Better News

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Better News

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Michele and I visited with our surgeon, Kit Fox, and oncologist, Punit Chadha Monday afternoon.

Dr Fox showed us side by side comparisons of the May and August MRI’s. There are actually two areas of concern.

On some MRI slices (or views), the small “enhancement” in the previous cancer location does not appear to have changed significantly. Dr Fox does not believe that this enhancement should be a major concern right now, but of course bears watching. He says that it is far outside the critical “eloquent” or “word area” of the brain. ( Dr Fox seems to define “far” as over a half inch or a centimeter in distance. ) He believes that in its present size and location, removal would be a much easier surgery than either of the surgeries he performed on Michele last year. He does not see any need for immediate surgery.

The other area of concern is completely outside of the original cancer area, perhaps over an inch or about three centimeters in front of the original site. It is closer to Michele’s left eye and is in the “frontal area“ of her brain. It is common for GBM cancer to reappear in different areas of the brain.

The area of “enhancement” is very small--pea sized--5mm by 7mm. It is not in a critical area of the brain and is on the surface, just beneath the skull. If you were a highly skilled (but somewhat flippant) brain surgeon, you might say that it doesn’t get any easier. He does not see any need for immediate surgery and thinks that we should consider all our treatment options before having a third surgery in the same general area of the brain. Some surgical risks are cumulative.


Drs Fox and Chadha will decide on a treatment plan Friday morning during a peer review meeting. We expect the following treatment plan to be endorsed by the committee:

1. Stop CPT-11 and start Carboplatin this Friday, 20 August and plan to continue on a four week cycle.
2. Continue Avastin, but on a two week cycle, beginning on 20 August.
3. Rest (no treatment) on alternate weeks.
4. Have another MRI in September. (Five weeks would be 16 Sep.)
5. Re-evaluate the situation in September.

RKS