13 August 2018 - Cancer Centre, Old QE Hospital

Deb had her latest MRI scan (her 47th) on 21 July 2018. This scan was only 6 weeks after the previous scan. A shorter time period was decided upon to allow close monitoring of tumour growth. At the hospital we saw Dr Beshar Allos, registrar to Dr Sanghera who was on holiday.

Screen shots of Deb's scans are shown below. The MRI takes horizontal slices through the brain. The images are then shown reversed on the screen . So although Deb's tumour is in her RHS frontal lobe, it is shown on the left in the scans. In all cases the scan on the right of the picture is from 18 Feb 2018 and the latest scan (21 July) is on the left.

Photo1: Actual screen shot showing tumour growth. The white areas on the top LHS show where the tumour is actually growing.

Photo 2: Screen shot showing growth. I have marked where I think the tumour is. I may have got this wrong - a lot of the tumour is darker and not actually progressing at this time. But you can see growth over the last 6 months.

Photo 3: This is a screen shot of a different scan showing swelling around the tumour.

Photo 4: I have marked where I think the actual swelling is (fluid produced by the brain's reaction to the tumour). Again you can see that the amount of swelling has increased.

Dr Allos said that the radiologist's report on the latest scan indicated that there had been further tumour growth. This was less marked than the growth that had happened between the previous two scans. He said the changes were subtle and small and he said it was a difficult to decide whether to continue with the chemotherapy or change to another therapy (ie radiotherapy.).  Dr Allos thought that the decision as to how we should proceed should best be made by Dr Sanghera and suggested we did nothing for a week and returned next Monday when  Dr Sanghera would be back. We therefore made arrangements to return on 20 August at 12.50.

We discussed how Deb had been over the past couple of months. I read from my list. I thought there had been significant deterioration. In particular: Deb had more difficulty in walking; she now always used a stick. We have borrowed a wheelchair and use this for any distance over about 50 yards. She slumps to her left when sitting and this is more pronounced. Often she has trouble getting up and down stairs. Her writing is often illegible and she has had periods when she is not aware of what is going on. She has difficulty with some simple tasks. She sleeps a lot more etc etc.

Dr Allos thought these symptoms may be a result of the increased swelling in the brain caused by the tumour. Because the brain is encased within the skull any swelling will squeeze the brain within the cranium and could cause a variety of symptoms. He has put Deb back onto steroids (dexamethazone, 4mg per day) to see if this reduces the swelling and improves her condition.