"That's an important milestone!"

Brain cancer is...

 ...hitting an important [and not-yet well understood] milestone.

Darrell's appointment with Dr. Park went well today.  Dr Park confirmed:  The next MRI isn't until July.

When Dr. Park checked Darrell's records, he was impressed to find that Darrell has been finished with his total course of temozolomide (chemotherapy; TMZ) for a year.  Dr. Park said he was very impressed by "this milestone."

Somehow I was so busy being surprised about a "milestone" and taking notes that I didn't ask the question, "Why?"  Sigh.  Nothing in my pre-today research signaled "time post temozolomide" as a milestone.

Back to the computer for more research!  Nothing in today's research signaled the importance of this milestone either.  As close as I can get is this:  The preponderance of evidence* suggests that longer courses of temozolomide are associated with longer survival periods, both overall survival and progression-free survival. 

"Shorter courses" of TMZ are defined as 6 months or fewer.  "Longer courses" are 9 months, or more typically, 12 months in length.  Darrell had the recommended 6-week course of TMZ concomitant with his radiation and then he had 12 full months of 5 days per month for his maintenance course.  (Here's a link to the post that shows one dose of Darrell's chemotherapy, if a visual helps.)


And I call myself a knowledgeable GBM caregiver!  This question will not, however, die.  If you find out first, please share.  Otherwise, stay tuned...until July.

And Now, About the Cocky Photo, above

You see, above, that despite the continued So Cal heat, Darrell didn't need to chase the shade today.  We managed to avoid Optune alarms with his vented hat and a well chosen walking path.  We were feeling pretty cocky.

Back at home, a couple hours later, Optune alarmed incessantly.  Darrell did all his best, engineer-trained troubleshooting.  We finally just needed to change his arrays.  It's only the second time we have needed to pursue the last-resort option to stop alarms.  But it worked.  Darrell says the lesson of the day is:  Don't get too cocky.



*Want some evidence?  Click here for one study.  Click here for another.