A spot to watch

After moving up Susan's scheduled two-month MRI by a week out of concern for what’s causing her increased confusion and fatigue, the scan yesterday revealed a new spot on her brain. It’s small, about 1 cm in size and does not appear to be growing quickly. It's located on the right frontal lobe near the ventricle (the original tumor site is on the left). It’s not necessarily new tumor growth and may not be what’s causing her symptoms. It’s neither great nor terrible news. It’s a spot to watch.

First appearing on her scan in August, it was too soon to conclude it was anything but a suspicious angle change compared to the scan in June. From scan to scan, the “slices” of digital images don’t match up perfectly with each other. Now we know the spot is definitely there and appears to have grown a couple of millimeters – not an alarming change. If it’s tumor tissue, there may be unseen tendrils growing; but there’s no way to know that right now. A biopsy would be premature and unnecessarily invasive. Likewise, chemotherapy at this point would be hasty given its side-effects.

She’ll return in five weeks for an MRI of her head and neck, as well as an F-DOPA PET scan. Susan had one previously in July 2009 as part of a diagnostic study requested by neurosurgeon Linda Liau. I’ll skip the five-syllable word that DOPA stands for – but a PET scan is another imaging tool that can lead to a quicker and more accurate diagnosis. We’re thankful to be associated with UCLA at times like this since they have one of only three such machines in the country.

Meanwhile, yesterday’s scans also showed the persistence of brain swelling that Dr Nghiemphu said is most likely radiation effect from 2007. The swelling hasn’t increased, but it’s still there and is most likely the root cause of headache and its related troubles. As a result, we decided it’s probably not possible for Susan to stop taking steroids altogether. We raised her Decadron dose from a taper to 1mg daily so it can be effective against swelling and relieve her from taking pain meds. We’ll see whether her recently increased confusion and fatigue may be relieved as well.

As I said, discovering a spot to watch is not good or bad news, but I admit to a heaviness that comes with interrupting the improvement Susan has enjoyed for most of the past two years. It’s a reminder that aggressive brain cancer is not presently curable with modern medicine and tends to grow over time. We cannot will it away; although God may, so we pray for healing.

As we viewed Susan's MRI yesterday, I noticed how visibly large her stroke area is in the left occipital (rear) lobe of her brain. It’s probably 2-3 inches both wide and long. The stroke occurred sometime between her seizure on July 3, 2007 and when she woke up after brain surgery on July 5^th. It caused the right-side visual field loss and right-side weakness that affect her today. Susan has been through so much. The brain images document her grueling battle with brain cancer – the stroke, the aneurism, the tumor cavity itself; and now the new spot to watch. Still, we trust God in all of it and desperately want to be obedient to him on this journey. The Apostle Peter writes to us in 1 Peter 1:2, “Grace and peace be yours in abundance.”  We’re thankful we’ve got loads of grace and peace. And we’ll take more.