October 24, 2018
I had an appointment with the Radiation Oncologist for my brain today. The plan is to radiate the 2nd tumor. She’ll be talking with my Oncologist about the targeted chemo to make sure that it’s crossing the blood/brain barrier and killing the microscopic disease in the tumor bed where the 4 cm tumor was removed because right now, it’s still too dangerous to radiate that bed. This is in part because the tumors are so close together – they’re barely a cm (about half an inch) apart, and she doesn’t want to treat too much of my healthy brain tissue if she can avoid it. If the Kadcyla doesn’t cross the blood/brain barrier, there are a couple of other chemo treatments that have worked with other people with metastatic brain cancer that we’ll be using instead.
There were 3 options on the table – one is Stereotactic Surgery, which would be a single, high dose of radiation to the tumor. The other is to use a lower dose to treat the tumor over 3-5 treatments. Lastly, whole brain radiation was another option, but one I don’t want to have at this point. The whole brain radiation causes problems similar to chemo brain. I can’t really afford any more cognitive issues at this point. It’s been hard enough to work and stay focused as it is. We’ll save that one as a nuclear option for later if I need it.
The planning for this radiation treatment is pretty similar to the planning for the breast treatment. I will have scans done, the physicist will come up with a plan for radiating the tumor, there will be a dry run and then 3-5 days of treatment. I’ll have a follow-up scan in 30 days to see if the radiation worked, and then MRIs every 3 months after that.
Over the next 30 days or so, she’ll also be monitoring the size of the tumor bed from the one that was removed. The hope is that it will shrink some and she’ll be able to radiate it at a later date. I’m also hoping this is the case. The rate of recurrence is pretty high, but one of the more promising things she said today was that she has much more control and success in radiating any new growths – when they’re only a few mm in size – as opposed to when they’ve had a chance to grow bigger. When they get to be large tumors, there is a lot more healthy tissue to work around and protect.
Guess I’ll be sporting a radiation bald spot for a while.