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.