Whole Brain Radiation Causes Collateral Damage aka Side Effects

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Do you know anyone who has received whole brain radiation? I do. Whole brain radiation causes ugly collateral damage aka side effects-

Whole brain radiation was “first used in 1954.” That means that millions of cancer survivors have received whole brain radiation since then. Dr. Paul Brown, professor of radiation oncology at the University of Texas MD Anderson Cancer Center, Houston is quoted as admitting that “The potential benefits of whole brain radiation therapy are far outweighed by the detriments of the therapy itself…”

Image result for photo of whole brain radiation

It has taken conventional oncology over 60 years to determine that the “potential benefits”  of whole brain radiation are “far outweighed” by the “detriments” aka collateral damage.

Don’t expect your oncologist to raise the subject of collateral damage aka side effects. Expect your oncologist to offer standard FDA approved cancer therapies. It is up to you to identify and prevent the side effects from these standard FDA approved therapies.

Cancer that spreads to the brain to cause metastases is a common problem in cancer management. The question for your oncologist for this or any aggressive cancer therapy is:

1) will this therapy help me live longer? If so, by how much (on average)

2) how will this therapy affect my quality of life?

Have you been diagnosed with cancer? Are you considering undergoing whole brain radiation?

For more information about your cancer and the pros and cons of therapies you may be considering, scroll down the page, post a question or comment and I will reply ASAP.

thank you,

David Emerson

  • Long-term cancer survivor
  • Cancer Coach
  • Director PeopleBeatingCancer


New Study Questions Use of Whole-Brain Radiation to Treat Cancer

“While the more aggressive treatment was better at preventing recurrence of tumors in the brain, it didn’t extend survival.

“The potential benefits of whole brain radiation therapy are far outweighed by the detriments of the therapy itself”…

Brain metastases is a common problem in cancer affecting an estimated 400,000 to 600,000 patients annually in the U.S. alone, some 200,000 of whom get whole brain radiation during the course of their disease. Lung cancer is the most common malignancy to spread to the brain, followed by breast cancer and melanoma…

Whole brain radiation was first used in 1954 and has long been a standard strategy for brain metastases…”

Treatment of Radiation-Induced Cognitive Decline in Adult Brain Tumor Patients


Cognitive abilities in brain tumor patients can be affected by a myriad of factors: the tumor itself, depression and anxiety, fatigue, sleep dysfunction, pre-brain tumor cognitive baseline (premorbid functioning), pain, and brain tumor treatments themselves (surgery, chemotherapy, and radiation). Most often, attention, working memory, and information processing speed are affected but patients can present with a wide array of cognitive symptoms [].

Radiation-induced cognitive decline (RICD) is considered a late effect of radiation therapy (RT) occurring in 30% or more of patients alive at 4 months after partial or whole brain irradiation.

For those living over 6 months, that number may rise to 50% [, ]. Patients with RICD may be unable to continue working and in severe cases may not be able to live independently. Memantine, donepezil, methylphenidate, and Ginkgo biloba have all been utilized as mitigating pharmacologic strategies with modest levels of success [, , , ]. Neurocognitive rehabilitation has been explored as a non-pharmacologic intervention []. Preventative strategies include using radiosurgery (SRS) when appropriate for patients with brain metastases or whole-brain RT with hippocampal avoidance. Cytoprotective agents under investigation include ramipril, fenofibrate, tamoxifen, indomethacin, and pioglitazone []. Here, we review the pathogenesis, diagnosis/classification, and management of RICD and discuss strategies used to minimize its risk…”


Leave a Comment:

Carole Johnson says a couple of years ago

Had surgery left upper lobe removed due to small cell lung cancer. Tumor was 1cm and no other cancerous cells found.
Will have 12 chemo treatments for prevention. Furthermore, after chemo they want to do radiation to my brain. I am 60 y/o, working full time and raising grand children.
Please advise

    David Emerson says a couple of years ago

    Hi Carole-

    Several things. First and foremost, I am sorry to read of your SC lung cancer. Secondly let me say that you are in charge of what therapies you undergo. Oncology may recommend therapies based on previous experience, research, who knows what. But you have to do what you think is right for you.

    Having said that, I have to say that by asking for my advice, you are questioning your oncologist’s recommendation to undergo whole brain radiation. Especially since you are already undergoing 12 chemo treatments for “prevention” as you say.

    When you say that the tumor found in your upper lobe was one centimeter, I am guessing that this is a relatively small tumor. Combined with the fact that your cancer has not spread (“no other cancerous cells found), you believe that our small cell lung cancer is local, not regional and not systemic.

    I am also 60 years old. Though I am a cancer survivor myself, I make decisions based on the assumption that I will live for decades to come. I think that you should make treatment decisions this way as well.

    I think your decision comes down to weighing the risks and benefits of more or less treatment. More treatment being “they want to do radiation to my brain.”

    If you undergo both surgery and chemotherapy, both to kill/remove lung cancer from your body, what is your risk of relapse? In other words, a local, 1 cm tumor, is considered to be early stage? Perhaps SCLC stage one?

    What is the published risk of relapse of stage 1 SCLC that is surgically removed?

    If you undergo 12 rounds of chemotherapy, what is the published risk of side effects, secondary cancers, organ damage, etc. caused by this “preventive” chemotherapy?

    If you undergo whole brain radiation, what is the published risk of side effect, secondary cancers, brain damage, etc. cause by this “preventive” radiation?

    I apologize for asking all this silly questions above. I’m just trying to illustate how I think and how you should think- what questions you should consider before making any sort of decision.

    And by the way, you should be able to ask your oncologist any/all of the questions above. All board-certified oncologists should be able to explain your risks of side effects cause by both “preventive” chemotherapy and radiation.

    Yes, my guess is that there is a small risk of your SCLC relapsing. However I believe that the risk of side effects from both your chemotherapy and radiation is greater.

    I would love to know what you think, what decisions you come to about your therapies. Let me know if you can.

    Thanks and good luck.


    David Emerson

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