Tuesday, January 22, 2013

From dread to joy

Twice yesterday Ellen and I had difficult conversations about the melanoma that doctors believed had recurred in my brain. In separate appointments, both my neurosurgeon and radiation oncologist called up recent MRI scans to lay out their joint plan to treat the brain cancer by stereotactic radiotherapy. My job was to transitition back into treatment mode without losing my composure. After receiving a really good MRI report on. Dec. 17, the follow-up on Jan. 11 was seriously compromised.

Or, at least it appeared to be.

We knew at the time of my brain surgery that traces of melanoma likely remained after the cutting was done. The goal of the whole-brain radiation (WBR) done last fall was to “clean up” the microscopic cancer that remained in and around the tumor bed. WBR is a harsh treatment and not entered into lightly. In exchange for minimizing the odds of the melanoma recurring in the brain, I accepted the considerable risk of possible memory loss and other neurocognitive decline.

I was disappointed but not much surprised a week ago when we learned that based on the MRI findings, my cancer was back. This is the news that every cancer patient dreads to hear. It’s bad enough to contend with cancer once, but it can become a living nightmare when it begins to recur.

I got additional news this morning that turned my dread to joy: The MRI scans had been misinterpreted. We got a call from Dr. Bader, my radiation oncologist, who told us he reconsidered the subtle findings in the tumor bed on which he initially based his diagnosis and invited the interpretation of a neuroradiologist he trusts. This doctor confirmed Bader’s suspicion that what appeared might be the reforming of tumor is more likely scar tissue and other nonspecific white matter at the surgery site. A not uncommon problem after the treatment of brain mets is the difficulty of differentiating between tumor recurrence and radiation-induced scar or necrosis.

So I’m left a little rattled but grateful for how this latest episode turned out. I’ll have another MRI exam in six weeks for which I hope these findings will be confirmed.

9 comments:

Nancyy said...

This is joyful news, Peter and Ellen. I was thinking and praying for you yesterday, knowing that you were seeing doctors and seeking answers. I hope your appetite is returning a bit, and that you are feeling better. Hugs all around to the Ogle family.

Anonymous said...

Yes, this is good news. Now eat.
Keith

grsmouse said...

We rejoice with you and for you ... looking forward to more good blogs to stir us up ...

Anonymous said...

So glad to hear this. I'll keep praying. Marsha

Thandi said...

Yay.Hurray for HOPE! Hope the next scans give us positively GOOD news.

Anonymous said...

Praise the Lord! Hope to see you sometime soon!

Eric S.

Anonymous said...

I am very interested in learning more about your treatment. I came upon your post about receiving whole brain radiation with IPI at the same time. It was an amazing finding for us because my husband with stage IV mucosal had just been told that he needed whole brain radiation for 7 small tumors in his brain. I was unaware of the possibility that one could treat with WBR and IPI at the same time. He got his first dose of whole brain radiation today and hopefully will begin IPI on Wednesday this week if approved by the insurance company. Your post was truly a gift. We would love to know more about your treatment. My e-mail is LRKG1234@hotmail.com if you wouldn't mind discussing your experience. By the way. I'm an Oregon State graduate through the satellite program in Bend Oregon. Living in Indiana now. Small world. Thanks, Lisa

Carl Pelz said...

This is indeed good news amid the twists and turns you, Ellen, and family have been through. Kim and I continue to pray for your recovery as well as sharpening of your near-term memory, the absence of nausea and itching, and a resurgence of appetite.

RBS said...

Peter I'm so pleased to read this news. As i've said before your insight, experience, strength and hope are an inspiration for me. I found out in a week if I pass month 9 of Zelboraf with a go or move onto to something else. regardless of the outcome of that set of scans your open sharing of your spirituality helps prepare me for the rest of this walk back home. Ron