The visit today was to review Deb's treatment options following the multi-disciplinary team meeting on 9 January. Kate came with us to the meeting and we saw Dr Sanghera, consultant oncologist and Claire, Clinical Nurse Specialist.
Dr Sanghera gave feedback on the discussion at the MDT which mainly concerned whether surgery was appropriate at this time. The surgeon, Mr Kay, felt that, as Deb was still so well and essentially asymptomatic from the tumour, surgery, with all its concomitant dangers and possible side effects was an unnecessary risk at this time especially when there were no clear cut benefits to be derived from the operation. Surgery may well still be considered at a later time.
Dr Sanghera gave us 3 options:
1 Do nothing. Scan again in 2 months. Tumour growth does not appear to be rapid but we have limited data at present and a further scan would give us the opportunity to better judge exactly the pace of tumour development.
2 Resume chemotherapy with temozolomide and scan in 2 months. Although temozolomide did not prove very effective last time, Deb does tolerate the drug very well and it may have some effect in slowing tumour growth.
3 Start PCV chemotherapy immediately. This combination of drugs is more toxic than temozolomide and will have more significant effects on Deb's immune system and bone marrow.
After discussion, Deb chose the do nothing for 2 months option.
There is a risk that in waiting 2 months Deb will develop some symptoms from the tumour. These could be headaches, tiredness, nausea or dizziness.
We also discussed radiotherapy. Dr Sangera said this was still a possibility but it would be the treatment of last resort. RT is a very aggressive and causes damage to parts of the brain around the tumour.
So we do nothing and Deb will have another scan in 2 months from her last scan ie end of February.
Monday 15 January 2018
Tuesday 9 January 2018
9 January 2018 - BRIEF UPDATE
We were contacted this afternoon by Will (a clinical nurse specialist like Claire and Fred) following the MDT meeting. Deb's case was discussed but outcome of discussions not straightforward. Dr Sanghera wants Deb to go in either this week of early next week to discuss the options available to her. Dr Sanghera or his secretary will call us tomorrow to arrange a time. From what Will said it does not look like surgery is being considered. I don't know what other options there are other than more chemotherapy. Will update again when there is more news.
Friday 5 January 2018
4 January 2018 - Neurosciences Outpatients Department, QE Hospital
Today's visit was to review the results of Deb's MRI Scan on 30th December 2017 (her 44th)
THE SCAN RESULT WAS BAD NEWS!
The tumours had progressed. The growth is slow but is happening, We discussed three options with Dr Sanghera.
Option 1
Do nothing and have another scan in 2 months time. Deb is well at the moment and tumour growth is slow and we could wait a couple of months before starting treatment. During this time Deb could consider the course of action she wanted to follow. However, we feel this just delays the decision and we will consider the other options now.
Option 2
Start Chemotherapy again. Dr Sanghera was particularly disappointed that the tumours had started to grow so soon after stopping Chemotherapy. This demonstrated that the last course of chemo. was not as effective as when first used. The new chemotherapy treatment would involve PCV. Deb has had this previously. PCV is a combination of 3 drugs, one of which is administered intravenously in hospital. It is an older chemotherapy drug and more aggressive than Temozolomide.
Option 3
Surgery. Another brain operation to remove as much of the tumours as possible.
Deb's case will be discussed at the Multi-disciplinary Team Meeting (MDT) on Tuesday 9th, Dr Sanghera, Mr Kay (Surgeon) and the Radiologist will be present at the meeting.
The CNS Nurse will contact us on Tuesday afternoon to let us know the outcome of the meeting. I will post again then.
This was very disappointing news for us. In the that past, Dr Sanghera has always given us the best advice and Deb will be guided by him.
THE SCAN RESULT WAS BAD NEWS!
The tumours had progressed. The growth is slow but is happening, We discussed three options with Dr Sanghera.
Option 1
Do nothing and have another scan in 2 months time. Deb is well at the moment and tumour growth is slow and we could wait a couple of months before starting treatment. During this time Deb could consider the course of action she wanted to follow. However, we feel this just delays the decision and we will consider the other options now.
Option 2
Start Chemotherapy again. Dr Sanghera was particularly disappointed that the tumours had started to grow so soon after stopping Chemotherapy. This demonstrated that the last course of chemo. was not as effective as when first used. The new chemotherapy treatment would involve PCV. Deb has had this previously. PCV is a combination of 3 drugs, one of which is administered intravenously in hospital. It is an older chemotherapy drug and more aggressive than Temozolomide.
Option 3
Surgery. Another brain operation to remove as much of the tumours as possible.
Deb's case will be discussed at the Multi-disciplinary Team Meeting (MDT) on Tuesday 9th, Dr Sanghera, Mr Kay (Surgeon) and the Radiologist will be present at the meeting.
The CNS Nurse will contact us on Tuesday afternoon to let us know the outcome of the meeting. I will post again then.
This was very disappointing news for us. In the that past, Dr Sanghera has always given us the best advice and Deb will be guided by him.
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