Brain mets - radiation?

Just when I thought things couldn't get any worse, they do.

Review: Mom had metastatic breast cancer for 11 years with mets to the bones and Ovarian cancer for 1 year (new primary). She was living alone independently with daily home care until two weeks ago when she got dizzy, fell and broke her arm. She's anemic, low platlets, and has congestive heart failure down to 25% function probably from the
Herceptin. She elected not to have the surgery and was psychologically evaluated a week ago Saturday as competent to make that decision. The hospital she was in was terrible, despite the large sign on the wall, just about every person who came in would pick up her broken arm and she would scream in pain! My brother and I looked into options and she wanted to go to a palliative care center that specializes in terminal cancer patients. She was transferred there last Wednesday. She was fine Wednesday night.

New developments: Something bad happened. Pretty much overnight, she has developed some kind of dementia. She's very confused. I am devastated. Her doctor said that there could be a number of causes, like a stroke, or infection, but its most likely brain mets. They will try to treat it with steroids first and if her response is sufficiently favorable, then they will do a cat scan to see what's going on. If they elect to go that route, they will have to do the cat scan in another hospital because the palliative specialty hospital she's in doesn't have the equipment. It is terribly cold this week in
New York. He said that if they determine that its brain mets, then radiation may shrink the mets and prolong her life from 3-6 months, possibly even restoring her mental function. Although she did improve a litte from the steroids, she was able to ask for milk and apple sauce, she reconized me, my brother, and a picture of her mother, she was able to say she was hot, from what he's seen of her, the doctor does not think its sufficient to warrant any further action. He thinks that if she doesn't respond sufficiently to the steroids, there is little hope for a response from radiation, and moving her to do the cat scan would be traumatic.

My question is why don't they just assume that its brain mets give her the radiation anyway and see what happens. Why bother with the expensive cat scan. I didn't think radiation was that expensive. Isn't it possible that she will respond to radiation when she doesn't respond to steroids?

I know I'm going to lose her, and she's being kept extremely comfortable, and she couldn't be in better more caring nursing hands.
But there is no amount I wouldn't give for just one more intelligent conversation. I don't know if I should force the issue possibly by moving her again. I don't know if that would be doing her a favor or should I just let her go.

My Mom who died from lung Cancer had brain mets. She had seizures ( that is what brought her into the hospital to have her lung mets diagnosed).
She had radiation treatment ( which she never completed) and every treatment she came home sicker and more confused. But to answer your question they have to know where to target the radiation before they do it. And believe it or not the radiation is more expensive then the CT Scan. I am sorry you and your mother are going through this.

<< New developments: Something bad happened. Pretty much overnight, she has developed some kind of dementia. She's very confused. >>

Is there any possibility that she was given a 'new,' different or 'wrong' medication?
I am not sure about the radiation but think that there might be possible legal ramifications if that were done without first determining the need.
Sorry to hear that your mom is having such a tough time. I am not one to advise on when it is time to 'let go' or if it ever is, being somewhat ambivalent on that subject as someone who has seen it all (with my mom and several of her relatives while I was growing up) who has breast cancer myself.