Back on track with a plan in place

On Monday evening, after a very frustrating and confusing day, Mark sent an email to his oncologist, Dr. Kendra, asking for answers about the tumor. He explained the discrepancy between her opinion and the neurosurgeon's and told her he really wanted to have some solid answers before meeting with the radiologist on Thursday.

As of this morning, Mark still hadn't heard back from Dr. Kendra so Mark called her to confirm that she did in fact receive his email. She had received it and agreed with Mark that he should meet with the neuro-oncologist, Dr. Cavaliery, who specializes in cancer of the brain. My mom and Mark were really excited about this recommendation as they have met with Dr. Cavaliery before and really value his opinion (and dry sense of humor). Mark called Dr. Cavaliery's office and they were able to get him an appointment this afternoon (after Mark adamantly objected to their first suggested date of August 19th, reminding them that he could have a life threatening, large tumor in his brain).

My Mom and Mark took the afternoon off work and drove to Columbus to meet with Dr. Cavaliery and get some answers. On their way to the appointment, my mom called the doctor's office to make sure Dr. Cavaliery had both the most recent MRI results as well as the last year's worth of scans as to not repeat the confusion of Monday's appointment. I have to applaud my mom and Mark for both being so proactive and determined to get the best care for Mark.

After reviewing the old and new scans of the brain, Dr. Cavaliery agreed with the neurosurgeon. The large tumor in the right frontal lobe of Mark's brain was in fact old news and a result of previous gamma knife treatments. The same spot was shown in MRI scans from 2009. The new spot in the center of Mark's brain is IS a new tumor and the area that needs to be addressed. I have to take back the negative things I said about the neurosurgeon who did actually know what he was talking about. It was Dr. Kendra who was somewhat off of her game when she first met with my mom and Mark. The day of their appointment with her, she had just returned to the country at 4:30 AM and saw my mom and Mark at the very end of her 12 hour day. She probably didn't look at his previous scans and just assumed it was a new tumor.

Unfortunately what this means is that Mark was taking steroids, the drug he didn't want to take in the first place because it could reduce the immunity he gained from his clinical trial, for no reason at all. Mark informed my mom that he had lied about taking them. He took the first steroid pill and then didn't take another one after that. He trusted his instincts which were telling him not to take it, and now we're glad that he did!

When I asked Mark if he was frustrated with Dr. Kendra for causing so much confusion and being somewhat careless with the results of the MRI he said he didn't want to point fingers and say 'You were wrong.' At this point he said it's more important that we move on and focus on his treatment. So that is what we plan to do. Gotta' love that "onward and upward" attitude of his! After all, as Dr. Cavaliery said to Mark about the small tumor in his brain, he has "bigger fish to fry," referring to the scans of Mark's lungs. He recommended that Mark have the gamma knife procedure on his brain as soon as possible and then start focusing on the six tumors in Mark's lungs.

Mark meets with Dr. Gresula, the oncology radiologist who would be performing the gamma knife procedure, tomorrow afternoon. He hopes to set up the gamma knife procedure for next week. This is the "frankenstein" treatment, as I so endearingly call it, which puts bolts in his head so that he can be attached to the equipment. It's no joy ride. That being said, I'm hoping it won't be nearly as painful for him this time around, as he won't have the huge, healing incision on the back of his head from brain surgery as he did the last time he underwent this procedure.

After the gamma knife procedure is completed, Mark has a big decision to make about his next course of action. He can either do the chemotherapy drug Temodar that he has used before with positive results, or he can try to enroll in another, new clinical trial using a new immunotherapy drug. At this point, I think he's leaning toward the immunotherapy but he still has a little time to decide. I know Mark and I know that he will be researching his options like crazy before he makes a decision.

So the good news is, Mark doesn't need to have brain surgery. He doesn't have a huge tumor in his head causing him to run the risk of having a seizure (although he does still have a new, small brain tumor), he didn't take the steroids so he probably hasn't done anything to diminish the results of the immunotherapy clinical trial and he finally has a plan of treatment in place. I can't emphasize enough how much more optimistic and relaxed he sounded today on the phone now that he actually knows what is going on with his brain and has an action plan in place.

I will let you know how his appointment with the radiologist goes tomorrow and when he will be having the gamma knife procedure. Thanks, as always, for the thoughts, prayers and encouraging messages you've been leaving for Mark. I appreciate it very much and I know it means a lot to my mom and Mark.