22 February 2011 - Cancer Centre, Neurosciences Outpatients Department, Oncology Unit, Old QEH

Last week, the start of Deb's fourth cycle of PCV chemotherapy was delayed because of her low platelet count. We returned to the hospital today for Deb to have a further blood test and to see Dr Sanghera to consider the next cycle of chemotherapy.

Cancer Centre

This took along time. The blood analysis machine was faulty and would not print out. Eventually we got the results which were not good. The platelet count had increased but only slightly. (Last week= 60, today = 78, minimum of healthy range = 140, minimum for chemotherapy = 100). Other counts - red blood cells etc - were slightly down but not enough to worry.

Neurosciences OPD

We saw Dr Sanghera who said that Deb could start her next cycle of chemotherapy but he would reduce the dose in some of the components because of the low platelet count. (Vincristine - as before, administered intravenously; Lomustine - 25% reduction, 3 tablets instead of 4; Procarbazine - 20% reduction, for 8 days instead of 10). Dr Sanghera wants Deb to return in 3 weeks for another blood test.

Oncology Unit

Chemotherapy unit has been decanted (their word) from its original site in the Cancer Centre to the second floor of the Old QE. This is a 'pre-move' in preparation for a move into the new hospital later in the year. We had to wait a long time before Deb had her vincristine. In total out of the house for 5.5 hours.

Yesterday we went to the West Midlands Brain Tumour Support Group. We had a talk from Latha Senthil, Consultant Neuroradiologist at the QE. I found her talk very interesting. One of the things she said was that grade IV brain tumours (like Deb's) grow very quickly and therefore have to generate their own blood supply. Because the blood vessels that supply the tumour have grown fast they do not have time to develop a blood brain barrier. So when contrast medium is injected during an MRI scan it leaks into the fast growing part of the tumour from these malformed blood vessels. It is this leakage that shows up as 'white' on Deb's scans. This lack of a blood/brain barrier around the fast growing parts of the tumour also allows the chemotherapy to be effective. It leaks into those parts of the brain where it is most needed. The tumour's fast growth is its own Achilles heel.