UCLA Journal of Radiation Oncology_SS 2025_FOR PRINT - Flipbook - Page 16
UCLA RADIATION ONCOLOGY JOURNAL
Bonnie, David and their two daughters, Lauren and
and Vice Chair of Clinical Operations for Radiation
Erin, didn’t accept the prognosis and began searching
Oncology and Co-Director of the Stereotactic
for the best medical team and care available. That
Radiosurgery and Brain Metastasis Program, for her
search led them to UCLA Health.
昀椀rst radiation treatment.
Bonnie’s 昀椀rst stop was to neurosurgeon Won Kim,
“Given the number of tumors and the fact that cancer
MD, associate professor of neurosurgery and co-
cells had spread into the cerebrospinal 昀氀uid, we
director of the Stereotactic Radiosurgery and Brain
needed to radiate the entire brain to shrink the tumors
Metastasis Program at UCLA.
and slow disease progression overall in the brain,”
said Dr. Kaprealian, who is also an investigator at
After reviewing Bonnie’s scans, Dr. Kim
the UCLA Health Jonsson Comprehensive Cancer
recommended whole brain radiation therapy as the
Center. “While whole brain radiation may a昀昀ect some
best course of action, as surgery was not an option
cognition and short-term memory over time, you can
due to the number and location of the metastases.
still remain fully functional. You will recognize your
In addition, Bonnie had developed leptomeningeal
friends and family, enjoy your days, perform your daily
disease, a condition that occurs when cancer cells
activities, and can maintain a good quality of life.”
spread to the cerebrospinal 昀氀uid that surround the
After completing radiation, Bonnie’s symptoms
started to improve, especially the severe headaches she
was experiencing for months. The next step would
to be revaluate in three months to determine the
e昀昀ectiveness of the radiation.
brain and spinal cord.
But before they could start treatment, they had to
get Bonnie out to Los Angeles, which carried some
potential health risks.
“At this time, we were now more optimistic about
Bonnie being able to enjoy her days outside of the
hospital,” said her husband, David. “We didn’t think
three more months of life was in the forecast and now
we 昀椀nally felt like there was hope.”
“Flying, where there is less atmospheric pressure, can
cause brain swelling,” said Dr. Kim, an investigator
at the UCLA Health Jonsson Comprehensive
Cancer Center. “Normally, this isn’t a big issue, but in
Along with radiation, Bonnie would need
chemotherapy to treat the HER2-positive breast
cancer that had spread to a lymph node in her left
armpit. The cancer had originated in her breast ducts,
with a small portion escaping and metastasizing to her
lymph nodes and brain.
Bonnie’s case, if she had experienced a bleed, seizure,
or additional swelling during the 昀氀ight, it could have
led to a stroke or coma.”
But Bonnie and her family decided it was worth the
risk. Dr. Kim prescribed an anti-seizure and steroid
Oncologist Kelly McCann, MD, PhD, assistant
professor of hematology/oncology, gave Bonnie a
combination of chemotherapy with drugs targeting
HER2 (tucatinib, capecitabine and Herceptin). This
regimen targets the entire body, including the brain.
medications to help with the 昀氀ight and Bonnie made it
safely to UCLA Health the next day.
After initial workups, Bonnie met with radiation
oncologist Tania Kaprealian, MD, MBA, Professor
Because Bonnie was handling the treatment well, Dr.
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