10/17 MRI and Follow-Up Meeting

So today’s MRI indicates that my tumor is stable. This basically means little to no growth. I am really relieved, however, in meeting with Dr. Lai, I have decided to start with radiation therapy as soon as possible. There’s still a very long road ahead. The surgery I had only removed what tumor tissue that could be removed, but did not of course provide any sort of treatment to prevent the remaining tumor tissue from future growth. Although today’s MRI showed little to no growth, it does not necessarily preclude the tumor from growth in the future. Most likely, it will begin to show signs of growth at some point and treatment is inevitable. It’s either treatment now, or treatment later so I figure doing now is better and I can just try to move forward with my life.

After meeting with Dr. Lai, I went to over to the radiaton-oncology office to let them know of my decision. I will be hearing from them sometime soon regarding the scheduling of my treatment, which should most likely start in the next week or two. According to Dr. Lai, and the radiation-oncology nurse, I should be able to drive myself to and from UCLA which will make it possible for me to receive treatment up there which I am thankful for. I had been concerned whether fatigue may prevent me from driving myself, but it appears that it won’t be an issue. I’ve contacted other people who’ve gone through radiation therapy and they’ve been okay with driving to and from their treatments as well.

So at this point, radiation therapy should consist of 28 sessions over a 5 to 6 week period. Each session should last roughly 30 minutes although most of the time should be primarily to set up everything. The actual radiating should only be 2 to 4 minutes in duration. The very first session as I understand it should be a bit longer as a custom molded mask will need to be made for me. As I mentioned, the radiation therapy will be conducted using the TrueBeam linear accelerator. Overall, I feel okay about this decision although there is always the unknown of course.

Not all the news was good though. In meeting with Dr. Lai, I was able to talk more depth with him about my recent bouts of dizziness and the feeling of off-centeredness. He’s still concerned that I may be having mini-partial seizures. I told him about my visit with my PCP last week who believes these sensations may be due to hypotension (low blood pressure). However, Dr. Lai thinks that it could be both hypotention and the tumor causing these issues and wants to be on the safe side and rule out anything that’s possible to be ruled out. So starting tomorrow, my Keppra dosage will be increased from 1,500 mg up to 2,000 mg to see if it makes a difference. I hope it leads to some answers.

Upcoming MRI on 10/17

Well, I have my next MRI this coming Monday and then a follow-up with Dr. Lai afterwards. Am a bit anxious about what the MRI will reveal. I believe this feeling of anxiousness before an MRI scan and its finding is called “scanxiety.”

This MRI should dictate the growth rate and characteristic of the type of tumor that I have. I am hoping for the best in that it will show no growth of the remaining tumor. According to Dr. Lai, there should be little to no growth as it is a grade 2 oligoastrocytoma. If there is significant growth then it will mean that the tumor will have taken a turn for the worse. Therefore, a more aggressive treatment would be needed such as radiation surgery, which is similar to radiation therapy, but at a much higher dosage. Also, I may need another surgery depending on the location and amount of growth.

At this point though, assuming that the results are positive, I am leaning towards radiation therapy. Again, it seems that the effectiveness of each treatment are about equal and it’s just coming down to what I think I can live with after assessing the positives and negatives of each. I probably won’t make the ultimate final decision until I’m in the office with Dr. Lai on Monday.

True Beam Linear Accelerator

If I choose to go with radiation therapy up at UCLA, the machine that would be utilized would be the TrueBeam system. It’s supposedly the latest machine available and was just made commercially available last year. Here is a link to UCLA radiation oncology page:
http://radonc.ucla.edu/body.cfm?id=297

So I haven’t had any dizziness since the second surgery, but been having dizzy spells again the past few days. Primarily in the mornings when I wake up and when I am lying down. On a couple of occasions, it’s been accompanied my an intense ringing in my right ear.
Dr. Liau believes that it might be a low blood pressure issue or possibly hydration issue. However Dr. Lai is concerned that they might be mini-partial seizures. He’s recommending that I take a 500mg Keppra pill in the morning and a 1,000mg Keppra pill in the evening as a precaution. Initially Dr. Liau wanted to wait to see if any new symptoms occur before possibly calling what I’ve been experiencing mini-partial seizures, but concurred with Dr. Lai’s recommendation. I’m a bit disappointed and hoping that I am not having mini-partial seizures again and that whatever is causing this will soon pass. Also hoping the body rash does not come back due to the increase in dosage.