I saw my new doctor today and liked him very much. He has a very different manner than my last radiation oncologist, a bit lighter and not so serious, which I personally prefer. Plus, he had good coffee in his office.
Although, truth be told, I wouldn't much care if the doctor had the personality of a bed post as long as he or she really, really knows their stuff, but I really don't appreciate arrogant doctors and am delighted to have an excellent, positive energetic doctor who has nary a trace of that "I'm a brain surgeon" swagger.
Anyway, he took lots of time with us in an office rather than an exam room (another touch I appreciate) to explain our options. He showed us the 3D image of the tumor and where exactly it is sitting. It is deep inside the brain and as so is inoperable. So it basically boiled down to two choices: zap it now or watch and see what it does. Everyone is so miffed by that last disappearing tumor back in March that there is almost a "let's wait and see" feel. However, it is growing so quickly (actually already 1.3 cm by his measurements in 3D, not just across one plain that showed the 7mm) that he suggested we get it before it gets any bigger. This has grown in under three months, since my last brain MRI in June showed no trace of it. My last doctor would not treat over a centimeter, but this doctor is willing to.
The concern with treating a larger tumor, I learned today, is that while they can be very precise with the intense radiation dose and where it goes, there is a halo of much less intense radiation that will circle the tumor, often leading over time to brain tissue necrosis in the area. The bigger the original tumor, the greater the halo and the more damage done to the brain. They are finding, as people with brain mets are living longer and longer, that this incidence is much higher than they had originally thought. But I still prefer to have more years with my kids than perfectly preserved brain tissue. They'll still love me if I'm a dummy. (At least they'd better!)
Today right after our get acquainted appointment, the office staff made my mask (you remember, the one that bolts you to the table and makes an excellent Halloween souvenir at the end) and something new to me...a bite plate that screws my jaw down with my mask so I can't move even the teeniest fraction of a millimeter. Warning: if you are claustrophobic or have a serious gag reflex, don't get cancer in your brain! I was fighting my own mild gag reflex all day. Breath through the nose, breath through the nose, don't let your tongue touch the intruder in your mouth. etc., etc.
So, net net, I am all set for a single mega dose of radiation on Tuesday. No decadron (yippee, yahoo!), a thirty minute procedure, and then we wait months to see what it does. My doctor believes I have a 80-90% chance of a complete response. I am praying for better odds than that, but I'll take what I can get.
There you have it, up to the minute. It's in God's hands now...always has been.