Mindful Matters

Spoke with my oncologist today.

Results of the brain scan were much better than feared. There appears to be only the one lesion, and it is quite contained. There is no evidence at this time of anything developing in any other area of my otherwise unspoilt (albeit occasionally overindulged) grey matter. This is extremely good news as it allows for the widest possible range of treatment options.

Over the next couple of days, my oncologist will be meeting with the BC Cancer Agency's lead neurosurgeon (one Dr. Toyota - yup, he's driving this project) as well as the radiation oncologist who worked with me three years ago. Together they will determine the best plan of action. This may or may not include surgery, targeted radiation, full-brain radiation (which would also take care of any microscopic lesions that aren't yet able to be detected via CT scans and other tests), steroid treatment, other treatments I haven't yet heard mentioned, or a combination of two or more options. There is also the chance the team will determine that things are better off left alone for the time being. Or I might be given the full meal deal. Should hear early next week when I'm to meet with the team to discuss their decision.

The general plan is to stabilize the situation in the brain, and then get back to regular chemo treatments. My next drug of choice is TDM-1, the investigative drug from last year's study. Taking this will help slow the progression of the disease in other parts of my body.

I've been asked why switching to another chemo drug isn't the advised route at this stage. The simple answer is that the drugs that work on my type of cancer (HER-2 pos) aren't able to cross the "blood-brain barrier". In other words, the brain is designed to keep harmful chemicals such as chemo out. It's a natural form of protection. Unfortunately, the brain isn't smart enough to know if chemo is good or bad, so it keeps it out just in case. At least that's my understanding. (not sure why it lets hallucinogenics in, not that I know from personal experience, but how else does one get "high" - anyone?) So if something goes sideways in the brain, it must be dealt with directly rather than indirectly, hence treatments such as surgery and radiation. Like I said, that's my understanding of it.

There is some minor swelling in the brain at present, no doubt due to something foreign pushing resident grey matter out of the way as it tries to expand. Am taking dexamethasone to combat that issue. Get a tad dizzy sometimes, but won't drive if I think it will be an issue. Other than that, it's life as usual. Well, usual for me at least.

So, the short story: There is only one, contained lesion in my brain. My medical team is meeting to determine the best course of action. I will hear from them early next week. Depending on the course of action, I may need surgery or other treatment that will require me to be in Vancouver for a period of time. Or not. I may call in some of those very generous offers of help. Or not. Much depends on what the plan is.

Must say I'm feeling a lot better just knowing what's between my ears and that someone is thinking of doing something with it.

Will post further information as it is received.