13 November 2014 - Neurosciences Outpatients Department, QE Hospital

Deb and I on holiday in Perugia, Italy; September 2014

Ok I know its 6 months since I last posted. I have no excuse. This blog is like Deb's tumour: active but only growing very slowly.

Since the last post Deb has had 2 scans (the 29th and 30th since radiotherapy). One scan was on the 27th August (which was a MRS - magnetic resonance spectroscopy - scan) and the other a normal MRI scan  on the 2 November (a Sunday!). The results of the scans were the same in both cases. In each case, the radiologists report stated that there were signs of increased tumour activity.  However the activity was slight.  As for the first time when this activity was reported Dr Sanghera said that whatever was happening; it wasn't normal GBM growth. It was much too slow, If it it had been normal grade IV tumour growth, it would be much more clear and unambiguous. As before he repeated that he did not want to start any treatment whilst growth was slow and Deb was not showing any symptoms. On screen we compared the results of the latest scan with one taken a year ago, With the untrained eye it was difficult to see much difference. The area where the tumour was located did look slightly different as it was more 'fuzzy'on the latest scan.

If treatment was considered it would be either more surgery (not a pleasant prospect: the thought of having more holes drilled into your skull) or chemotherapy. Chemotherapy works by targeting cells that are dividing. Rapidly dividing cells (like cancer cells) are therefore more likely to be killed. If the tumour is only growing slowly - as with Deb's - chemo would not be as effective.

So it was decided we do nothing. Deb's next scan is scheduled for 3 months time.

22 May 2014 - Neurosciences Outpatients Department, QE Hospital

   Bert on the beach at Southwold, Suffolk

Today saw Dr Sanghera (and Fred and Claire) to get results of Deb's MRI scan (28th scan since radiotherapy). The last scan - 2 months ago - had shown some signs of tumour progression and we approached this meeting with some anxiety and trepidation.

This time Deb had two scans: first the standard MRI scan and secondly a magnetic resonance spectroscopy (MRS) scan (MRI gives information about where a tumour is; MRS can in theory tell doctors how aggressive it is.) For Deb the results from the MRS scan showed some increase in metabolism within the tumour. However the results of ordinary scan (although how any technique which uses superconducting magnets at the temperature of liquid helium (-269C) can be called 'ordinary' I don't know) showed no change since last time.  The results indicated that maybe something is happening in the tumour but its development is slow. Dr Sanghera thought there was enough uncertainty to delay the onset of treatment until the results were decisive.

So for the time being we do nothing. Deb is to have a further scan in 3 months time. Tomorrow, on Deb's birthday, is the 6th anniversary of her diagnosis. So we can celebrate. She is still doing well. Symptoms from the tumour are minimal and any changes appear to be slow in development.

28 March 2014 - Neurosciences Outpatients Department. QE Hospital

Deb and I at Marco Pierre White's restaurant, The Cube, Birmingham on my birthday

OK, I know I haven't updated the blog for 9 months but that is because nothing changed. Deb had scans in August and November and the tumour stayed dormant. However Deb had another MRI scan on 12 March (her 27th since radiotherapy) and today we met Dr Sanghera to get the results.  This time the news was worrying. The radiologist's report stated that the tumour was more active than on the scan taken 3 months previously. And you could see this on the screen. The tumour was about the same size but the white 'active' area around the edge of the tumour was more pronounced. Dr Sanghera played down the significance of this. He said that the tumour growth was minimal, scans can often be difficult to interpret and we had seen false results before. He did not intend to restart chemotherapy now but would put Deb in for another scan in 2 months time and start chemo then if necessary,

We also discussed Deb's forthcoming operation to have her gall bladder removed. Dr Sanghera thought Deb should still go ahead with this. It was him implying there was some doubt about whether Deb should proceed that unnerved me. We were instantly back in the realm of the terminal illness where every decision has to take on the added dimension of time.

Still tomorrow we are off on holiday to Suffolk for a week. Plenty of walking the dog, supping beer and leisurely dinners.