Met with radiation oncologist

Yesterday (12/29/2010), Holly, Jean and I met with Dr. Diaz (attending radiation oncologist) in the radiation oncology department at Rush University. After giving my History to the nurse, we met with Dr. Marsh (chief resident, I think). Dr. Marsh is Fabulous with a capital F. He is very personable, and OMG, knows what he is talking about. He had a medical student tagging along with him, and Dr Marsh was quizzing him every 2 minutes about the symptoms I was describing by asking for the neurological explanation behind them. There were so many 5 dollar words being tossed around, each sentence was worth at least $50.00. That poor students head must have been spinning, but he was getting the lesson of a lifetime. It is nice knowing that not only do I have some of the best doctors in the world looking after me, but new doctors are being trained at the same time.

Dr. Marsh had a neurological explanation related to my tumor for each of my symptoms. I don't think any of us understood what he was talking about, but it was reassuring that he clearly had a firm grasp of the subject.

From there, Dr. Marsh went into some clarifications about my diagnosis. He explained that the tumor grading from 1 to 4 is not as clear cut as it sounds. Grade 1 is a benign tumor that is usually just watched, where grade 2 can progress to a 3, and 3 can progress to 4. They (the tumor board at Rush) feel that although my official diagnosis is a grade 2, it is close to becoming a grade 3. This combined with the current size and location, is the reason for the drastic treatment not usually done on a grade 2.

My sister then asked if my condition is considered 'brain cancer'. The treatment they are recommending is usually reserved for cancer. Dr. Marsh said there is a lot of confusion around this. Grades 3 and 4 are usually called brain cancer, but any brain tumor is not really a 'cancer'. Cancers are usually defined as uncontrolled cell growth that spreads to other parts of the body. Brain tumors (grades 2+) are uncontrolled cell growth, but do not spread to other parts of the body. So technically I do not have cancer, but Dr. Marsh indicated that my situation is serious enough to warrant cancer treatments.

Dr. Diaz then joined the party. He explained the goal of radiation therapy. Radiation therapy works by stunting the growth of the tumor cells. The radiation cannot be 100% controlled, so healthy parts of the brain are also affected.  This causes collateral damage which can worsen my condition, including damage to memory and cognition. He then posed the question,  knowing the risks, do you want to have this procedure done?  I asked, well, are there alternatives? No. Either go with their recommendations or take the chance of doing nothing and hoping that my condition does not get worse. I asked what is the chance of my condition declining without treatment. He basically answered he was sure my condition would worsen without treatment. Given that, I elected go ahead with the recommendations. 

 We asked if we could have the Doctors at Rush University do the planning, and have a local hospital do the treatment. This would be a lot more convenient for us. They said this was not a good idea. Rats.  So we made an appointment to start the planning (a special CT scan and MRI) , and the treatments will start in the middle of January.