Thursday, 30 April 2009

Week 7 .... MRI result and consultation

Sorry about the new Profile Photo but this looks pretty much how I feel after yesterday's news ... anxious and shell-shocked, and several years older!

Wednesday - MRI day.
This was not unpleasant, just strange, plus a little hard on the neck having to keep very, very still for 30 minutes or so. It was also incredibly noisy despite ear-plugs and padding! No word or sign regarding what they could see except to say that the images were good and clear.

Thursday - Consultation with LK, Radiation Oncologist
This turned out to be an incredibly long, long day as my appointment wasn't until 15.50hrs and the time seemed to drag intermidably. And then there was a long wait so I was not actually seen until around 16.50 hrs.

This time Mandy accompanied John and I to the meeting with LK, which also included a trainee radiologist and the radiotherapy nurse who will be looking after me in times to come.

MRI result: Meningioma at the apex of (L) petrous temporal bone extending over inferior aspect of (L) temporal lobe.

What this means is that, not content with having a fat little body cuddled up to the Internal Carotid Artery and facial nerves, Feckit has grown a trailing branch which is growing around part of the underside of the temporal lobe.

The concensus seems to be that this makes it a non-contender for treatment with either conventional surgery, one-session stereotactic radiosurgery or fractionated stereotactic radiosurgery.

Treatment:

Radiation therapy x 30 doses, delivered 5 days per week for 6 weeks. Course of treatment to begin in a month's time (this to give time for my broken front crown to be excised and the bone healed). From what I could understand the treatment may possibly include a mix of 3-dimensional Radiation Therapy and Intensity Modulated Radiation Therapy.

Three-dimentional conformal radiation therapy. Based on images from CT and MRI scans, a 3-dimensional model of the tumor and normal tissues is created using a computer. Beam size and angles are determined in a way that maximises the dose of radiation to the tumor, while reducing the amount of radiation exposure to normal tissue.

Intensity modulated radiation therapy (IMRT). Radiation therapy is delivered with greater intensity or dose to thicker areas of the tumor and with less intensity to thinner areas of the tumor. This is accomplished by placing tiny metal leaves in the path of the beam to reduce intensity and to customise the shape of the dose to the shape of the tumor.

THE GOOD NEWS

1. Feckit is a meningioma and not a malignant tumor.
2. It has not invaded the pituitary fossa.
3. It does not seem to have caused much damage to nerves, blood vessels or brain tissue as yet.


NOT SO GOOD NEWS

1. Feckit is in a difficult place to access.
2. It is not conforming to a shape suitable for FSRS.
3. Radiotherapy should kill the tumor cells but my current symptoms may not be relieved as Feckit may not be obliging enough to shrink away after treatment.

EFFECTS OF TREATMENT

Short term - possible loss of clumps of hair, mild fatigue, mild skin irritation, headache or nausea.
Longer term - likely loss of hearing (L) ear, maybe damage to (L) parotid gland, possible difficulties with other neurological functions e.g. memory, attention deficit.

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So today I have had a bit of a melt-down and felt highly emotional to say the least. Luckily I have a supportive family and some wonderful friends (at times like this you realise what a blessing true friends are) who I hope will understand that I just can't be expected to put on a brave face ALL the time.

Sometimes its good to let your feelings out.

Things will seem better tomorrow. And other platitudes.