Friday, December 14, 2007
12.14.2007 - Three Weeks Into Treatment
It is 12.14.2007 and so far I have completed three weeks of radiation therapy and one cycle of chemotherapy. Next week, I will start my second cycle of chemotherapy. I don't feel that much fatigue so far, but I started noticing some hair loss last night and this morning. It is mainly in the area of my scalp where the surgical procedure incision scar is and that makes sense because the tumor tissue was underneath there, so the focused radiation is directed there to irradiate the remaining tumor tissue. The hair will grow back, but not until the radiation therapy is completed. My physician has continued to taper down my steroid dose, which is good because it is only needed to deal with swelling and I don't have much swelling any more. The less medication I have to take the better.
Saturday, December 8, 2007
12.08.2007 - Two Weeks Into Treatment
It is 12.08.2007 and it has been two weeks since I started the daily radiation treatments and I have only felt some waves of fatigue, but nothing too persistent. The chemotherapy schedule in place makes it so that I won't begin the second cycle of chemo for another week and a half. My neurooncologist cleared me to resume driving again, but thought it would be a good idea to start slow. The radiation-oncology staff has reminded me that the fatigue may still be coming because the effects of the radiation therapy is cumulative as the treatments continue. It isn't anything to look forward to, but some increased fatigue isn't the worst thing that one could experience. They also said I could experience some hair loss, but I haven't noticed any yet.
Saturday, December 1, 2007
12.01.2007 - No Side Effects So Far
It is now 12.01.2007 and I haven't felt any nausea or really any other side effects. While I haven't had to go through any of this before, I would say that I am doing pretty well with it all. When I initially learned of the brain tumor back in late 2004, I felt like if I had to have a mutation (cancer is the result of cellular mutation), I should get some cool power, like the X-MEN. My wife advises that my cool power appears to be not to experience side effects.
Following both the surgeries (early 2005 and late 2007) I never experienced any nausea after having been under general anesthesia. I haven't had any nausea from the chemotherapy as of yet and haven't had any noticeable side effects from the radiation therapy as of yet. After a couple weeks, perhaps things won't be so rosy, but things are going well so far.
Following both the surgeries (early 2005 and late 2007) I never experienced any nausea after having been under general anesthesia. I haven't had any nausea from the chemotherapy as of yet and haven't had any noticeable side effects from the radiation therapy as of yet. After a couple weeks, perhaps things won't be so rosy, but things are going well so far.
Wednesday, November 28, 2007
11.26.2007 - Treatment Begins
Treatment began this week. 11.26.2007 was a "dry run" of the focused radiation therapy. They called it a "dry run" because it was for fine tuning and calibration.
11.27.2008 was my first focused radiation therapy session. Unfortunately, the visit took over an hour when it was supposed to take only 15 minutes or so and we brought all the kids with us because we thought it would be so brief. They were late in getting me to the machine and then after the session, because the swelling in my head had decreased so significantly since the surgery, they wanted to make a new mesh mask for my head (which keeps my head positioned precisely) and rescan me wearing the mask with the CT machine.
11.28.2007, my brother-in-law volunteered to take me to my appointment. He volunteered for a lot because this was my first long day of treatment. The focused radiation therapy session was very brief and then I had my first IV chemotherapy infusion. They told me the IV session would be 90 minutes or so. Well, it didn't work out that way. We had left the house at 1230 hours and didn't get back home until 1800 hours.
What was a pleasant surprise was to learn that the neurooncologist wanted to change the chemotherapy schedule so that I had higher doses administered per session, but the sessions would be less frequent. The initial schedule was for the IV infusions to take place one day per week throughout the treatment plan and the oral chemotherapy to be taken every week day throughout the treatment plan. Now, I will be doing the IV infusions once every three weeks and the oral chemotherapy daily for a five day period once every three weeks.
They gave me anti-nausea medication with the IV and I haven't felt sick so far. Hopefully the oral chemotherapy won't cause me any nausea either...of course I will be taking anti-nausea medication with the oral chemotherapy as well.
11.27.2008 was my first focused radiation therapy session. Unfortunately, the visit took over an hour when it was supposed to take only 15 minutes or so and we brought all the kids with us because we thought it would be so brief. They were late in getting me to the machine and then after the session, because the swelling in my head had decreased so significantly since the surgery, they wanted to make a new mesh mask for my head (which keeps my head positioned precisely) and rescan me wearing the mask with the CT machine.
11.28.2007, my brother-in-law volunteered to take me to my appointment. He volunteered for a lot because this was my first long day of treatment. The focused radiation therapy session was very brief and then I had my first IV chemotherapy infusion. They told me the IV session would be 90 minutes or so. Well, it didn't work out that way. We had left the house at 1230 hours and didn't get back home until 1800 hours.
What was a pleasant surprise was to learn that the neurooncologist wanted to change the chemotherapy schedule so that I had higher doses administered per session, but the sessions would be less frequent. The initial schedule was for the IV infusions to take place one day per week throughout the treatment plan and the oral chemotherapy to be taken every week day throughout the treatment plan. Now, I will be doing the IV infusions once every three weeks and the oral chemotherapy daily for a five day period once every three weeks.
They gave me anti-nausea medication with the IV and I haven't felt sick so far. Hopefully the oral chemotherapy won't cause me any nausea either...of course I will be taking anti-nausea medication with the oral chemotherapy as well.
Saturday, November 17, 2007
11.17.2007 - Treatment Schedule
After meeting with the neurooncologist again on 11.17.2007, he had a preference to begin treatment starting after Thanksgiving weekend. We could have started this coming week, but he did not want to start with an abbreviated week that then had the four day Thanksgiving holiday off from the therapy. Simultaneous administration of chemotherapy and focused radiation therapy should take place on the weekdays after that time and should conclude in mid-January.
I feel better and better each day with less fatigue as each day goes on, but we'll see what effect the therapy has on my mind and body because the most significant side effect described by the physicians is increased fatigue.
I now have some projects to work on from home from my employer and we will see how that goes too. I wanted to work again and know that it can only be part time for now. My employer has been very supportive and willing to let me work from home right now.
I feel better and better each day with less fatigue as each day goes on, but we'll see what effect the therapy has on my mind and body because the most significant side effect described by the physicians is increased fatigue.
I now have some projects to work on from home from my employer and we will see how that goes too. I wanted to work again and know that it can only be part time for now. My employer has been very supportive and willing to let me work from home right now.
Friday, November 9, 2007
11.06.2007 - Treatment Plan
On 11.06.2007, we met with my new neurooncologist here and then met with a radiation oncologist. The pathology of the tumor has changed. They are classifying it as a grade four (most aggressive type) astrocytoma - often referred to as a glioblastoma multiforme. Astrocytomas are the most common form of brain tumor. My neurooncolgist has a very positive attitude and wants to aggressively treat it. He believes that cures for these situations are possible. Real world statistics aren't good, but we are going to fight this.
The treatment plan will involve simultaneous administration of chemotherapy and focused radiation therapy. Radiation therapy will involve 33 fractionated therapy sessions that are normally administered daily over the week days. Most of the chemotherapy will be orally administered and is generally well tolerated by the majority of patients who receive it. I will also receive a once a week IV infusion of another chemotherapy agent. The most significant side effect described will be increased fatigue as a result of all of it. Fatigue levels will get better after treatment. They will take a month off of treatment and then do follow-up MRI scans to see how the treatment went.
On 11.08.2007, I met with my neurosurgeon and he removed the staples from head. That was really nice to have done because I was finally able to take a full shower and wash my head since the surgical procedure.
On 11.09.2007, I had the pre-treatment planning CT and MRI scans done so that they can design the specific treatment plan for the focused radiation therapy. It was a long morning, but will enable the treatment to proceed now. They are anticipating treatment to begin in about ten days or so and then will involve the daily treatment sessions. The sessions will only take 20-30 minutes each day, so actual treatment - other than the once a week IV chemotherapy infusions - won't take too long, it will just be the daily grind of driving down to the hospital for the sessions on a daily basis.
The treatment plan will involve simultaneous administration of chemotherapy and focused radiation therapy. Radiation therapy will involve 33 fractionated therapy sessions that are normally administered daily over the week days. Most of the chemotherapy will be orally administered and is generally well tolerated by the majority of patients who receive it. I will also receive a once a week IV infusion of another chemotherapy agent. The most significant side effect described will be increased fatigue as a result of all of it. Fatigue levels will get better after treatment. They will take a month off of treatment and then do follow-up MRI scans to see how the treatment went.
On 11.08.2007, I met with my neurosurgeon and he removed the staples from head. That was really nice to have done because I was finally able to take a full shower and wash my head since the surgical procedure.
On 11.09.2007, I had the pre-treatment planning CT and MRI scans done so that they can design the specific treatment plan for the focused radiation therapy. It was a long morning, but will enable the treatment to proceed now. They are anticipating treatment to begin in about ten days or so and then will involve the daily treatment sessions. The sessions will only take 20-30 minutes each day, so actual treatment - other than the once a week IV chemotherapy infusions - won't take too long, it will just be the daily grind of driving down to the hospital for the sessions on a daily basis.
Tuesday, October 30, 2007
10.13.2007 - Headaches
I don't recall what dates they started occurring, but I started having headaches at work. I thought it was likely because I was starting a new job and it was stressful at times. When I would get the headaches, they were always generalized headaches, like a normal tension headache. I would take some Advil and they would go away and then things would be normal. I didn't think too much of them.
I woke up early on a Saturday morning, 10.13.2007, with a significant headache. I wasn't at work, so it surely wasn't due to stress from work. It also wasn't generalized like the other headaches. This one was localized to the area where the tumor tissue was. I knew that couldn't be good. I tried taking some Advil, but it didn't work this time. My wife thought I should go to emergency room and I agreed.
At our local hospital, which is a very new facility, they were humble enough to acknowledge that they were ill equipped to deal with a brain tumor situation. They had no neurologists or neurosurgeons on their staff and their imaging equipment wasn't really ready for something like my situation presented. They did do a good job in assisting with the pain and referred me to another hospital in the Metro Denver area.
My wife took me there and they had a neurologist, a neurosurgeon, and did MRI and CT scans. The neurosurgeon I consulted with viewed the films and could instantly tell that my present scans did not reflect a stable and unchanged situation. It looked to him that my tumor had grown back, but he wanted to see the prior films to see what things looked like when I had the last MRI.
I overnighted the CDs with the MRI scans from Colorado to Stanford and had the CDs with the MRI scans from California overnighted to the neurosurgeon here. The physicians consulted with one another and everyone was in agreement that things had definitely changed since the last MRI scan. The tumor was back and it had changed quickly. Surgery would need to be performed again.
On 10.25.2007, I had surgery. The neurosurgeon was able to resect about 90% of the tumor tissue and there were no complications from the surgery. I spent some time in the hospital recovering and was discharged on 10.30.2007, to continue my recovery at home. It was very nice to be discharged. I like the level of care at the hospital, but I like being at home much better.
I woke up early on a Saturday morning, 10.13.2007, with a significant headache. I wasn't at work, so it surely wasn't due to stress from work. It also wasn't generalized like the other headaches. This one was localized to the area where the tumor tissue was. I knew that couldn't be good. I tried taking some Advil, but it didn't work this time. My wife thought I should go to emergency room and I agreed.
At our local hospital, which is a very new facility, they were humble enough to acknowledge that they were ill equipped to deal with a brain tumor situation. They had no neurologists or neurosurgeons on their staff and their imaging equipment wasn't really ready for something like my situation presented. They did do a good job in assisting with the pain and referred me to another hospital in the Metro Denver area.
My wife took me there and they had a neurologist, a neurosurgeon, and did MRI and CT scans. The neurosurgeon I consulted with viewed the films and could instantly tell that my present scans did not reflect a stable and unchanged situation. It looked to him that my tumor had grown back, but he wanted to see the prior films to see what things looked like when I had the last MRI.
I overnighted the CDs with the MRI scans from Colorado to Stanford and had the CDs with the MRI scans from California overnighted to the neurosurgeon here. The physicians consulted with one another and everyone was in agreement that things had definitely changed since the last MRI scan. The tumor was back and it had changed quickly. Surgery would need to be performed again.
On 10.25.2007, I had surgery. The neurosurgeon was able to resect about 90% of the tumor tissue and there were no complications from the surgery. I spent some time in the hospital recovering and was discharged on 10.30.2007, to continue my recovery at home. It was very nice to be discharged. I like the level of care at the hospital, but I like being at home much better.
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