Brain mets

Possibly one of the scariest things a patient can hear (after "You have cancer" and before "There's nothing else we can do for you") are the words brain metastases.

Last week's brain MRI showed three lesions in my right cerebellum. They don't behave definitively like cancer, but as the radiologist who read the scan said to Dr G, what else could they be?

So the feeling stupid, making typos and feeling not-quite-vertigo were worth reporting and not related solely to starting the new chemo combo or tapering off the antidepressant (which it looks like I will need to start again anyway).

It's going to take me some time to wrap my head around this news. Here are the brief things I know so far:

1) I will see my radiation oncologist, Stephen Eulau, to get his opinion on whether or not I should have cyber knife or gamma knife treatments. Since these are about $80,000 per lesion, and I have three lesions, the insurance company may not cover the procedure, which Swedish does perform (cyber knife).

2) Dr G is against whole brain radiation, which he says will leave me feeling much more stupid, and prone to make many more typing errors, than I feel now.

3) I will continue on the Abraxane for one more week, and next week's labs will also test a sample of CA 27.29, my tumor marker. If the tumor marker shows a decline, then we might continue the Abraxane/Avastin combo. If it continues to go up, then Dr G will consider changing to Xeloda, an oral chemotherapy which he believes is more proven to cross the blood/brain barrier.

The active drug in Xeloda, 5 FU, is the one that put me in the hospital in 2009 with severe infections. However, if I'm monitored more closely, and given a lower oral dose, instead of a larger intravenous dose, it might not prove so toxic.

Like I said, this is a lot to digest. I'm going to bed now and will write more tomorrow. Those of you who live nearby and want to talk, I'm just not up for it now, but Rik might be.