John_H_T Posted May 22, 2019 Share Posted May 22, 2019 Hi, I am currently on ADT having completed Chemo last year and recently had my 6 monthly PSMA CT/PET scan and PSA blood test. The scan came back with nothing showing in the body and PSA undetectable but, the scan showed some PSMA uptake in the Brain so my doc sent me off for a Brain MRI. This showed a 9mm dia lesion surrounded by swelling and the neurosurgeon thinks its related to the Prostate as he has seen a few like this recently. He is recommending removal and I was wondering if anyone has had a similar experience - I am not looking forward to this but don't think there is much alternative. Regards John_H_T Link to comment Share on other sites More sharing options...
Clive Posted May 22, 2019 Share Posted May 22, 2019 I wish you all the best John. Please let us know how you go. Link to comment Share on other sites More sharing options...
alanbarlee Posted May 22, 2019 Share Posted May 22, 2019 G'day John, You're pretty unusual among the PCa brotherhood in having a brain met. Most times visceral mets seem to target the liver and/or lungs, so at least you'll have some bragging rights!. I really like neurosurgeons, especially the one who extracted some bone from my spine over a year ago and allowed me to resume walking, among other normal things. My only experience with brain mets relates to a son-in-law, who acquired a couple as a result of Stage 4 melanoma - which often migrates there. Sadly, he was treated with whole brain radiotherapy, rather than targeted stereotactic radiation. (I would certainly ask a whole lot of questions if the former option is ever presented to you, since the side effects were debilitating, to put it mildly, and the treatment was quite unsuccessful). Cyberknife is available in Sydney (at least), and Linac in most other places that offer stereotactic surgery, which is a widely used candidate treatment for brain tumours. As always, the surgeon's experience is the critical factor, especially with brain surgery, whether by targeted radiation or conventional surgery. The only other things I can think of asking about is whether or not shrinking the swelling around the tumour (e.g. with dexamethasone) is appropriate prior to surgery, and whether or not there might be a role for hydrogel to protect adjacent structures from radiation damage if your surgery goes that way. (That is sometimes done to protect the rectum from radiation damage when the prostate gland is the target). Best of luck Mate! Alan Link to comment Share on other sites More sharing options...
deanbatt Posted May 22, 2019 Share Posted May 22, 2019 My best wishes to you. I'll be praying for your total recovery. Link to comment Share on other sites More sharing options...
ardee Posted May 22, 2019 Share Posted May 22, 2019 We have had a couple of gents participate in our advanced PCa virtual group with brain mets, John - to date they have not had any procedures. There is one current participant. You are very welcome to join us - we meet online https://www.gotomeet.me/AnswerCanceror by phone (local Oz #) +61 2 9091 7603 # 222-583-973 on: 1st & 3rd Mondays at 5 pm US Pacific, and 2nd & 4th Tuesdays at 3 pm US Pacific I think the meetings occur the following morning by you; we sometimes have Aussie particpants. More info at www.ancan.org . I would also suggest you reach out to Brain Tumour Alliance Australia to see what support they have https://www.btaa.org.au/. Until recently we had a brain tumor support virtual group too .. it is now moving to another platform although we are in discussion to replace it. Onward & upwards, rick PS If you send your e-mail address to info@ancan.org, we are happy to add you to our distribution for advanced notice - or you can visit our site www.ancan.org Link to comment Share on other sites More sharing options...
Raymond Posted May 23, 2019 Share Posted May 23, 2019 Have you looked into proton beam radiation. It may be an option but you would need to research it further. I believe it targets the area better and does not extend beyond the depth of the lesion. Ray Link to comment Share on other sites More sharing options...
John_H_T Posted May 23, 2019 Author Share Posted May 23, 2019 Thank you all for your comments. I will follow up on some of the suggestion given, thanks very much. I have had experience with stereotactic treatment as I was in a trial at Epworth for 18 months, 6 months after my radical prostatectomy to treat mets in my abdomen after my PSA started to rise. I then fell out of the trial as I exceeded the met limit criteria (max of 5 mets ). I also had a recurrence in a rib bone so in taking the decision to remove the brain met I considered this past experiences. I think that removal will also allow to confirm that this met is related to Prostate Cancer and not something else. At least I will then know what I am dealing with going forward. While I was doing Chemo I was initially on dexamethasone but that gave me uncontrollable hiccups so I moved to predmisolone which I am taking now to reduce the swelling. At this stage I am booked in for Monday so will be of line for a week or so. Regards John_H_T Link to comment Share on other sites More sharing options...
Kerrie McMahon Posted May 23, 2019 Share Posted May 23, 2019 Hi John My now 87 year old Dad had four brain mets that were only discovered after he had a small seizure four years ago. He had a craniotomy and the large one in the right posterior frontal lobe (14mm x 16mm x 13mm)was surgically removed ... it was biopsied and was found to be Prostate Cancer. The three small ones to the back of his head could not be removed but all including the large one were treated with one high dose of radiation. After many MRIs and Pet scans none have returned. The only thing the corner of his lip is a bit numb from the op and he didnt have any side effects from the Radiation.( Not that we noticed. )He then went on to have Chemo and three monthly Zoladex injections and after failing some ADT drugs is now doing very well on Zytiga and Prednisone. 🤞 We were told that Dad is a very rare case as Prostate Cancer hardly ever spreads to the brain. So far he doesnt have any bone mets but has a adrenal met. The side effects he has atm are fatigue hot flushes...just the usual with ADT. He is getting a bit mixed up sometimes but probably brain fog or just plain old age nothing to do with his brain mets. Not sure if your brain lesion is similar to Dads but just thought I'd let you know his story. All the very best for Monday. Kind Regards Kerrie Link to comment Share on other sites More sharing options...
Kezza2 Posted May 24, 2019 Share Posted May 24, 2019 Hi John. I am currently in recovery from radiation to the dura, the membrane that covers the brain just under the skull. I had three areas of mets in the dura, which were pushing on the brain inwards up to 30mm, with the largest met measuring 44mm across. The steroids had been masking the mets while I was having chemo (docetaxel) but as soon as I stopped pred they went nuts. So at present I am starting to wean myself off dex, and will have a full set of scans in two weeks to see what is happening, but at this stage I am looking to have Lutetium177 as a paying customer as I also have five areas on bone mets. Is your met actually in the brain ?? Link to comment Share on other sites More sharing options...
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