This afternoon we met with Dr. Simpson, the radiation oncologist at Siteman Cancer Center (Barnes). He said the "tumor board" met last evening and decided the only course of treatment they are going to follow is the simultaneous administration of radiation and chemo (Temodar) for 6 weeks followed by an increased (double) dose of chemo taken for the first 5 days of a 28 day cycle for a year or two. He (they) did not agree to follow Dr. Yung's (MD Anderson) treatment plan of just radiation followed by chemo. According to them the chemo and radiation will work synergistically and be more effective.
The radiation method they would be using is called Intensity Modulated Radiation Therapy (IMRT), which is the most state-of-the-art technology for treating brain tumors. It focuses radiation on the tumor bed and the nearby area (margin) using different concentrations of radiation for different aspects of the treatment field.
Probable short-term side effects of radiation include localized temporary hair loss and fatigue. Possible but rare long-term side effects (as stated on the consent form) include brain damage, developing another brain tumor, deafness, blindness, spinal cord injury, decreased pituitary gland function, scar tissue, permanent hair loss, discoloration of skin, and sun sensitivity.
So basically our choices are:
1. Follow the treatment protocol at Barnes. (Barnes has the only appropriate radiation equipment in the area for this type of treatment)
2. Travel to Houston for treatment at MD Anderson, which would mean Kate would live in Houston for 6-8 weeks straight since she would be receiving treatment Monday-Friday. This option seems undesirable from a family perspective and for Kate's support and well-being.
3. Take a completely different (alternative) treatment approach.
We believe it was a good thing to have our case brought before the tumor board for consideration. Could the tumor board's strong stance mean that the Lord is leading us to follow option #1? We aren't exactly sure but we definitely want everyone reading our blog to be praying that we would have clarity and peace about whatever decision we make. We would like to have a firm decision by the end of the week.
On a positive note, Dr. Simpson gave us another bit of information about Benny (Kate's tumor). He said the MRI completed before surgery, using contrast enhancement, showed it did not enhance. This is a good thing and means the tumor did not show signs of branching out into surrounding brain tissue. This has a positive effect on Kate's prognosis, giving her 10+ years (median survival).
As you can imagine, we are growing tired of doctor visits and competing medical opinions, we just want to make a decision and move forward.
Thank you for your many prayers on our behalf and your notes of encouragement on our blog. It really helps to know there are so many who are coming alongside to bear our burdens.
Kate & Dave