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This chapter discusses how important follow-up is after radiosurgery for brain metastases. Watch the entire documentary from the beginning here: • Brain Metastases: A Documentary | How Brai... The goal of clinicians is to one day be able to treat brain metastases as a chronic illness, rather than a fatal disease. A large part of that is regular follow-up appointments and scans to detect any new brain metastases as early as possible. ---------------------------------------------------------------------------------------------------------- Video Transcript: David Roberge, MD: If you just give someone radiosurgery and you never see them again well, unfortunately it’s about 50/50 that they’ll get new brain metastases and if you don’t follow them, the only reason you’ll see them back is because they’re sick and they’re in the emergency room. But if you see them every few months and you do an MRI, you might find that new metastases when it’s only a few millimeters and you can zap if before it causes any trouble and often the patients, despite having advanced cancer and brain metastases, they’re not going to die from the brain metastases because we can control them by following them and treating them when they’re small. Douglas Kondziolka, MD: And that’s really part of managing cancer as more of a chronic illness with these periodic tests. It’s been part of the care of the body, PET scans, periodic CT scans, it needs to be part of the care of the brain. Orin Bloch, MD: If you have a garden and you notice a couple of weeds, you can either go and pull those couple of weeds or you can tear up your entire lawn. There might be two or three other weeds that you didn’t see. If they grow up later, you’ll just pull them out later. ---------------------------------------------------------------------------------------------------------- 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 — Bra... How do brain metastases develop and what causes them? • What Causes Brain Metastases? Chapter 2 — ... What are the possible treatment options for brain metastases? • Is Chemotherapy Effective for Brain Metast... What is Whole Brain Radiation Therapy (WBRT) and how is it used to treat brain metastases? • What is Whole Brain Radiation Therapy (WBR... What is stereotactic radiosurgery? • What is Stereotactic Radiosurgery? Chapter... What is the Gamma Knife? • What is the Gamma Knife? Chapter 6 — Brain... What is a linear accelerator and how does it work? • What is a Linear Accelerator? Chapter 7 — ... Frame-based vs. frameless radiosurgery. What’s the difference and how does it impact the patient and treatment? • How are Patients Immobilized During Radiat... How does Cyberknife technology treat brain tumors? • What is the CyberKnife? Chapter 9 — Brain ... What is a multileaf collimator and what role does it play in radiosurgery? • What is Shaped Beam Radiosurgery? Chapter ... What if a patient has more than one brain metastases? How are they treated? • Can Multiple Tumors Be Treated at the Same... Some radiosurgery treatments can be completed in just one visit. Why are multiple treatments (known as fractions) sometimes necessary? • When is Radiosurgery Performed More than O... If it can harm the patient, why is Whole Brain Radiation Therapy (WBRT) still done? • Why is Whole Brain Radiation Therapy Still... Why is surgery sometimes necessary to treat brain metastases? • When is Surgery Recommended? Chapter 15 — ... Do you ever need to have both surgery and radiosurgery to treat brain metastases? Why? • Do You Ever Need Both Surgery and Radiosur... How do I choose the best care team for treating my brain metastases? • How to Choose the Best Radiosurgery Treatm... What is the future outlook a brain metastases diagnosis? • What is the Future of Brain Metastases Tre...