Good News!

Brain cancer is...

Nanette Fong, PA, Darrell Guillaume, SH, Tim Cloughesy, MD

...okay for today!  

In Darrell's words, "We heard no bad news today."  Thank heavens!

Briefly, the news from Dr. Cloughesy is:

• The "regular" scans show no increased contrast over time.  That's good; increased contrast would indicate increased tumor growth.
• The "regular" scans do (confirmed) show increased edema.  Dr. Cloughesy feels that the swelling could be the maintenance chemo.  Because of Darrell's unmethylated tumor (remember MGMT-negative status?), Dr. Cloughesy thinks it's likely that Darrell may quit the Temodar some time in the future...earlier than the planned one-year course.
• Darrell will have another set of scans and another UCLA appointment early July.  No more chemo (yea!) until after that visit, just to track the swelling and possible changes to it.
• Dr. Cloughesy read the perfusion scan. It's okay.  Darrell did choose to read the report before our visit with Dr. Park last week.  We were all a bit nervous because it mentioned increased vascularization near part of the tumor's edge.  Dr. Cloughesy showed us that the majority of the tumor cavity rim was "cold"  (dark, no increased blood flow), and, yes, a small part was bright ("hot," blood flow).  But in his opinion the bright part is not part of the tumor, it's part of the cortex (surrounding brain).  Let's hope time continues to support that conclusion,

So...Team D has a very good news day!  Thank you all for your prayers, thoughts, and good wishes!

More Detail (for those team members inclined toward detail)

• Darrell's sticking with 4 mg of the steroids per day.  Higher doses would be safe and give more of an effect, but trials--which may be part of our future--sometimes limit eligibility to patients who take no more than 4 mg per day.  
• Fascinating polio virus update:  Darrell would never be eligible for the Duke trial with polio virus for two reasons:  It's for tumors smaller than 2 cm, and his tumor is in the right hemisphere.  Only people with left-hemisphere tumors are eligible.  I did not know that!  Dr. Cloughesy commented on the high toxicity of that treatment (some people die).  The polio virus treatment is too toxic for a tumor where language occurs.  Fascinating!  It's a reminder that there are no "magic pills" in brain cancer treatment.
• There are trials occurring at UCLA for which Darrell might be a candidate, were he to have a recurrence.  Some are immunotherapy based.  Not all would require a second craniotomy. Some would be IV drug infusions.  But those are bridges nowhere on the horizon today.  Today is sunny and clear, with traffic-free So Cal freeways.