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SRS and Infusion on the same day. Doctors say we must choose…
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SRS and Infusion on the same day. Doctors say we must choose…

› Forums › General Melanoma Community › SRS and Infusion on the same day. Doctors say we must choose…

  • Post
    • September 21, 2017 at 2:42 pm
    thinkingofu
    Participant

      Hello everyone xxx

      As the title suggests, we are due to have a second infusion (yervoy + opdivo) on Monday, however, on the same day mom shall have a second SRS treatment. They state they can either give her her IV infusion or SRS treatment a week later because she cannot have both on the same day. 

      If we choose to have the infusion on a later date, it would mean she will get her 2nd dose of Yervoy+Opdivo 4 weeks later instead of 3. 

      If SRS, then there will be a 2 week gap between her first SRS and the second one (she will have her first one tomorrow). 

      What would you suggest, please? Would someone with mets in brain better to have SRS or Infusion sooner?

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    • Replies
        • September 21, 2017 at 3:23 pm
        Bubbles
        Participant

          We have learned that there is actually no reason at all to avoid administration of immunotherapy and radiation together.  Here is a post from 2016 that addresses that:  http://chaoticallypreciselifeloveandmelanoma.blogspot.co.uk/2016/06/brain-mets-in-melanoma-dont-wait-to-add.html  

          Here are about a zillion immunotherapy with radiation reports:  http://chaoticallypreciselifeloveandmelanoma.blogspot.co.uk/search?q=radiation+and+immunotherapy

          However, given the time frame of 2 weeks (as well as the 4 vs 3 week gap with immunotherapy) it is probably soon enough that it will not make a significant difference.  I wish your mom well.  Celeste

            • September 21, 2017 at 4:07 pm
            thinkingofu
            Participant

              Thank you! So does it mean it can be done on the same day? xxx

              • September 21, 2017 at 9:34 pm
              Bubbles
              Participant

                Yes…though sometimes it is hard to get docs and institutions to come around and then there are just simple scheduling issues.  At any rate, the amount of delay you are looking at are probably not consequential.  Hang in there.  c

              • September 21, 2017 at 4:09 pm
              cancersnewnormal
              Participant

                If they aren't going to allow both to happen on the same day, I would personally pounce on SRS first. When deciding between "now" or "later" with brain lesions… now is/was always my top priority. The brain is the control center. You don't want your computer's mother board going down, or it isn't going to matter that the keys are sticking and the usb port no longer functions. 

                  • September 21, 2017 at 4:13 pm
                  thinkingofu
                  Participant

                    Thank you so much. So it would not be generally bad if she would have an infusion at 4 weeks instead of 3 weeks, right? Maybe you have heard something about it, because doctors are not sure. Thank you again xxx

                    • September 21, 2017 at 4:29 pm
                    jennunicorn
                    Participant

                      I agree that if you have to choose which to do first, go with SRS. Many of us have dealt with a postponed infusion due to side effects or what not and had no affect on how well it worked. Infusion can wait, take care of the brain bugger straight on first. 🙂

                      • September 21, 2017 at 4:34 pm
                      thinkingofu
                      Participant

                        Thank you so much for answering! I just posted another question before I saw your answer xxx

                        • September 21, 2017 at 4:37 pm
                        cancersnewnormal
                        Participant

                          I fished back through my calendars, and on November 4, 2014 I had gamma. My first Keytruda infusion was the following week… Nov 11.

                          In 2015, I did skip an infusion on April 7, because I'd had a seizure 2 days prior, which lead to a craniotomy on April 13. My next infusion was a week later on April 21. Sooooooo… I went from March 17 to April 21 on infusions… that's a 5 week gap on what should have been a 3 week schedule. Granted, it was for brain surgery, not radiation… but the gap in immunotherapy drugs wasn't detrimental. 

                          Jump to 2016… I had an infusion January 19 (Tues)… Gamma 2 weeks (plus 2 days) later on Feb 4 (Thurs)… then my next routine infusion 4 days later on Feb 8 (Mon). Technically, we never skipped a beat on hitting infusions when they were due, regardless of the brain radiation. Brain surgery, yes, but that was a whole different ballgame. : )

                          The SRS can cause some lesion swelling. The immuno drugs can cause some lesion swelling (hence my need for that second brain surgery referenced above). Docs may be doing their best to "play it safe" with her brain, knowing that pushing off an infusion really isn't going to be a big deal in the grand scheme. 

                          • September 21, 2017 at 4:42 pm
                          thinkingofu
                          Participant

                            Thank you, thank you and thank you xxx

                          • September 21, 2017 at 5:20 pm
                          ed williams
                          Participant

                            How many tumours are they hitting in the brain? Also how big are they? It was not that long ago that the only way you could get access to the combination of Ipi/Nivo was in trials and trials would allow active brain mets, we have come a long way in a short time! Best wishes!!! Ed

                              • September 21, 2017 at 6:02 pm
                              thinkingofu
                              Participant

                                Thank you, Ed xxx

                                She has 2 mets there. Around 2 cm each. 

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