Our visit to Dr. Nicholas yesterday was more positive than our visit to Dr. Babu the day before and our impressions from reading the MRI report. Dr. Nicholas said the tumor has grown some, but it's nothing like you would expect from a glioblastoma multiforme. He described it more like the tumor "flexing its muscles".
He said the changes are subtle, and what he sees looks more like radiation effect than tumor growth. It's definitely not a tumor out of control. It wouldn't qualify Paul for a clinical trial and he doesn't think there's any need to try other treatments at this point.
Paul will continue with the 6 mg/day of Decadron to see if that helps alleviate some of the symptoms which may be due to swelling. He is also weaning Paul off of Phenobarbitol and putting him back on Tegretol, since the Phenobarbitol can cause some slowing of mental processes and can also act as a depressant. The reason Paul had gone off Tegretol before was because his white count was so low, and Tegretol can contribute to low white count. However, now that Paul's not on any chemotherapy that shouldn't be a problem.
He is referring Paul to the neuro-psych department to go through a battery of tests to see exactly where his strengths and weaknesses are. They will then help Paul find ways to work around the weaknesses so he can continue to function as long as possible. He is also taking Paul's case to the tumor board at U of C to see if they have any other recommendations.
He agreed with Dr. Babu that Paul didn't need to go for the Vincristine injection today, not so much because the chemo was no longer working but because the Vincristine is not really that powerful anyway, and Paul had the extra procarbazine before he began the PCV chemotherapy. We'll go back for another MRI in 2 months. In the meantime, Paul can enjoy some time without chemotherapy.
Continue to: Aug. 1, 1998
Return to: Diary of a Brain Tumor Patient's Wife
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Created: May 31, 1999
Last updated: July 18, 2010