Hi - my husband was DX mRCC, with lung mets and (later!) brain mets.
After his rad neph, he's been put on Sutent, which he takes at about 6 pm daily, though if you get bad immediate symptoms some folk take it last thing at night, so they sleep through them!. Four weeks on, two weeks off - standard cycle, 50mg dose (the strongest - they tend to put you on the strongest unless the sides are unbearable!)
The Sutent will, I hope, tackle the lung mets (multiple!)(as in, loads and loads). We were told it has a 75% chance of either holding the mets stable, with no growth, or actually reducing them (it's about 50:50 for either). Some folk are still going from the trial, and have been kept alive on Sutent for nearly five years, but that is not everyone of course. After Sutent there are still other drugs to move on to, and I have also read that sometimes they may think to put you back on to Sutent as it may get a second wind!!
Around three cycles of Sutent should be long enough to see whether it's impacting on the mets (we were told).
What is happenign about your brain mets? The docs don't yet know if Sutent gets through to the brain, as brain met patients were excluded from the trials, but there is now one running at Sloan Kettering though it won't report till 2010. I found a couple of case studies to indicate it MIGHT be tackling brain mets.
Otherwise, your options are neurosurgery, if the mets are in an operable position, or radiation. Radiation is either targetted (stereotactic), with various 'trade names' such as Gamma knife. We are hoping for this option ourselves. Success can be good. The other form of radiation is wholebrain radiation, which is when there are tiny mets scattered that are hard to target with the gamma knife. BUT, WBR carries more of a risk of mental impairment, suc has memory loss (gamma knife can cause it too, depending on where the mets are in the brain, but it's only confined to impairment of what the particular lobe function was, eg, visual, etc). We are hoping to avoid WBR, and hope that gamma knife is all we need.
All the very best to you, and I don't think we have an OJohn here so guess you are OK!!
Take care, Julie.