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This chapter explains Whole Brain Radiation Therapy and its use in treating brain metastases. Watch the entire documentary from the beginning here: • Brain Metastases: A Documentary | How... Whole Brain Radiation Therapy (WBRT) involves treating the entire brain with radiation to destroy any visible or not-yet-detected brain metastases. WBRT, however, can create side effects in regards to brain function. --------------------------------------------------------------------------------------------------------- Video Transcript: Dwight Heron, MD: All brain radiation is as it sounds; We’re treating the entire brain with radiation. David Roberge, MD: Conventional radiation, the way it’s been given for a long time is that a little bit of radiation is given every day and that’s repeated five days a week up to seven or eight weeks. In that process, there’s a lot of healthy cells that receive the same amount of radiation as the cancer cells, but the healthy cells are better at repairing between the different radiation treatments. So if you give a treatment today and you give another one 24 hours later between those two treatments the healthy cells are repairing at a faster rate than the cancer cells. Eric Chang, MD: Unfortunately when a patient is diagnosed with brain metastases, there are many more lesions that are not detectable on an MRI or any imaging modality that we have today. They have the potential to grow. Some have referred to this as the “dandelion effect”. When you blow on a dandelion, all these seeds shower an area. It’s not dissimilar to that phenomenon where there is a primary cancer somewhere in the body and therefore there’s a possibility for cancer cells to seed and deposit multiple areas of the brain. So whole brain radiation therapy is used to try to sterilize not just the visible brain metastases but also the microscopic brain metastases that we just can’t see yet. DR: Radiation has been around for about 100 years and it’s been a really important part of treating cancer. For some people that’s an appropriate treatment but it comes with a lot of side effects. Almost everybody is tired, sometimes really severely tired. You lose your hair. You can get inflammation in your ear, sometimes it leads to hearing loss. It makes people nauseous sometimes. What worries patients the most and what caused us the most concern is it can have an effect on memory, concentration and other brain functioning. Orin Bloch, MD: Whole brain radiotherapy has a devastating impact on cognition. We’re targeting the areas where new memories are formed, the hippocampus, as well as all of the interconnections between different parts of the brain that are critical for higher-level thought and memory. You can’t expose that much of the brain to toxic radiation and expect to have no consequences. So if we are going to strive for a cure or at least long-term suppression of cancer and keep patients alive for years and years, we really have to think about what their quality of life is going to be and quality of life starts with what’s up here. ----------------------------------------------------------------------------------------------------------- Interested in learning more? See our other chapters below that address many questions regarding brain metastases: What are brain metastases? • What are Brain Metastases? Chapter 1 ... How do brain metastases develop and what causes them? • What Causes Brain Metastases? Chapter... What are the possible treatment options for brain metastases? • Is Chemotherapy Effective for Brain M... What is Whole Brain Radiation Therapy (WBRT) and how is it used to treat brain metastases? • What is Whole Brain Radiation Therapy... What is stereotactic radiosurgery? • What is Stereotactic Radiosurgery? Ch... What is the Gamma Knife? • What is the Gamma Knife? Chapter 6 — ... What is a linear accelerator and how does it work? • What is a Linear Accelerator? Chapter... Frame-based vs. frameless radiosurgery. What’s the difference and how does it impact the patient and treatment? • How are Patients Immobilized During R... How does Cyberknife technology treat brain tumors? • What is the CyberKnife? Chapter 9 — B... What is a multileaf collimator and what role does it play in radiosurgery? • What is Shaped Beam Radiosurgery? Cha... What if a patient has more than one brain metastases? How are they treated? • Can Multiple Tumors Be Treated at the... Some radiosurgery treatments can be completed in just one visit. Why are multiple treatments (known as fractions) sometimes necessary? • When is Radiosurgery Performed More t... If it can harm the patient, why is Whole Brain Radiation Therapy (WBRT) still done? • Why is Whole Brain Radiation Therapy ... What does “Cancer is being treated as a chronic illness" mean? How do brain metastases patients maintain their quality of life? • What Happens After Radiosurgery? Chap... Why is surgery sometimes necessary to treat brain metastases? • When is Surgery Recommended? Chapter ... How do I choose the best care team for treating my brain metastases? • How to Choose the Best Radiosurgery T... What is the future outlook a brain metastases diagnosis? • What is the Future of Brain Metastase...