What is WBR whole brain radiation

Last few days, I am reading alot about WBR , what is it about and the possible side effect.

Not that I worry , but, I believe to know what will happen and plan ahead is important.

Few things I need to do before the treatment ...
- to discuss with doctor to have 10 to 15 times instead of 5 times, as I was told , it is better to have more times with lower dose, this will help to reduce side effect.
- to find out more and decide wheher to hold on the WBR until I feel not well, or to proceed with it . Reason being, I do not have any sympton yet, going ahead with WBR, means I will have to go thro' the side effect immediate. if I hold on, am I going to have more days of quality life .

Praying to Lord for wisdom to guide me.


Following are information about Whole Brain Radiation , extract from Living with Brain Mets.

http://www.livingwithbrainmets.org/brain-radiation-treatment.html

Whole Brain Radiation
Whole brain radiation consists of small daily doses of radiation delivered to the entire brain. Whole brain irradiation is frequently prescribed for patients with brain metastases. This treatment uses radiation to treat the visible lumps of tumor and the presumed invisible tumor deposits that are so small they may not be seen on even a sensitive MRI scan. Therefore, large areas of the brain may be treated to stop the spread of the tumors.

Does it work?
Symptoms caused by tumors metastatic to the brain usually respond to whole brain radiation therapy; different studies have reported response rates of 50 to 70 percent.

The Radiation Therapy Oncology Group (RTOG) performed randomized studies that showed a course of 10 treatments over two weeks to give a total dose of 30 Gray the same as 3000 centiGray or 3000 rads, to use older terms was as good as more extended courses of radiation therapy that give higher doses. In some situations, a shorter or longer course of treatment than two weeks may be preferable. For patients who have a single brain metastasis that is removed surgically, whole brain radiation therapy was found in a randomized study to give great improvements in preventing cancer from regrowing in the brain and in prolonging survival.

What are the side effects?
In general, there will be hair loss, skin irritation, loss of appetite, and neurologic effects. The most prevalent side effect is fatigue which is may last through treatment and for two months afterwards. The neurologic effects most affecting quality of life are eventual permanent memory and speech problems. These are just a few of the problems that can develop.

Whole Brain Radiation combined with Stereotactic Radiosurgery
Stereotactic radiosurgery can be combined with whole brain radiation therapy for brain metastases. The whole brain radiation therapy will treat the visible metastases and any presumed microscopic tumor deposits as well. This is possible because whole brain radiation therapy is given as a low dose to a larger volume and targeted to the tumor and the area of possible tumor spread, while stereotactic radiosurgery is a high dose given to a very small volume and targeted only within the tumor itself. The two treatment techniques can be thought of as complementary in achieving control of metastases to the brain.

Whole brain radiation therapy can cause shrinkage of visible brain metastases, sometimes making them more amenable to stereotactic radiosurgery or microsurgery. The addition of whole brain radiation therapy to stereotactic radiosurgery can decrease the possibility of additional metastatic lesions and decrease the chance that visible lesions treated with radiosurgery may have recurrences after radiosurgical treatment. Omission of whole brain radiation therapy for brain metastases is slightly controversial, but this is an area of ongoing intensive research.

Recently, some investigators have tried stereotactic radiosurgery alone without whole brain radiation therapy for selected patients with brain metastases to avoid causing the side effects of whole brain radiotherapy. Because whole brain radiation therapy can be given at a later date to these patients if their metastases are not controlled by the radiosurgery, this strategy may relieve symptoms effectively while not adversely affecting survival.

There is a widely accepted belief that for melanoma, kidney cancer and sarcomas that spread to the brain, stereotactic radiosurgery may be more effective at controlling the lesions than whole brain radiation therapy. The Eastern Cooperative Oncology Group (ECOG) is evaluating radiosurgery as a solitary treatment for patients with one to three brain metastases of these types of tumors.