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Bwian duh Bwain Tumowr

March 13, 2014

On Tuesday, March 11, Holly and I went to the hospital to meet with Dr. Litofsky (neurosurgeon), Dr. Johnson (radiologist) and Dr. Doll (medical oncologist) to determine a plan of action to get rid of my brain tumor. We’re on information overload so the essay may be a little drier than usual. Being the infinitely curious type, I tried to scatter links around to satisfy anyone else with a similarly inquiring nature. “Knowledge is power,” as my main man Francis Bacon says.

Pre-Surgery (022414)

World, meet Bwian!
Bwian duh Bwain Tumowr!

TYPE:

We got more specific info on Bwian yesterday. He’s a low-grade Stage 3 Glioneurocytoma. He’s apparently a complicated mess containing multiple different glial (brain) cell types. The majority of the cell types are low-grade (slower division rate) Stage 3 (anaplastic) astrocytoma cells, but oligodendroglioma cells are also dividing in an abnormal fashion. In addition, the minor component was a dysembryonic neuroepithelial tumor. Oligodendroglioma cells can have missing genetic markers that allow it to be more easily treated by chemotherapy. But I’ll talk about that later.

THE PLAN:

About twenty doctor’s met yesterday morning (03/12/14) to determine my fate. There was some division among the ranks due to the multiple cell types, stages, and tumor types. The consensus is to treat with the combined three pronged approach of chemotherapy and radiation therapy along with the co-deletion of the 1p/19q chromosomal oligodendroglioma arms (all explained below).  Both therapies start on St Patty’s Day. I really wish I would have realized that before I scheduled it… Guess I’ll have to settle for a good Sunday drunk!

RADIATION:

My radiation therapy (RT) is prescribed daily, Monday through Friday, for the next six weeks. It’s very quick and relatively easy (other than the potential side effects) as I’ll be in and out in fifteen minutes. Not too shabby, I say!

HOW IT WORKS:

Radiation uses high doses of radiation to kill cancer cells and stop them from spreading. My head will be strapped to a table, under a mask made of wire mesh, to prevent any movement. We don’t want my eyeballs zapped! While lying on the table three beams of radiation will be aimed at the leftovers of my tumor to irradiate that nasty cancerous DNA.

CHEMOTHERAPY:

My chemotherapy will use a drug called Temodar. I will take it before bedtime each night. It is prescribed concurrently with RT but will continue for at least 6 months after RT. Blech! Makes me want to barf already! Speaking of…to combat 7-1/2 delicious months of potential sickness, I am also being prescribed an anti-nausea pill called Zofran, a serotonin blocker, to (cross your fingers!) prevent nausea and that general sticky, icky feeling. It is prescribed to be taken at night with the Temodar and in the morning when I wake up.

SIDE EFFECTS:

Both radiation and chemotherapy are poisonous. Their side effects are similar and include fatigue, hair loss, skin changes (dry skin or skin burns) from high radiation dosages, and the possibility of nausea. I’m one of those people who never gets sick – no headaches, no vomiting. So, my fingers are crossed that my generally robust nature combined with the prescriptions will help deter any of these nasty symptoms. My doctor said that 90% of his patients are able to avoid sickness with the use of Zofran. We will know the side effects of the chemotherapy immediately, but side effects for the RT will not start for a couple of weeks. Considering the concurrent treatments and side effects and the delay in RT side effects, I’m preparing myself for a potential worst case scenario beginning two-weeks into radiation and lasting for six weeks. It sounds bad, but I assure you that timeframes make all the difference as far as I’m concerned. I like to know when I can expect the worst.

*1p/19q GENETIC CO-DELETION

One very good piece of news we received yesterday is that portions of the tumor were noted as being oligodendroglioma cells. These have a potential weakness in that they may be vulnerable to what is called a genetic co-deletion. This method uses techniques of molecular biology to delete the 1p and 19q chromosomal DNA arms which makes them more susceptible to the toxic affects of chemotherapy. Ah, the wonders of medical science! The 1P/19q test results came back positive on my tumor. So, the missing genetic markers can in fact be co-deleted. Yip! Yip! Turning these genes “off” will make chemotherapy more successful against these oligodendroglioma cells. I’m ok with one less cancerous cell to worry about! In the end, it gives me a better long-term survival rate as the chemotherapy will be able to wipe out a greater percentage of the cancerous oligodendroglioma cells thereby extending the timeframe in which a tumor of this type may reoccur in the future.

Don’t quote me quite, yet, but it could all be much worse than three pills and fifteen minutes of radiation a day. While I may be miserable for a 7-1/2 months, I’m not on an IV, I’m not required to take injections, and I’m alive to annoy my wifey!

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One comment

  1. Reblogged this on That Space There and commented:
    We finally got some direction on what Mike has so affectionately dubbed “Bwian the Brain Tumowr” (he apparently feels his tumor had a speech impediment). Tuesday and Wednesday were pretty bad days with some terrifying statistics so I’m copping out a bit and just reblogging Mike’s blog update. I’m having a hard time typing out my feelings and version of events right now. We appreciate the continued love and support!



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