Thursday, September 17, 2009

the bad news and the good news

Here are two frames from the MRI scans done for Mom on September 11. They were hard for a non-expert like me to find, but after much digging through nearly 3000 images, I'm pretty sure I've found the correct two frames that show what the doctors were talking about at the consultation. If not, perhaps someone reading my blog at NCI can leave a comment or send an email to correct me. The last thing I want to do is pass along misinformation.

The top frame shows the bad news: Mom has a new mass-- her third major one. The first mass was largely debulked; the second mass grew during the period when Mom was on her daptomycin regimen to guard against potential infection. The third mass may or may not have formed during radiotherapy. Given how aggressively these tumors have appeared-- all within startlingly short time frames-- it's possible that this third mass began forming right after Mom's radiotherapy stopped. I don't know, and I didn't ask. It was mentioned that the radiologist missed this mass, but Dr. Fine spotted it upon review.

The bottom frame shows the more or less good news: Mom's second mass was, in fact, affected by the in-tandem therapy: the darker center indicates necrosis. It's too bad she didn't get the full dosage of Temodar (you'll recall that she restarted radiotherapy before going back on the Temodar), but at least we see that the therapy did something. I should also note that the doctor never said the second tumor had been completely killed off. It still represents a danger. Even a single living cancer cell is a danger.

The plan, now, is to move forward with Avastin. As I wrote before, dosages are administered intravenously. Mom's first session will be an infusion over a 90-minute period. On the second visit, two weeks later, Mom will have the infusion done over 60 minutes. On the third visit-- and on every visit thereafter-- Mom's infusion will last only 30 minutes. The space between visits will always be two weeks, from what I understand. Dr. Fine seems pretty confident that Mom "fits the profile" for people responsive to Avastin. Unlike that article I linked to a while back, he puts the non-responsive rate at 30%, not 50%-- a more optimistic reading of the situation.

For myself, I just hope we're not wasting our time. I'm willing to try Avastin because I've heard good things about it, but I also recall Dr. Tonnesen's pessimism: in his opinion, the treatment won't add more than a few weeks to Mom's life. We'll see. Nothing wrong with hoping for a better outcome.



Lorianne said...

Still hoping for the best.

It's so strange to see these images knowing they're from YOUR MOM. I suppose you feel the same sort of disconnect to see a loved one portrayed in such a clinical fashion. It's amazing what kind of imaging medical technology is capable of these days.

Kevin Kim said...

Yeah, it's a mixture of the real and the surreal. The external signs of Mom's deterioration keep me anchored in reality, even as part of me rebels against this entire situation.

I agree: the tech that allows us to see what's going on is truly amazing. Now if only an equally amazing cure could be found...