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Picking the grain out of the manure pile.

July 23, 2010

[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.

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12 Comments leave one →
  1. Ellen permalink
    July 23, 2010 5:34 pm

    Sounds very promising, Jill. At least you know who and where the enemy is, and how to get under their skin, litterally speaking!

    Let’s hear it for the FOOT! My toes are doing a standing ovation for this great news! Well, it’s move like the “wave” they did a lot of walking this week. But they mean well.

    I hope you are getting help for your anxiety, it must be off the wall, and is so, so unpleasant.

    Sweet dreams, my dear and dream about the day your scans will be clear, and they will!

    Ellen

    P.S: Bless the discoverers of Xeloda!

  2. July 23, 2010 6:17 pm

    Those seven new little spots shall be known as the 7 Dwarves, and your new meds will keep them that way!
    Love ya!

  3. July 23, 2010 8:32 pm

    Shit. I keep hoping one day I’ll read a post that says “HOLY CRAP! ALL CLEAR!” Love you, my friend (((HUGS)))

  4. Sarahtee permalink
    July 24, 2010 12:52 am

    Yay about your foot, and that the lung lesion growth rate is slow. Those three brain lesions won’t know what hit them :p

    Thinking of you here, Jill,

    Sarahtee xxx

  5. Resa permalink
    July 24, 2010 9:09 am

    Good on the foot just being a broken bone. Never thought I’d be glad about something like that, but I am. (picking out the grain)

    Good news too on the torso scan. (picking out some more grain….which makes me wonder….is corn a vegetable or a grain? Just random wondering.)

    As to the brain scan….my grain picking mind thinks seven is better than eight. The gamma knife would be what I would want to pursue over the whole brian radiation, and I’d probably be inclined to make up my mind about that before Monday, only to change my mind on Monday after hearing out what the oncologist says. Then again, out of sheer frustration I can imagine myself thinking, “Zap the whole sucker and consequences to the bladder be damned, just get rid of those seven little, um, monsters.” ( I really want to use a more colorful term here, but there’s probably kids reading and I don’t want to embarass your mother ;-).)

    In any case…keep picking out the grain…or maybe you could envision the picking out as coffee beans and the pile as cat crap. You know that coffee they make from the beans consumed and then crapped out by those cats sells for $200 a pound. Might be some kind of inspirational analogy there…..

  6. Sharon permalink
    July 24, 2010 9:15 am

    Two things come to mind …1) you are an amazing writer so when this is all done how about a book? maybe even just a collection of all of the blogs 2) you have an amazing attitude and have been through a lot but you have looked at all the angles so how about taking that inspiration on the road and speak a few times about it many people with situations like yours just feel confused about the options I think you could offer valuable insight to sorting it all out.

  7. E Lis permalink
    July 24, 2010 12:21 pm

    Prayers and good thoughts! Always in my thoughts…

  8. Babs McNeely permalink
    July 24, 2010 5:29 pm

    I’ll scoop the poop for ya!!!!!!
    Hugs Girl

  9. Murray permalink
    July 24, 2010 7:16 pm

    We pray for your total healing daily, but we’ll celebrate the victories along the way. I agree with your friend’s idea for a book. Not only to support others in similar situations, but to make us all laugh, cry, and put things in perspective.

    Blessings to you and yours,

    Maria

  10. July 25, 2010 8:20 am

    Jill, wow. . . Lotsa news. You seem to really know your options.

  11. Mimi permalink
    July 28, 2010 1:44 am

    Just a reminder to me to keep you on my prayer list! I have the same hope that Cassie does — same sentiment, perhaps worded differently. 😀

  12. JakKim permalink
    July 29, 2010 10:58 pm

    Thinking about you, as always Jill. xoxo Jakk

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