1st Round Treatment Follow Up

Wednesday I had my appointments to follow up from my first round of treatment.  The list of reasons I have to thank God for are endless.  It was a day full of good news.

First,  I had my MRI.  It seems like a something simple, and it is.  However, I have to get there an hour early and get set up on an IV drip every time I go so that they can put a contrast dye into my body.  The dye highlights tumor areas during the MRI.

After the MRI,  Paul and I grabbed some lunch at the cafeteria and then headed to my first doctor's appointment with my nuero-oncologist.  He was already able to see the scans which was amazing!  He brought them up on the computer and said they looked very good and he saw no reason to worry.

He then discussed that he felt it was best for me to continue on the chemotherapy pills.  The study I quoted a long time ago with IV chemo showed that patients who continue on with the chemo after the radiation/chemo combo do better than patients who don't.  They do not have studies for this particular type of chemo but they assume it will react the same as the kind that was used in the study.  He recommended a 6 month period to possibly be renewed up to two years.

The chemo is the same medicine I took for the 42 days in March/April.  The dose that I will take is more than double what I took before, but it is for 5 days out of a 28 day cycle.

There are of course positives and negatives to this.

The positives are that this is still a pill form that I can take anywhere.  While it is the same medicine I was on before,  it is an increased dose and so there is a possibility that I will have an increase in side effects.  My oncologist said that is more likely I will have symptoms of fatigue, weariness and tiredness than symptoms of nausea and vomiting.   The side effects are generally going to be present during the 5 days of medicine and for up to 5 days after the medicine.

Another positive is that I didn't believe that I felt any side effects from Temodar before and so I'm hopeful I won't feel any again, even with the increase.

In addition to the chemo medicine I'll have to go in every other week for blood work and see my doctor once a month.  I'll have another MRI in two months and then if everything looks the same another one two months after that.

We reviewed my blood work from the first round of Temodar and my numbers held up really well.  There was one area where my numbers dropped a little but not to a point of concern.

If I don't tolerate these rounds of chemo, either with a drastic change in blood cells or with extreme side effects the doctor said I can stop taking the pills.

After this doctor, I then met with a radiation oncology resident who performed a routine neurological exam.

Lastly I met with my regular radiation oncologist and he shared the first doctor's sentiment that the scan looked great.

He brought up the images for us to look at more closely and was able to put the image before radiation and the image yesterday side by side.

Basically, when you look at the picture of my brain, there is a big black hole where the tumor used to be.  This is called the resection cavity.  The doctors focus on the perimeter of this area closely because it is most likely that remaining brain tumor particles would be in the area around where the brain tumor used to be.

For the most part the pictures yesterday had cleaner edges around the cavity than they did in February which likely means that the radiation and chemo did their job.  There was one area where there was a white section and we asked about that.  The doctor said that most likely it is scar tissue from the surgery and that it would be an area to watch.  At the next MRI this area will either look the same which means it is scar tissue or it will grow and change which means it is made of brain tumor particles.  The only way to really tell what is in the white area is to open me up and take a biopsy, which they aren't going to do! There is no imaging test that can tell what is in that area.

I asked why there would be particles there if they got 100% of the tumor and he corrected me to say that they got 100% of the tumor that they could see.

So, the doctors were very pleased with the images and the blood work from treatment and sent in prescriptions for the chemo pills and then sent me for another round of blood work to get a new baseline for the next round.

If you have me on your prayer list, specific prayer requests I have are:

that the next round of treatment has the same minimal side effects as the first

that my blood work holds up through this next round and my bone marrow remains strong

that the white area in the scan is scar tissue and remains unchanged at the next MRI

that I can push through and view all of this as a great blessing... none of it is difficult and I feel really great and I need to focus on that!