Thursday, 24 January 2013

"can I make it on my own?"


This month I had my annual MRI scan to "check up" on my two skull base meningiomas, Feckit and Fuss.

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FINDINGS
The homogeneous high T2 signal and enhancing 2 cms left petroclival mass remains similar in size and appearances with sparing of the cavernous sinus.
(in January 2012 this tumour was 2.1 cms)

The homogeneous high T2 signal and enhancing 1cm crista galli mass is also unchanged from previously.
(in both March 2009 and January 2012 tumour was 0.9 cms)

No other new lesion or abnormal enhancement is seen.
The overall parenchyma remains normal with preserved ventricles.

COMMENT
The two meningiomata are unaltered.

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The following are (referenced) conclusions with regard to observation and follow-up for meningioma and are from: 

Radiation_Oncology/CNS/Meningioma


Majority (~2/3) of asymptomatic, incidentally found meningiomas are stable on imaging. If they progress, the rate of growth tends to be 2-4 mm per year and tumor doubling time is on average 20 years

Calcified and hypointense on T2 meningiomas appear less likely to progress; elderly patients appear to have slower growth rates

Reasonable to consider observation for asymptomatic meningiomas, particularly in elderly patients or patients with skull-base (high operative risk) tumors. If so, MRI at 3 months, then 6 months later, then annually is considered reasonable

For younger patients and patients with non-calcified tumors, consider treatment due to higher expected growth rates

oooOooo


I have not been given a neurology appointment for 2 years now and the radiologist-oncologist does not think it necessary that I see a neurologist this time either. I am happy with that. She also suggests that they switch from annual check MRIs to 18-monthly ones .... not so happy with that but will go with her decision. 

However, I would like to know why Feckit (the one treated with radiation) appears to have reduced in size by 1mm while Fuss appears to have increased in size by a similar amount. So, as I am unlikely to speak to any specialist for a further 18 months, I have written asking whether the measurements given in the radiology reports are accurate or only approximations.

This may well be considered an imposition but I think it is entirely reasonable to ask for an explanation of the apparent changes in size of both tumours (especially as both are described in the report as 'unaltered'). Hopefully I will receive an answer before too long.

It is unlikely that many specialists have any concept of what it is like to walk around with a couple of tumours inside your head which may or may not be affecting your brain's functioning both now and in the long term! 

Of course I am very grateful that Feckit has been treated (apparently successfully thus far) and hope that he/it will shrink over time, but I am concerned that Fuss may be actively growing and need an answer if I am to "make it on my own" ........  as apparently I must.



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