Radiation Oncologist Appointment

Had the first appontment with my Radiation Oncologist today who explained how the Radiation Therapy portion of my treatment will work.

I am going to receive "conventional" external beam Ionizing Radiation (X-Rays) using a method called Conformal 3-D. This is where they focus the beam at the tumour area and a small margin (in my case 3cm). They also come in from different directions in order to reduce accidental "treatment" of good brain.

The way radiation therapy is suppoesd to work is quite neat, it disrupts the DNA of the fast reproducing tumour cells while leaving the healthy cells mostly OK. Normal cells are also better at repairing any damage from the radiation than tumour cells. This repairng capability is helped along by breaking up the treatment (fractionation) over 6 weeks.

I will receive 60 Gy (Grays) of radiation which is considered to be the maximum dose that a human can safely take (radiation is cumulative) at 2 Gy a day in 30 sessions for 6 weeks.

In order to plan my treatment I'll have to come in for a planning session next week. This will involve making a mask for me and taking CT scans to position the tumour in relation to the mask.

Likely short term side effects from this treatment are tiredeness, soreness and hair loss around the beam entry points.

I wish this wasn't taking so long, I just want to get going before that little bastard gets much bigger.

Diagnosis & Treatment

Carol and I were a little suspicious when the Neurologist ask us to come into the hospital to get the diagnosis news rather than get it over the phone. So we quietly drove the 35km to the hospital to be told the bad news.

Essentially I have been diagnosed with the worst kind of Brain Tumor a Glioblastoma Multiforme with a survival rate of 25% at 2 years (with treatment). These tumours are incurable and the only hope is to slow down their growth with therapies such as Radiation and Chemo. It is most likely that this will kill me. That is quite a lot to take in.

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The rest of this posting is the technical details of the diagnosis:

Diagnosis: Glioblastoma Multiforme (malignant grade IV astrocytoma)

In order to get to this decision both cell pathology (histology) and tumour behaviour were taken into consideration

Pathology reported that all tumour cells were from brain material (primary tumour) and indicated a low grade astrocytoma with high grade areas found in one of the four samples taken during the biopsy. While Pre-surgery MRI's show that the tumour has pretty much DOUBLED in size in the 19 days between scans. This rate of growth is normally associated with high grade tumours.

Treatment:

Given the combined evidence of a Glioblastoma Multiforme , the tumour board decided to recommend standard treatment accordingly. This consists of 6 weeks of conformal 3D Radiation therapy to a total dosage of 60 Gray (maximum allowable dosage) concurrently with Temozolomid Chemo therapy followed by a further 6 cycles of Temozolomid (1 week in every 4) for the next six months.

Treatment cannot start until I have recovered from the Biopsy (basically until the scar has healed) because both Radiation and Chemo affect the healing process.