Tx Plan Neurosurgery

From the notes from my 7/11/23 Zoom call with the neurosurgeon:

It is my impression that the patient presents with clear radiographic evidence of progression in the left parieto-occipital resection cavity. As such and given the control of the most recently resected and seeded area in the right temporal lobe and the overall systemic disease control I have discussed the various options and have recommended to proceed with another surgical resection. Given the wide opening of the cavity into the ventricular system, placement of radioactive seeds would be relatively contra-indicated and would proceed with postop radiosurgery. Risks, benefits and alternatives were discussed and I answered all the patient's questions to his satisfaction.

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2nd talk with Surgeon

Found out more about the VATS procedure today. They'll remove a nodule, and then keep me on the table while it's biopsied. If it is positive, they'll get more material, then wrap up. If the biopsy comes back negative, they'll do another nodule... and biopsy again and wait... not sure how many times they'll repeat. I guess I'm hoping for a long procedure. The surgeon said he'll ask the lab to freeze some of the material so that I could have it retrieved at a later time... mentioned I was getting a second opinion from UCSF cancer center, and that UCSF may therefore be interested in getting some of the sample as well.

Cyberknife 11/9-10

Underwent 2 cyberknife sessions, the first to treat the tumor bed of the first brain tumor, the second to treat the second one that showed up recently. The procedure is pretty straightforward, it's outpatient. The picture shows the mask they made for me which holds my head in place so the laser is accurate. Each session was an hour or so. I should know by the end of the weekend if there are any short-term complications (none I hope). Then it's a matter of letting the radiation do its job over the next couple of months. Then re-scanning to see both how the two treated areas are doing, and also to see if anything new shows up in the brain.

Cycle 4/Course 2 Finished

(8/6-8/9/2010) Finished cycle 4/course 2. Stopped this time due to some combination of high white T cell count, neurotoxicity and maybe something else. Tolerated 4 bags out of a total of 14, felt as bad as the other times where I tolerated more doses. Will get more scans in about 5 weeks time, and see what they look like compared to the last sets.

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