M.D. Anderson, Day 1

Today's visit with the neuro-oncologist offered us some hope.

The oncologist, Dr. C, says that based on his review of all the records and films, he thinks Steve's lesion is mostly likely a glioma (a general term for a brain tumor that forms from brain tissue). Lymphoma, sarcoidosis, a viral infection and demylination are much less likely.

Dr. C suspects that the tumor is an anaplastic astrocytoma. Such tumors are graded low grade, mid grade and high grade. He believes that Steve's is a mid grade, which means it is malignant but not as bad as a high grade.

Such a tumor is typically treated with radiation therapy for five days a week for five or six weeks. That is followed with Temodar, an oral chemotherapy, which Dr. C says is relatively easy on the body.

Treatment depends on a tissue sample, which requires a biopsy. Dr. C says we can afford to wait two or three weeks for a biopsy. We meet tomorrow morning with an M.D. Anderson neurosurgeon, Dr. L. He is one of the specialists in stereotactic biopsies of the brain.

If we choose to do the biopsy at M.D. Anderson, we would most likely return in a week or two for the procedure. After hospitalization, we'd return home. Then we'd come back to Houston in two or three weeks to learn results and discuss the treatment plan.

Most likely the treatments would be administered in Dallas. There are some tumors that respond well to proton therapy, which is done at M.D. Anderson, but Dr. C doubts Steve has that kind of tumor.

Gamma knife, a concentrated form of radiation, is a possibility we had been hoping for, but Dr. C says it won't work on Steve's tumor. The lesion is already too large.

The experience was smooth. We had been warned that the complex is huge, but it was easy to navigate, and the Brain and Spine Center staff was efficient and friendly. We loved meeting Shauna and Marie, who had been corresponding with us for weeks. Marie is an RN and the patient coordinator. Shauna is the pharmacy manager for the center and is one of Liz's best friends. Isn't it amazing that we have had access to countless resources? We are certainly blessed to have had in place so many remarkable people to help, from the very beginning of this ordeal.

After the appointment this morning, Jim took us to lunch and returned us to Jayshree and Sanjay's house. Steve is now napping, and I need to get some work done.

Recap:
1. The lesion is most likely a brain tumor called an anaplastic astrocytoma.
2. The next step is a biopsy, which we could do here or in Dallas. We meet with an M.D. Anderson surgeon tomorrow.
3. The tissue sample from the biopsy would determine the course of treatment, which will most likely be a combination of radiation and chemotherapy.