakness in her left arm again and had a seizure, for which she was admitted. We were informed that this was due to excessive edema arond the lesion.However the current CT scan that we have taken shows a slight increase in the size of the lesion as well.She is currently being given Valporin, Lasix and Frisium 5. She is due for another Ct and checkup in 2 months, however she is again facing some weakness in the left side. I had asked the neurosurgeon regarding this during her last checkup around  a month back, however he said it was normal for the size to fluctuate for some time and it can still reduce. Would appreciate your opininon on this.

[Fernando Roque, MD]

Hi. The gamma knife is not an actual knife but a tightly focused beam of radiation.  So it doesn't actually excise the tumor, but burns it.  Since the radiation beam is focused, the normal tissue surrounding the tumor is damaged minimally.  Once burned, the tumor will shrink as a matter of course, but sometimes some swelling in the burned area may occur as part of the normal inflammatory response.  This swelling should subside within a couple of weeks after the treatment.  Since your relative had an increase in tumor size two months after treatment, this may not be attributable to post-radiation inflammation.  In this case, it's possible that the tumor may have grown back again.  My question to you is: what particular medication has your relative been receiving? Steroids? Chemotherapy? I might be able to give you a more accurate answer if I have this additional information. Thanks.