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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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My neurologist says that my having radiology on my full head,

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My neurologist says that my having radiology on my full head, a left frontal lobe head cancer caused my blood vessels?, I can't remember the exact term, to keep dying off. My oncologist says it is Dementia. Both say there is no cure for it. My husband as researching and says that you have an oxygen chamber. He is convinced that it would be the way for me to go. I am checking to see if it is even an option?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

neuromd2012 :

Hello. there could be a few terms used. He could have mentioned microvascular disease, or he could have said the blood vessels were Atretic

neuromd2012 :

Radiation Damage to the Brain from RT, either full axis neuroradiation, or more focal beam therapy for tumor ablation, can cause radiation cerebritis

neuromd2012 :

this is an inflammatory condition of the blood vessels, which causes them to break down

neuromd2012 :

it usually starts no sooner than 6 months following radiation therapy

neuromd2012 :

And there is no known cure for it

neuromd2012 :

In this type of radiation induced damage, you can see a "dying back" or atresia of the blood vessels, and I expect that is what the neurologist said

neuromd2012 :

If you wish to figure out if this is radiation induced or a neurodegenerative dementia,, the way to tell is a specific PET study that looks

neuromd2012 :

at amyloid deposition in the brain as seen in dementia

neuromd2012 :

there are a few radiotracers to choose from,

neuromd2012 :

In terms of HBOT (hyperbaric oxygen therapy), recent "evidence based studies" done by the American academy of neurology

neuromd2012 :

has suggested that HBOT is not effective in treating stroke. This is a point of controversy, I have attached a paper from taiwan, that states it is effective in stroke, http://www.ncbi.nlm.nih.gov/pubmed/23533308 That is not to say it would not help radiation cerebritis.

neuromd2012 :

but there are no studies to support its use

neuromd2012 :

please get back to me to discuss this further if I can help when you come online

neuromd2012 :

Dr frank T

Expert:  Dr. Frank replied 1 year ago.
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Customer: replied 1 year ago.


Will this reach a point where it stops? full axis neuroradiation is what I had done. Will L-Arginine help?


If oxygen chamber won't help then it wouldn't be beneficial for me to come there? We were hoping by coming to Mayo something might be found to help slow the progression. I had a pet scan done over a year ago when they took out my left frontal lobe of my lung. Then it moved to my brain. frontal left lobe. Doubled within 6 weeks. Was recommended to have the radiation.


 

Customer: replied 1 year ago.

 


Will this reach a point where it stops? full axis neuroradiation is what I had done. Will L-Arginine help?


If oxygen chamber won't help then it wouldn't be beneficial for me to come there? We were hoping by coming to Mayo something might be found to help slow the progression. I had a pet scan done over a year ago when they took out my left frontal lobe of my lung. Then it moved to my brain. frontal left lobe. Doubled within 6 weeks. Was recommended to have the radiation.

Expert:  Dr. Frank replied 1 year ago.
Hello I am not saying that HBOT will not help radiation cerebritis. The truth is that I do not know, and in checking the literature, there are no studies showing that it is effective in treating this problem. For years we have said that there is no treatment, but that may not be true. I can say that you can also measure the change of radiation to the brain by doing MR Spectroscopy, and measuring the NAA levels in select areas of the brain. I will attach an article on doing that study, you might ask the doctors at the Mayo about doing this prior to treatment.
http://www.rima.org/web/medline_pdf/JComputAssistTomogr_29%283%29_293-7.pdf
The concept in radiation induced cerebritis is that it does not stop, the blood vessels are inflammed and ultimately cause micro thrombotic strokes. I would also say from your history, that you probably made the correct decision to have RT for the metastasis, as studies have shown that solitary brain metastasis from lung cancer should be treated with either surgery, radiation or both. Please get back to me if you have questions I can answer L- Arginine will not hurt, and it adds precursors to be used in formation of energy metabolites in the TCA cycle. Dr Frank T
Customer: replied 1 year ago.


We want to explore every option. So we are thinking we want to come to Mayo and get another opinion. We don't need a referral according to our insurance. I would like to have test done and get a second opinion at Mayo. How do I get an appointment?

Expert:  Dr. Frank replied 1 year ago.
To get an Appointment at the Mayo (rochester minn, jacksonville, fla, or scottsdale Az) you need your referring doc to write a letter on your behalf, and send your records. They take care of everything else.
Just start under Patient Care
http://www.mayoclinic.com/
Customer: replied 1 year ago.


Which Dr.? Oncology, Neurologist or My family Dr. My family Dr. agreed we should have a second opinion and said she would send me one if I needed it.

Expert:  Dr. Frank replied 1 year ago.
Hello. The Mayo is a very different place. What will happen is that after you send the chart, they will review it, and design a outpatient schedule where you will go from department to department, everything timed out to the minute in a day. You will see a neurologist, (neuro-oncologist) and probably an oncologist as well, then you might get some testing that afternoon or the next day, etc. They design an entire schedule with no time wasted, very efficient. So they will tell you ahead of time which doctors you will be seeing and when. Dr Frank T
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 1 year ago.

Thank you so much. I appreciate your help.

Expert:  Dr. Frank replied 1 year ago.
you are welcome. please get back to me anytime if I can help. Dr frank t. please rate my service as that is how I am compensated for my work

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