So I am deciding between radiation therapy and chemotherapy. Here’s a somewhat generalized summary of each treatment:
Radiation Therapy:
The recommended radiation therapy would consist of 28 sessions so about 5.5 to 6 weeks as I would go in everyday, Monday through Friday. Each session would last about 15 to 20 minutes. The type of radiation therapy proposed is called stereotatic radiotherapy and would be done up at UCLA because of the special equipment they have that most other institution does not have. The equipment allows for a very precise placement of the radiation beams.
The treatment would consist of initially having a customize mask made. Once this mask is made, my head would be clamped in place. Three beams of very low dosage would then be administered with the help of 3D imaging to assist the radiation therapist and further increase accuracy. The beams can be shaped to the shape of the tumor to minimize healthy tissue damage. However, there will be somewhat of an overlap to ensure that unseen tumor cells are radiated as well. So inherently, this can lead to long-term mental deficits (e.g., short-term memory loss, lowered cognition, etc…) which is a drawback to this procedure. In speaking with Dr. Selch, the UCLA radiation-oncologist, he does not believe the risk of potential mental deficits to be high because of the location of the remaining tumor, although of course he also said there is no guarantee. Again, possible mental deficits are just the inherent consequences associated with radiation. Short-term side effects can include hair loss for the areas where the beams enter, skin irritation, fatigue, loss of short-term memory. As these are short-term effects, they should all go away in time, however, the hair loss may become permanent. Surprisingly, according to Dr. Selch, he said that although I may feel fatigue, that I should be able to drive after each treatment option.
Chemotherapy
As for chemotherapy, as I mentioned in an earlier post, the neuro-oncologist is recommending a high dose treatment. So it would consist of taking temodar orally for a 5 day period for the first week of every month for the next one to two years. Short-term side effects include nausea (controllable with anti-nausea drug), fatigue and constipation, hair loss (very minimal) and blood count lowering which can cause constant low grade fever. The long terms effects are minimal, with a very small chance of developing a leukemia although the advantage of chemo is that it does not have the long term delayed neurocognitive effects of radiation. Unfortunately, there is no way of monitoring or predicting whether someone would develop leukemia. However, the chances are relatively small. In my own research, I’ve come across figures of 1 to 2%. According to Dr. Lai, of the couple thousand that’s been treated at UCLA, only one patient has developed leukemia.
There’s also the option to do a low dose treatment, which would require taking Temodar everyday for a 5 to 6 month period. However, there doesn’t seem to be an advantage over the high dose. Also, Dr. Lai has stated that the low dose option could end up resulting in more short and delayed side effects as it could result in actually ingesting a higher overall dosage of Temodar in the long run.
From people who is or did chemo using Temodar and according to Dr. Lai, usually the 10-12 days out of every month people don’t feel so great, but feel relatively okay the rest of the month. However, as with everything, it really just depends on the person. Some people can take the treatment really well with hardly any issues, while others need to be taken off because they cannot adjust to it.
I initially thought of going with chemotherapy. There are certain markers that are looked for to determine how effective chemo will be. Unfortunately, the characteristic of my tumor does not exhibit markers that would seem to make it chemosensitive. However, Dr. Lai did say that while having certain markers do help, it does not necessary mean that chemo won’t be effective. Anyway, there is no cure for brain tumors and only treatments. Both radiation and chemo does not cure really tumors, but primarily prevents or prolongs tumor recurrence.
I’ll post more later, but any advice would be appreciated. I am having a difficult time deciding between the two as one is not exponentially better than the other and both have their drawbacks. My number one concern is quality of life more so than longevity.
Radiation Therapy:
The recommended radiation therapy would consist of 28 sessions so about 5.5 to 6 weeks as I would go in everyday, Monday through Friday. Each session would last about 15 to 20 minutes. The type of radiation therapy proposed is called stereotatic radiotherapy and would be done up at UCLA because of the special equipment they have that most other institution does not have. The equipment allows for a very precise placement of the radiation beams.
The treatment would consist of initially having a customize mask made. Once this mask is made, my head would be clamped in place. Three beams of very low dosage would then be administered with the help of 3D imaging to assist the radiation therapist and further increase accuracy. The beams can be shaped to the shape of the tumor to minimize healthy tissue damage. However, there will be somewhat of an overlap to ensure that unseen tumor cells are radiated as well. So inherently, this can lead to long-term mental deficits (e.g., short-term memory loss, lowered cognition, etc…) which is a drawback to this procedure. In speaking with Dr. Selch, the UCLA radiation-oncologist, he does not believe the risk of potential mental deficits to be high because of the location of the remaining tumor, although of course he also said there is no guarantee. Again, possible mental deficits are just the inherent consequences associated with radiation. Short-term side effects can include hair loss for the areas where the beams enter, skin irritation, fatigue, loss of short-term memory. As these are short-term effects, they should all go away in time, however, the hair loss may become permanent. Surprisingly, according to Dr. Selch, he said that although I may feel fatigue, that I should be able to drive after each treatment option.
Chemotherapy
As for chemotherapy, as I mentioned in an earlier post, the neuro-oncologist is recommending a high dose treatment. So it would consist of taking temodar orally for a 5 day period for the first week of every month for the next one to two years. Short-term side effects include nausea (controllable with anti-nausea drug), fatigue and constipation, hair loss (very minimal) and blood count lowering which can cause constant low grade fever. The long terms effects are minimal, with a very small chance of developing a leukemia although the advantage of chemo is that it does not have the long term delayed neurocognitive effects of radiation. Unfortunately, there is no way of monitoring or predicting whether someone would develop leukemia. However, the chances are relatively small. In my own research, I’ve come across figures of 1 to 2%. According to Dr. Lai, of the couple thousand that’s been treated at UCLA, only one patient has developed leukemia.
There’s also the option to do a low dose treatment, which would require taking Temodar everyday for a 5 to 6 month period. However, there doesn’t seem to be an advantage over the high dose. Also, Dr. Lai has stated that the low dose option could end up resulting in more short and delayed side effects as it could result in actually ingesting a higher overall dosage of Temodar in the long run.
From people who is or did chemo using Temodar and according to Dr. Lai, usually the 10-12 days out of every month people don’t feel so great, but feel relatively okay the rest of the month. However, as with everything, it really just depends on the person. Some people can take the treatment really well with hardly any issues, while others need to be taken off because they cannot adjust to it.
I initially thought of going with chemotherapy. There are certain markers that are looked for to determine how effective chemo will be. Unfortunately, the characteristic of my tumor does not exhibit markers that would seem to make it chemosensitive. However, Dr. Lai did say that while having certain markers do help, it does not necessary mean that chemo won’t be effective. Anyway, there is no cure for brain tumors and only treatments. Both radiation and chemo does not cure really tumors, but primarily prevents or prolongs tumor recurrence.
I’ll post more later, but any advice would be appreciated. I am having a difficult time deciding between the two as one is not exponentially better than the other and both have their drawbacks. My number one concern is quality of life more so than longevity.
