Keith Update
Keith is back in the hospital. He has a new tumor in the right frontal area of his brain - the previous tumor was on the left side. The new mass was not there 7 weeks ago when we did our last MRI, so it has grown quite rapidly.
We landed in the ER Wednesday after Keith struggled for several days with a splitting headache, nausea and fever. We had hoped he just had a bad bug - by the time we got to the hospital, it was fairly clear that his symptoms suggested a recurrence.
This new tumor is mostly operable (unlike the last). Our surgeon thinks we can get a majority, although not quite all of the new mass - there is a bit which is on the motor strip - on the right side rather than the left - he would lose function on the left side if we touched that area.
There is a large area of swelling and edema surrounding the tumor. The size of the tumor along with the swelling result in intense pressure on the rest of the brain and in turn the pain and the vomiting. We started steroids immediately and Keith is feeling much better today and yesterday. He is on pain meds as needed.
We spent yesterday working through our next steps. Surgery is a must - to relieve the pressure on the brain - but surgery is not "curative" with this disease. Radiation at present is not an option - normally that is something that can only be done once - but we consulted the radiologist "just in case". Temodar, which has served us so well to date, has clearly run its course - so we are in need of a new chemo agent or agents.
Our oncologist is recommending a Phase 2 trial consisting of a combination of two drugs - Erlotinib (Tarceva) and Temsirolimus. Both of these have been used for other cancers, but not in combo as far as I can see. One is in pill form and is taken daily and one is a drip administered weekly. The trial is at UCLA.
Our only hesitation is that this particular trial requires that we do 5 days of the chemo BEFORE surgery. (Note: Our surgeon is ready to go "now".) Notwithstanding we have opted to go for the trial. We will meet with the UCLA team Monday and expect to begin therapy on Tuesday - with the earliest surgery the following Monday.
There is some risk in waiting to do the surgery - but the belief is that steroids and the initial blast of chemo can keep the tumor in check for the initial week. If we did surgery right away, we would need to wait 2-3 weeks before beginning chemo - and we would need to find a different trial. In the long run, it is the chemotherapy agents which will give us the most benefit - and we hated delaying the start of that attack. If we run into problems during this next week, we can do the surgery sooner - albeit on an emergency basis.
Keith is in good fighting spirits - and we will take each day one at a time - and make the best choices we can make in each moment.
We landed in the ER Wednesday after Keith struggled for several days with a splitting headache, nausea and fever. We had hoped he just had a bad bug - by the time we got to the hospital, it was fairly clear that his symptoms suggested a recurrence.
This new tumor is mostly operable (unlike the last). Our surgeon thinks we can get a majority, although not quite all of the new mass - there is a bit which is on the motor strip - on the right side rather than the left - he would lose function on the left side if we touched that area.
There is a large area of swelling and edema surrounding the tumor. The size of the tumor along with the swelling result in intense pressure on the rest of the brain and in turn the pain and the vomiting. We started steroids immediately and Keith is feeling much better today and yesterday. He is on pain meds as needed.
We spent yesterday working through our next steps. Surgery is a must - to relieve the pressure on the brain - but surgery is not "curative" with this disease. Radiation at present is not an option - normally that is something that can only be done once - but we consulted the radiologist "just in case". Temodar, which has served us so well to date, has clearly run its course - so we are in need of a new chemo agent or agents.
Our oncologist is recommending a Phase 2 trial consisting of a combination of two drugs - Erlotinib (Tarceva) and Temsirolimus. Both of these have been used for other cancers, but not in combo as far as I can see. One is in pill form and is taken daily and one is a drip administered weekly. The trial is at UCLA.
Our only hesitation is that this particular trial requires that we do 5 days of the chemo BEFORE surgery. (Note: Our surgeon is ready to go "now".) Notwithstanding we have opted to go for the trial. We will meet with the UCLA team Monday and expect to begin therapy on Tuesday - with the earliest surgery the following Monday.
There is some risk in waiting to do the surgery - but the belief is that steroids and the initial blast of chemo can keep the tumor in check for the initial week. If we did surgery right away, we would need to wait 2-3 weeks before beginning chemo - and we would need to find a different trial. In the long run, it is the chemotherapy agents which will give us the most benefit - and we hated delaying the start of that attack. If we run into problems during this next week, we can do the surgery sooner - albeit on an emergency basis.
Keith is in good fighting spirits - and we will take each day one at a time - and make the best choices we can make in each moment.
posted by Keith and Kathy | 3:01 PM
2 Comments:
Love, warmth and strength to you all.
Helene (in Toronto)
Holding you all in my thoughts and heart...Elaine Millin Cape Town
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