23 August 2018 - Neurosciences Outpatients Dept, QE Hospital

Deb with Kate's new dog

Meeting with Dr Sanghera (oncology consultant) and Fred Berki (CNS) to discuss future treatment for Deb's tumour. 

On Tuesday this week a multi disciplinary team (MDT) meeting had been held when Deb's case was considered. The main options discussed were surgery and radiotherapy. The opinion of Mr Kay, the Neurosurgeon, and the rest of the meeting was that surgery was not a good option and the best way forward was a course of radiotherapy. It was felt that because of the time that had elapsed since the last treatment the brain had had a chance to recover from the original radiotherapy and further treatment at a lower dose would be appropriate. Dr Sanghera considered that the radiotherapy was best carried out now while Deb was still relatively well and could withstand the treatment. He did stress the possible side effects - tiredness, hair loss, cognitive disruption - and made sure Deb was entirely happy with proceeding.

Deb agreed to this course of action and signed a consent form.

The next step is for Deb to visit the hospital next week to have a CT scan which is used to provide information to target the radiation accurately and to have a mask made of her head. The mask is used to restrain Deb's head during radiotherapy so the gamma rays are accurately targeted. The radiotherapy will likely start the following week i.e. the first week in September and will consist of 40 sessions over 4 weeks. The effects of the radiotherapy are cumulative and as treatment progresses Deb is likely to feel very tired which could continue for 2 or 3 weeks after treatment ends. We will be contacted with the exact dates in the near future.

Deb had another blood test and the platelet count was 59. This was a slight improvement on the previous count. Dr Sanghera thought that Deb did not need a blood transfusion but would monitor her platelet count again on her next visit to the hospital.

We also discussed how Deb was responding to the lower dose of steroids. Deb (and I) had noticed a deterioration in her since the reduction and it was agreed that the dose would be returned to the  previous level (4mg).

I have now known Dr Sanghera, Fred and Claire for 10 years. We have seen them approaching 150 times. They are friends as well as professional medical staff. At this visit they were both very kind and supportive. They are good people.