Whole Brain Train

Two, Four, Six, Eight!
Did NOT
Want To

Whole Brain

Radiate

But… it is the best approach.

I had another MRI on Monday (April 30th).  This was to obtain a current snapshot of the tumors that were to be treated with Gamma Knife that day.  The physicist uses the snapshot to program the machine to hit the target areas.

When I go for a Gamma Knife treatment it is typical that I only see Dr. Lee (the surgeon who attaches the frame) and Dr. Kim (radiological oncologist) who directs the process.   But, if Dr. Mittal (brain surgeon) is called in….then I know there is a problem.

So when Dr. Mittal again wanted to ‘show me’ something I immediately let him know I was not interested in hearing there was an 8th tumor.  He quickly assured me there was not another tumor.  But, as I walked down the hallway I realized that this did not necessarily mean there was not a problem.   This time Dr. Mittal was there to tell me the larger of the two newest tumors that were to be treated that morning had tripled in size from 1cm to 3cm in just 17 days.   

So, I had a choice to make.    

1. Proceed with Gamma Knife only.

• Pro:  Able to reach the smaller tumor that is so deep in my brain it cannot be treated via craniotomy.  Though smaller, this tumor is in a critical area of the brain.
• Con: Does not address the potential for multiple new tumors.

2. Have a 3rd craniotomy to remove the larger tumor, then Gamma Knife to the smaller tumor and the bed of the larger tumor.

• Pro:  Craniotomy is a clean scoop of the larger tumor, surrounding blood vessels remain viable which speeds healing and recovery.
• Con:  Usual surgical risks.  The smaller tumor (which is not reachable via surgery) could grow during the required post op recovery period and next Gamma Knife.

3. Proceed with Gamma Knife on both new tumors, then immediately start whole brain radiation.

• Pro: Gamma Knife now will immediately address the smaller tumor.  Gamma Knife may limit further growth of the larger tumor.  Whole brain radiation limits the potential for multiple new tumors (7 is enough!)
• Con:  Whole brain radiation can only be done once.  It affects brain functions, but it’s not possible to predict which brain functions could be involved. Depending on the outcome, a future craniotomy may still be necessary to relieve the pressure in my brain.

I chose #3.    While none of the choices are perfect, it is the most aggressive approach.  It also was helpful that for the first time since the April 30th MRI, each of the doctors agreed with my choice.

So, I had Gamma Knife on both new tumors on Monday, followed by four whole brain radiation treatments Tuesday through Friday.  There are six more treatments ahead of me.  

Keith and I will be heading down to Karmanos every afternoon this week.  I usually am home in time for a nap before dinner.   My appetite remains legendary – Piggy Peggy still reigns!