Picking the grain out of the manure pile.
[picapp align=”right” wrap=”true” link=”term=manure&iid=7312286″ src=”http://view1.picapp.com/pictures.photo/image/7312286/the-manure-cart-from/the-manure-cart-from.jpg?size=500&imageId=7312286″ width=”234″ height=”158″ /]Sorry for the graphic metaphor. This is what comes to mind these days when people tell me to “keep a positive attitude.” As usual, the scan results are a steaming pile with a few salvageable bits to pick out. Her’s the “scoop.”
1) My foot is fine. I don’t have foot cancer, just a fractured metatarsal. No biggie. A couple of more weeks with RoboBoot and I’ll be fine.
2) Nothing new in the chest and torso. The same old lung lesion is there and has grown from 4mm to 7mm. The margin of error in the scans is 2mm. So, it’s grown slightly. Again, no biggie except the trend is to growth. To me this is the best news.
3) My brain scan lit up a bit more. The three lesions we’ve been watching since January grew from the 4-5mm range to the 10-11 mm range. There are also “several small new foci, worrisome for progression of metastatic disease” in other parts of my brain. If I’m counting correctly from the description, there are seven of them. I have some swelling around one of the 11mm lesions, so I’ll start steriods again (blech) to take that swelling down. I’ll meet with the radiation oncologist on Monday morning to see what to do about everything. It could be that we can just do the SRS again (gamma knife), or he might suggest whole brain radiation. Lots to consider there: http://www.brainmetsbc.org/index.php?q=content/current-treatments-brain-metastases#WBR. I’ll likely put up a fuss about whole brain radiation — way too much risk of dementia and loss of motor skills such as bladder control. Just what I need.
Other thoughts: New research is showing that Xeloda, one of the pill form chemos the oncologist recommends, is showing promise for crossing the blood-brain barrier, so that’s one to consider even more at this point. I’ll be talking with the naturopath on Tuesday. After that I’ll have a couple of different perspectives and we’ll decide from there.
If you want to read a huge amount of detail about my choices for my brain, you can read this: http://bcwatchdigest-brain.evidencewatch.com/
The most important points I got from it are:
1) It’s possible to have whole brain radiation without damaging your cognitive abilities, but the SRS seems to have just as good (or better) survival rate with much-reduced cognitive risk.
2) It’s possible to do SRS on up to 25 lesions over a life time — not all at once, and the 25 is just the maximum number that have been done on anyone reported so far.
3) Xeloda (one of the drugs that Dr. Ingber is recommending for me to take orally) is showing great promise in crossing the blood-brain barrier. Since the naturopath thinks I’d do fine on the low-dose therapy of this drug, I’m getting more inclined to do it.
4) Several minuscule lesions in the brain (too small for the SRS to treat) do not usually affect a patient’s quality of life. So to me that means we could treat the 3 larger lesions and hope the Xeloda catches the smaller ones.