Treatment Options


We spent a good part of yesterday at VCU talking with the Radiation Oncologists about David’s next step in his treatment. They are concerned about the tumor he has in his 4th ventricle. It is partially obstructing the flow of Cerebral Spinal Fluid, and it could cause major problems if it grows and blocks that passage way. They recommended treating it right away with stereotactic radiation to try to keep it from having any further growth. Radiation would most likely keep the tumor from growing, but we wouldn’t see the full benefit for 5-6 months. There is a potential that the swelling from radiation could cause some issues, but they think they can control that with steroids.

With something this major, we felt it was important to get a second opinion, so we went to the National Institute of Health’s Cancer Center today. Mark had planned to drive David up there and Richard and I were going to meet them. Mark had some car trouble at the last minute, and so Richard and I picked up David and took him to his appointment. I offered Mark a ride, too, but he said he would just talk to David about it when he returned. We met with Dr. Fine, who is head of the NeuroOncology Department at NIH. He said he had presented David’s case to their tumor board, and that they felt he had some time before the tumor in the 4th ventricle started causing any problems. He said that there are a number of symptoms that would show we are heading for trouble, and David isn’t exhibiting any of those. He recommended that we do a mix of Avastin and Carboplatin for a month to see if it would halt and/or shrink  the tumors. He recommended this approach because a) it would attack all the tumors we can see, as well as other cancer cells we can’t yet see and b) it would give us a chance to evaluate the chemotherapy without any side effects from the radiation clouding the results.

We expressed some concern about the Avastin and possible problems with wounds healing because if the tumor does start to block the flow of CSF, they would need to put in a shunt to drain the fluid. Dr. Fine said that he didn’t think there would be a problem with that.

He further recommended another MRI in a month to see what effect the chemo was having, and said that radiation could be an option at that point if we weren’t happy with the results.

We talked about possible trials, and Dr. Fine thought that chemo was the best option to quickly combat the growths that David currently has. He definitely has an eye on clinical trial options for David, and I felt that he was really optimistic about David being able to be with us for years. With a GBM, that is a great outlook. We are hoping that we can keep fighting this disease with the latest tools at hand until they find a cure.

David wants to talk to the Oncologist at VCU tomorrow to see if he has any recommendations that differ from Dr. Fine’s plan.

These are tough decisions for anyone to make, but especially someone who has only recently had this power given to them. (That 18th birthday was a doozy!) I’m really proud of David for how he has handled everything so far, and pray that God will continue to guide him down the path that is right for him. We stand behind David in his fight, and I know that many of you do, too.

Cancer is a tough battle, but every day we see little signs that God is with us. Please continue to pray for wisdom that we will all make the right choices, that God will give David the strength to fight this disease and stand up for himself, and that David will be able to just relax and enjoy some time with his friends very soon.

We really enjoyed our time with him today, even though he was very tired. He slept for the entire car ride, and even while we waited at the hospital. He did wake up to eat dinner at Mike’s American Grill, though! It was Richard’s birthday, and we had a really nice meal there with some friends before taking David back to his dad’s house.

Tomorrow will be a big day of decisions, so I’ll sign off now to get some sleep. I’ll let you all know what he decides.


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