Brain Cancer: What’s next

We’re home again after two days in Denver, where we consulted  with Richard’s oncologist and his neurosurgeon about what’s next in dealing with the growing glioblastoma in his right brain. I had planned to post something  last night about what we learned, but the wifi in the apartment where we were staying wouldn’t speak to my laptop, so we went to bed early instead.

We were both exhausted after a morning at the hospital and then an afternoon at the local Apple store helping my 82-year-old, legally blind dad investigate Macintosh computers. (We left after a couple of hours with a brand-new iMac with a 22-inch screen. My dad, who has used PCs for 25 years, is  in heaven. Come the revolution…)

Today we spent much of the  morning at the hospital again, this time meeting with Richard’s neurosurgeon. Then we did our city errands, and I drove us home over the mountains in a howling spring wind. So I can’t say I’m any less exhausted now, but at least I’m home where mountains have new snow and the wifi works… (I shot the photo above from the highway winding down into our valley as our home mountains, the Sawatch Range, rose into view. And yes, I did stop the car first!)

Yesterday morning’s Oncology consult was amazing. Dr. Klein looked at Richard, listened as he and I reported his current  symptoms, and then immediately wrote a prescription for a steroid (dexamethasone) to alleviate that swelling that seems to be causing issues with left-side motor and sensory function. Then we talked about our options, and she agreed that Avastin infusions are a reasonable next step.

First however, she wanted to make sure we understand the “scary” side effects (things like debilitating strokes, heart attacks and sudden death from uncontrolled brain bleeding). We knew those risk, but still… My eyes filled with tears and Richard put his arm around me. “Don’t you start,” said Dr. Klein with mock fierceness, “Or I’ll be crying too!”

So we talked about the process: Wait two weeks to make sure Richard has completely healed from the most recent brain surgery. Then he’ll begin a course of three Avastin infusions, one every two weeks (assuming his blood pressure and white blood cell counts hold up), followed by another MRI to see how that’s affected the tumor. She reminded us that Avastin is not a cure, but could provide  better quality of life in the meantime. However long that meantime may be, and I’m holding out hope for a very long time.

Dr. Klein called the infusion center to set up  a tour and orientation. Then she sent us off with hugs, and we climbed the stairs to the fifth floor, where Becky, the charge nurse at the infusion center, showed us around, went through their information packet, and got us set up for Richard’s first infusion on May 11th. We left feeling profoundly grateful to have such compassionate and skilled care.

At today’s neurosurgery consult, Dr. Brega spent almost an hour talking to us about Richard’s current symptoms, what we learned from the recommendations of the neuro-oncology folks at UC-SF, and the Avastin infusions. She was delighted to see that after just three doses, the dexamethasone is already relieving his symptoms–he  buttoned his own shirt this morning, he’s experiencing less confusion, and best of all from my point of view, he’s smiling more now that the left side of his face is responding again. (The way he’s smiling in the photo below, with my dad and cousin Halvard.) Dr. Brega is in agreement with the plan for Avastin infusions, and she also wants to present his case to the tumor review board at the University of Colorado medical school next Tuesday, to see if her colleagues have any other suggestions. 

So now we have a plan, and we’re home where we can settle in for a couple of quiet weeks of recruiting our energy for the next steps.

We’ve been blessed with so much support on this journey–from the staff and docs at the VA,  to all who have chipped in for our expenses, sent Starbucks and Chipotle gift cards, provided lodging, offered massages, brought fresh eggs and meals, cleaned our house, and just given much-need and very welcome hugs and words of  encouragement.

Thank you all for walking with us. We’re very fortunate to have your Light in our lives.