15 January 2018 - Cancer Centre, Old QE Hospital, Birmingham

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.