Wednesday, 22 April 2009

Week 6 ..... first radio-oncology visit

Tuesday (John's birthday) was my first visit to see the radiology-oncologist who will be looking after me. For some reason I had expected to see a male doctor but was pleased to find that I will be under the care of a woman. I say that because, with a few notable exceptions, as a nurse I have always found it easier on the whole to talk to women doctors professionally, socially and also as a patient. Anyway it looks as if I am going to be in good hands with LK. Very important to feel comfortable about that!

However, it was quite disconcerting to find the LK has some reservations about the CT scan as she thinks the tumour may be affecting bone as well as nerves and blood vessels. Its actual location involves the Left Cavernous Sinus and may extend further.

I have been searching for images that make sense of this for me!!! Not easy. This one gives an idea of where in my head the tumour is .... the dark areas under the part labeled 'sella turcica (bone)' are the blood filled
cavernous sinuses which pass through the sphenoid bone which is shaped rather like a flying bat when seen straight on! The sella turcica is a depression in the sphenoid bone and is where the pituitary gland sits - in the pituitary fossa). As you can see this area lies in fairly close proximity to the back of the throat, nose and optic chiasma.

So having got to grips with where the cavernous sinuses ARE the next question for me to get clear in my own mind was where my dear little tumour (which I after Tuesday I have decided to christen 'Feckit') actually IS in relation to everything else .......

So looking at this diagram from the lower right there is a purple line labelled 'Dura and Arachnoid' - if one follows this purple line this is exactly where Feckit is growing, and it is encircling the blue area (one of the cavernous sinuses) and possibly the floor of the pituitary fossa. The diagram clearly shows the difficulties in treatment decisions due to the positions of the nerves, arteries and other vital structures.

The next image is a similar view as the diagram above but is from an MRI with diagrammatic explanation of structures.

The big question at the moment is how far has Feckit managed to affect the cavernous sinus and its contents and whether there is any infiltration into the sphenoid bone or elsewhere.

But fear not, Lesly, all will hopefully be much clearer after the MRI next week. Fingers crossed!