13 October 2008 - Start of chemotherapy

Deb with Aaron Ramsey(Arsenal) and , members of the Wales U21 football squad.

(Photo taken at the Belfry on Sunday 12 October. Wales under 21s played England 21s at Villa Park on Tuesday 14 October. The game finished 2-2 - including a great goal by Aaron Ramsey but Wales lost 4 -5 on aggregate. Thanks to Gethin for arranging the meetings with the players - and the match tickets.)

After finishing the combined radio/chemotherapy Deb had a 4 week break without any treatment (apart from the steroids). On 13 October Deb returned to the Cancer Centre at the QE Hospital and had a blood test before seeing the consultant oncologist. This time we saw a Dr Spooner - he is standing in following the departure of Professor Jones until a new Doctor is in post. Some of the issues we discussed:

1 Chemotherapy dose - Deb's blood test results were good and the doctor gave consent for the chemotherapy to go ahead. For chemotherapy treatment alone the temozolomide dose is higher than when used in conjunction with radiotherapy. The dose is based on body surface area (200mg/sq metre). For Deb this worked out as a dose per day of 360mg (compared with 135mg during the combined treatment). Deb will take this for 5 days - last thing at night; so she sleeps through any side effects - and will then have nothing for 23 days until we start the next cycle.

2 Symptoms - Dr Spooner showed concern over Deb's symptoms (something the other doctors have not been). He was particularly interested in her dizzy spells. He thought these could be mini-siezures. He did not prescribe any medication but asked Deb to keep a log of when these occurred, how long they lasted, their severity etc. We also discussed Deb not sleeping. He told Deb that she should not 'cat-nap' during the day and only sleep at night and persevere with this until a normal sleep pattern was re-established.

3 Steroids - The doctor suggested that Deb reduced her steroid dose. She is currently on 4mg and she is to reduce her dose by 0.5mg per week down to 2mg. Dr Spooner compared coming off steroids to landing a plane; you can come down steeply but before you land you have to approach the runway gradually or you will crash.

4 Scan - Deb will have a scan towards the end of November - the hospital will write to us with a date. Because of radiation effects in the brain this cannot be compared with previous scans but will be used as a baseline for comparison to subsequent scans. (I still don't understand this. If you cannot see if the tumour has reduced in size how do you know if the treatment is working?).

5 We return to hospital on the 10 November for another blood test and the next cycle of chemotherapy.