New Challenges

You will note it has not been six months since my last post, and that is not good news. Just over a week ago I began experiencing pain in the back of my neck and had some balance issues. This led to an MRI of my brain on Wednesday June 2 and several doctor visits over the next two days. As of Friday afternoon, here is what we know and what is planned:

• The MRI showed one golf-ball size tumor in the lower left back of the brain. There are also two pea-size tumors on the left side of the brain.
• While it is not certain, given my past history with lung cancer there is a greater than 90% chance that the tumors are malignant and have spread from the lung cancer.
• In the short term, steroids have reduced the swelling and this is taking care of the pain and balance issues.
• Given the location of the large tumor, conventional surgery is not recommended.
• Given the size of the larger tumor, "radio surgery" (basically radiation focused on just the tumor) is not recommended.
• Since the two options above are out, and because there are multiple tumors, starting with whole-brain radiation is the recommended option. This will reduce the size of the large tumor, hopefully eliminate the other two visible tumors, and attack any remaining tumors that are not yet visible.
• I need to talk again with the Radiation Oncologist, but this will likely mean daily radiation treatments for the next four week.
• Following the whole-brain radiation, there will be a follow-up MRI to confirm that the large tumor is smaller. Assuming this happens, it may then be possible to use one of the standard radiation surgery processes to remove the tumor.

The entire process will take several weeks and needless to say we are very concerned about the process and the outcome. Your thoughts, prayers, and support are welcome - for both of us!

I guess I'm back to providing frequent blog updates. They won't be daily, but I will share more as I know more.

Dick

For those that want more details:

• Neck pain and lack of balance led to the decision to have the MRI.
• MRI (Magnetic Resonance Imaging) is one of the methods used to view tissue within the brain. It uses magnetic fields and computers to capture pictures of the brain. In this particular case, contrast fluid was injected which causes tumors to "glow" or be more visible in the 3-D picture created by the MRI.
• The larger tumor and two smaller tumors are clearly visible in the pictures. These are likely metastatic or secondary brain tumors resulting from the lung cancer. Metastatic tumors are the largest source of brain tumors.
• The large tumor is located in the middle of the cerebellum. It is located behind the brain stem and below the main sections of the brain. The cerebellum has many connections to the brain and the spinal cord. This part of the brain is responsible for coordinating muscle groups, controlling small movements, and balance. The tumor leads to inflammation which leads to pressure. This caused the pain and lack of balance.
• The tumor is also located near a duct that contains fluid. Pressure on the duct (from the tumor or inflammation) or surgery near the duct can be dangerous. This is part of the reason for taking action quickly and for not performing conventional surgery.
• The steroids really are working. They have reduced the inflammation and many tests today indicate that the tumor is not creating any immediate problems.
• Yesterday we met with my radiation oncologist. We met today with two groups of neurosurgeons. The conclusions were the same - no surgery now. Do the whole-brain radiation and then do another MRI and determine next steps.
• The two groups in Cincinnati are well-recognized nationally. I will continue to work with the current oncology team at OHC (Oncology and Hematology Care) and will now add a neurology team from the Mayfield Clinic. Sharon and I feel very good about the doctors and staff that we talked to today. In addition, there are P&G colleagues and medical professional that have had very good experiences with the Mayfield Clinic. This first-hand experience is reassuring as we need to make difficult decisions.