June 15, 2009

Today's MRI Results:

Evan's MRI showed no signs of new growth today, and our doctor was very pleased! So pleased, in fact, that he suggested we stop the chemo! (Yes, we had to pick our jaws up off the floor too.)

We were completely shocked! We thought, best case scenario, maybe he would space the treatments out to four weeks instead of three if the MRI looked really good. At the very least, we were prepared to be grateful for anything, as long as we didn't have to go back on the two week schedule. But stopping the chemo altogether had not even entered the realm of possibilities for us yet.

I was thrilled, but Evan was a little more cautious about it - it is his life at stake after all. But Dr. Choucair talked with us for a long time and we feel good about it. Basically, he said that we've probably seen all the reduction we're going to get from the chemo, and (considering how lousy it makes Evan feel) it's probably doing more harm than good at this point.

So, from here on out our goal is to improve Evan's quality of life and simply keep the tumor from growing. That means getting rid of the heavy chemo drug (called Irinotecan), but continue receiving I.V. treatments of the drug called Avastin (which Evan has already been receiving with the Irinotecan for the last 15 months).

The Irinotecan is what makes Evan so tired and sick, so he should start feeling a lot better without that. And hopefully, the Avastin will be enough to keep the tumor from growing. I don't understand exactly how it works, but somehow the Avastin effects the blood vessels in such a way that it cuts off the blood supply to the tumor. Without the blood supply, the cancer cells cannot multiply and reproduce so easily.

Of course, as the doctor explained, all this comes with a certain level of risk. Don't ask me how or why, but for some reason once you go off this chemo drug, the cancer cells can (in some cases) get really smart and find a way to build up a resistance to that drug. If that happens, and the tumor starts growing again, this chemo may not be able to stop it a second time around.

With other types of cancer the patient can move on to a different type of chemo drug because there are lots to choose from. However, with glioblastoma multiforme there are no other chemo drugs out there to try. So unless they come up with something new between now and whenever Evan's tumor starts growing again, we could be shutting the door on the one and only treatment option available to us.

When we stop and think about it that way, it feels a little bit scary. On the other hand, when we think about how miserable Evan has been over the last few months, then it feels like we have very little to lose and a whole lot to gain.

So, the plan is to continue the Avastin treatments (every four weeks) for the next three months and do another MRI in September.

The main side-effect we have to worry about with Avastin is that, with prolonged use, it causes increased blood pressure which Evan already started having problems with about two months ago. They started him on blood pressure medication, and have been steadily increasing the dose, but his blood pressure still hasn't dropped back to a normal range yet. Hopefully, they'll be able to get that under control soon.

Luckily, we haven't had any problems with blood clots since our little scare a few months ago. Lately, we've actually had trouble with his blood getting too thin instead of too thick. It just seems to go back and forth - which is just annoying!

Anyway, that's about it, in a nutshell. As always, we thank you more than we can say for your continued prayers on our behalf. I am absolutely certain that's the reason we got such a pleasant surprise today! We love you all!

Gratefully yours,
Margot