New tumor treatment plan

This week's MRI revealed more about Susan's recent tumor growth and allowed us to sketch out a treatment plan. While brain tumor growth is hardly good news, several positive aspects of our consultation with Dr Nghiemphu brightened our outlook about this phase of the journey. First, the new area of growth spanning the midline near Susan's original tumor site appears to be a less-aggressive type of tumor called Oligodendroglioma. Its appearance on recent scans lacks the intense contrast of a high-grade cancer with lots of blood vessels like Glioblastoma, which is not a surprise since Susan's tissue sample in 2007 contained both types of cells. While it's not benign and usually is classified as Grade II or III, Oligodendroglioma does grow more slowly than GBM and can be treated effectively with chemotherapy. Dr Leia said it's reasonable once GBM has been knocked down by treatment with Avastin that a lower-grade cancer could emerge, since what's effective for one doesn't faze the other. The drug Susan will have next is CCNU, taken orally every six weeks instead of by injection more frequently. So, a less aggressive tumor that's responsive to chemo with no clinic visits for injections? The report could be much worse.

Susan's been dogged recently by a persistent infection, so the doctor wants to allow a month for healing with more antibiotic treatment before starting CCNU since it can lower the blood count and weaken the immune system. Meanwhile, we were encouraged that a return of the fog last week (as I call the recurring load on Susan's brain and body) did not last and was followed by a 6-8 days of alertness and good energy. It's hard when it comes because you never know if an intruding complication means the spell will linger or worsen. She's been burdened again the past few days, making me wonder whether it's from tumor or infection – but we'll find out when she gets some more antibiotics on board. We'll see her infectious disease specialist on Monday and may need to ramp up her treatment.

The Lord continues to provide for us at every turn in meeting our basic needs and reminding us of his care. Psalm 91:1 says, "He who dwells in the shelter of the Most High will rest in the shadow of the Almighty." People give us food, send cards, offer prayer, share their time, and continually express their love and their desire to do more. While we undergo the great storm of Susan's brain tumor journey, God himself has become our shelter and has caused us to rest in his shadow. His peace is a gift to us.