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Whole Brain Radiation

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My chemobrain seems insignificant when compared to the side effects caused by whole brain radiation. Ironically, years of research into brain health helps me write a better post about whole brain radiation. I guess the issue here is cognitive decline now how the decline occurred.

I am a long-term cancer survivor. Living with long-term and late stage side effects compels me to research and write about cancer and its many related problems.

What are the short, long-term and late stage side effects from whole brain radiation?

Short-Term Side Effects:

  1. Fatigue: Feeling tired or lacking energy is common during and after radiation therapy.
  2. Hair Loss: Hair loss is possible, although it typically grows back after treatment ends.
  3. Nausea and Vomiting: Some individuals may experience nausea and vomiting during treatment, which can usually be managed with medication.
  4. Headaches: Headaches can occur during treatment, especially in the initial stages.
  5. Scalp Irritation: Skin on the scalp may become red, irritated, or sensitive during radiation therapy.

Long-Term Side Effects:

  1. Cognitive Changes: Some patients may experience cognitive decline, memory problems, or difficulty concentrating months to years after treatment.
  2. Radiation Necrosis: This is a potential long-term side effect where radiation damages healthy brain tissue, leading to swelling, inflammation, and neurological symptoms.
  3. Endocrine Dysfunction: Radiation to the brain can affect the function of the pituitary gland, leading to hormone imbalances.
  4. Secondary Cancers: Radiation therapy increases the risk of developing secondary cancers in the long term, although this risk is generally low.
  5. Hearing Loss: Radiation therapy can sometimes affect hearing, especially if the ears are included in the treatment field.

Late-Stage Side Effects:

  1. Dementia: In rare cases, long-term cognitive decline can progress to dementia-like symptoms.
  2. Seizures: Some individuals may develop seizures months to years after treatment.
  3. Vascular Damage: Radiation can damage blood vessels in the brain, leading to vascular issues such as strokes or bleeding.
  4. Chronic Pain: Rarely, individuals may experience chronic pain related to radiation-induced nerve damage.
  5. Reduced Quality of Life: The cumulative effects of radiation therapy and its long-term side effects can impact overall quality of life, including physical, cognitive, and emotional well-being.

In my experience, therapies for slowing or eliminating cognitive decline are:
  • Brain games
  • Hyperbaric oxygen therapy (HBOT)
  • Moderate, daily exercise
  • Brain healthy supplementation
  • Brain healthy diet
Needless to say, whole brain radiation can cause serious side effects to the patient. As the study linked below says “WBR should be the therapy of last resort.” If however, the patients must undergo WBR, then I hope some of these therapies help.
To learn more about both conventional and non-conventional cancer therapies send me an email- David.Peoplebeatingcancer@gmail.com

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Strategies for preservation of memory function in patients with brain metastases

“Cognitive decline, particularly in memory, is a side effect seen in patients with brain metastases and when severe, can have a significant impact on their quality of life. It is most often the result of multiple intersecting etiologic factors, including the use of whole brain radiation therapy, effects of which, in part, are mediated by damage within the hippocampus. A variety of clinical factors and comorbidities may impact the likelihood and severity of this cognitive decline, and affected patients should be considered for evaluation in a comprehensive neuro-rehabilitation or “brain fitness” program…

Prevention strategies of neurocognitive decline due to whole brain radiotherapy (wbrt):

Avoiding WBRT is warranted for some patients with brain metastases; particularly those <50 years old. However, when WBRT is clinically indicated, hippocampal avoidance WBRT (HA-WBRT) has been shown to significantly reduce memory decline compared to historical controls without compromising treatment efficacy.

Additionally, the NMDA receptor antagonist memantine and renin-angiotensin-aldosterone system (RAAS) blockers have shown promise as neuroprotective agents that could be used prophylactically with radiation…

After the onset of neurocognitive decline the treatment is largely symptom-driven, however simply screening for and treating depression, fatigue, anxiety, cognitive slowing, and other processes may alleviate some impairment. Stimulants such as methylphenidate may be useful in treating symptoms of fatigue and cognitive slowing. Other treatments including donepezil and cognitive rehabilitation have been extensively tested in the population at risk for dementia, although they have not been adequately studied in patients following cranial radiotherapy. An innovative hypothetical approach is the use of intranasal metabolic stimulants such as low dose insulin, which could be valuable in improving cognition and memory, by reversing impaired brain metabolic activity.

Conclusions: Prevention of neurocognitive decline in patients with brain metastases requires a multimodal approach tailored to each patient’s need,

  • avoiding WBRT in some,
  • altering the WBRT plan in others,
  • and/or using neuroprotective prophylaxis in those in whom avoidance cannot be utilized.

Likewise treatment will require a personalized combination of strategies optimized to address the patient’s symptoms.”

Treatment of Radiation-Induced Brain Necrosis

“Radiation-induced brain necrosis (RBN) is a serious complication of intracranial as well as skull base tumors after radiotherapy. In the past, due to the lack of effective treatment, radiation brain necrosis was considered to be progressive and irreversible. With better understanding in histopathology and neuroimaging, the occurrence and development of RBN have been gradually clarified, and new treatment methods are constantly emerging. In recent years, some scholars have tried to treat RBN with


nerve growth factor, and

gangliosides and have achieved similar results. Some cases of brain necrosis can be repairable and reversible. We aimed to summarize the incidence, pathogenesis, and treatment of RBN…

  1. Glucocorticoid
  2. Anticoagulant
  3. Bevacizumab
  4. Nerve Growth Factor
  5. Shenqi Fuzheng Injection (SFI)
  6. Surgery
  7. Hyperbaric Oxygen Therapy (HBOT)
  8. Laser Interstitial Thermal Ablation (LITT)

The Demise of Whole-Brain Radiation Therapy

“Whole-brain radiation therapy (WBRT) is the treatment of last resort in the management of brain metastasis. Our duty to our patients is to cause the least harm possible balanced against the goals of therapy. This is a truism in any clinical scenario. When we are treating brain metastases, our clear first goal of treatment is to minimize the degree of neurologic injury that our patients experience. This injury can be from the brain metastasis itself or the treatment…



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