CT/PET Scan Follow-Up with Neurosurgeon... a hard day.

Dad took Mama Marian today to see Dr. Senatus, her neurosurgeon. She had a PET/CT scan yesterday afternoon at UCONN that looks at the tissue's metabolic activity in the tumor and provides images of its shape and size.

After an hour and a half of anxious waiting for the images to load on the computer, Dr. Senatus explained that it appears the tumor has recurred. Perhaps it is not responding to the infiltration of radiation and poison we've been sending its way for three months, as we had hoped.

In order to be absolutely positive that the tumor is growing, Dr. Senatus has ordered a Thallium SPECT to provide 3-D images of her brain and to look at cross-sections of the tumor itself to determine localized function (where the growth is most aggressive).

There are a few options to consider at this point in time, including surgical resection of the tumor, similar to the awake craniotomy Mom had in November, but this time she would not have to be awake. Dr. Senatus could go back in and extract more tissue from the tumor if it is possible to do so safely without resulting in severe loss of mobility. Mom would have to decide beforehand how much she would be willing to risk losing.

The resection might involve placing gliadel wafers into the vacant spots from which the tumor tissue is removed. These wafers are cut to fit inside these areas and bathe the tumor in chemicals that provide direct chemotherapy. They dissolve on their own and, as they do so, they release high doses of BCNU to destroy tumor cells. However, they can cause seizures, infections in the brain, and swelling.

Dr. Senatus is also considering a very new treatment, just entering phase II of clinical trials. He has been working with a colleague from Harvard, who is now at UCSF, on developing a GBM tumor vaccine. If he was able to obtain enough tissue from the tumor, he could use it to develop a vaccine specifically for her. It would be injected after development and could cause her immune system to attack the tumor cells. This treatment works on certain GBM patients whose tumors have a certain type of mutant protein that gets stuck in the "on" position, resulting in freakishly unrelenting cell division.

Above the cellular level, this journey remains unpredictable and, quite honestly, along the lines of torture on some days. Thankfully, spring is coming and mom's tulips and lillies will be coming up before she knows it. We could use some reminders of all that is beautiful in this world... some good regeneration and natural growth after a cold, harsh winter.