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Topics:
Radiation Oncology • Palliation • Melanoma/Skin Cancer • Medical Oncology • Merkel Cell Carcinoma • Cardio-Oncology
How would you manage a cardiac metastasis from Merkel cell carcinoma?
The patient has an asymptomatic metastasis in the left atrial appendage.
Would you start off with immunotherapy then add radiation later, or visa versa?
What dose/fractionation of radiation would you recommend?
Answer from: Radiation Oncologist at Academic Institution
I would first determine the extent of metastases and carefully determine the extent of the tumor in the heart (usually with cardiac MRI). I would also discuss the threat of the tumor to the heart with a cardiologist (if possible). If extensive metastases were present, I would suggest starting w...
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