Good news/Bad news

I went to see the radiation oncologist, Dr. Halahz, at the University of Washington today.  She showed us the brain MRI.  Two of the three brain metastases are located in the left cerebellum, the largest being  1.8 cm.  The third is located in the left parietal lobe.  None have interfered with my basic functions.  I had a choice of Whole Brain Radiation or the more directed, gamma ray knife.  Both have similar life outcome expectations.  Whole brain radiation attacks the entire brain, is done over a period of weeks, causes your hair to fall out and some studies have indicated that 4 months out, it shows interference with higher brain functioning.  The plus is that it gets the entire brain covered.  But I chose the gamma ray knife because I don't want to lose my hair again and the downturn in brain functioning was not attractive to me. Plus the gamma ray knife is a one time deal and they can also deal with the scalp tumors at the same time.

We talked about my left shoulder where the pain is so much greater these days, and the return of my swallowing problems as perhaps susceptible to radiation as well. Dr. Halazh suggested that since I had not had a CT scan in May it would be a good idea to get a more recent one so she could see what was going on.  As opposed to Group Health, where we would have had to wait several weeks, if not a month or more for the CT scan, she got me in today. 

And she called this afternoon.  News is not good.  The supraclavicular tumor on my left shoulder has grown and it appears that it has spread into my jugular vein.  Either that or it's a large blood clot.  The mediastinal tumor (which is on the front of my chest next to my heart, has also grown and has isolated a part of my esophagus in which liquid is pooling.    So I am first to go through a 5 day radiation therapy attacking the supraclavicular tumor.  This begins next Thursday and will finish the day before I go into have the gamma ray knife radiation done.  The have to fix a frame into my skull so that they can position the gamma ray precisely where the tumors are.  But I will first have to go through another brain MRI.  I have asked for sedation, which I think is not unreasonable.

The good news is that we caught it now, not when the jugular vein or the esophagus was completely blocked. But that's about it.

So this is a scary time.  Let's hope it goes well.