Today's MRI showed significant improvement over the most recent MRI of Nov. 21, the first indication via imaging that the tumor had started growing again.
(I'm still learning how to best explain the MRI images without getting bogged down in medical jargon. If one of our medically skilled friends reads this and finds an error or can explain it better, please let me know!)
When Steve gets an MRI, the machine first takes "pictures" of his brain. Then he's wheeled out of the machine, and a contrast dye is injected into his bloodstream. Then he's wheeled back in and the machine takes "pictures" of his brain with the dye.
So then there are two kinds of images to compare. One without contrast media and one with.
Dr. M was most pleased with the contrast media image, as it showed a marked improvement between Nov. 21 and today.
On Nov. 21, the tumor area was surrounded by a huge flair. It showed up bright white on the scan. It stretched across the brain stem and beyond. That image indicated that there were lots of leaky vessels. Everywhere it was white on the scan was where the vessels were leaking.
On today's image, there was still flair, but a much smaller cloud of white. And it wasn't as bright. This indicates that the brain has started repairing, that the vessels aren't as leaky.
It also indicates that the Avastin is doing what we'd hoped it would do. It has blocked the leaks and given the chemotherapy (CPT-11) a clear path to reach the tumor cells and kill them.
The scan without contrast media also indicates that the bulk of the tumor is smaller today than in November. We had assumed this was true, based on Steve's recovery from quickly deteriorating symptoms. But it sure was a relief to see the proof. In November, the brain stem looked swollen. Today it is still swollen, but not as badly.
Dr. M says that based on today's scan and her experience, we can believe that Steve's tumor will continue to respond to the Avastin/CPT-11 combination.
He is back on track for the chemotherapy infusions every two weeks. We'll return next Wednesday to start the first dose of the second cycle. After three doses, he'll have another MRI so we can see the damage.
After all this awesome news was explained and discussed, we talked a little about the sometimes disappointing experience at St. Paul the week before Christmas.
Wheezing and crackling
Then Dr. M did a quick exam of Steve. She's not sure why he's had an increase in left-side symptoms this week. She wants him to stay at his current level of steroids (5 mg daily).
She did hear some crackling and wheezing in his lungs. We headed from the second floor to the third floor for a chest X-ray.
We just received a phone call from Dr. M's nurse that the chest X-ray is clear, indicating no bronchitis or pneumonia. Whew! Steve will need to keep his rescue inhaler nearby and use it as necessary. Right now he doesn't feel any respiratory distress.
Today was the last day of Steve's IV antibiotic treatment for the MRSA diagnosed just before Christmas. He'll keep the PICC line in his arm for an indefinite period, and we'll continue to pray that it doesn't get infected as the chest port did.
As long as the PICC line remains in, I'll flush the line daily with a syringe of Heparin. And the home health nurse will come once a week to change the dressing and check for signs of infection.
The big picture
The big news from today is that we have more time.
When a glioblastoma begins growing again, after initial treatment of radiation and chemotherapy, the average life expectancy without additional therapy is three to six months. When the tumor responds favorably to Avastin and CPT-11, that window is extended. The drugs add months and sometimes years.
Among our many prayers is that science will continue to advance at a rapid speed and a third line of defense -- or even better, a cure -- will be discovered. Not just for Steve, but for the thousands of others who also fight glioblastomas, the most lethal of all the brain tumors.
We know that Steve is lucky and blessed to have survived until 2009. We continue to pray that he retains the strength and spirit to keep fighting. We continue to give thanks for our blessings. We continue to rejoice in each new day, a true gift.
We also continue to celebrate! Tonight we each ate a decadent cupcake. Cooper and Katie may not completely understand the meaning of today's MRI, but they definitely understand the significance of a Sprinkles cupcake!