Friday, July 3, 2015

Round Two

Vince had a followup MRI Monday.  The tumor has returned.  It's about the size of a grape.  He'll be having neurosurgery again soon (7/27), followed by chemo.  (I can't believe I'm typing these words, that I've had to return to this blog.)

I'm going to try to answer some questions you may have, in no particular order...

1. Weren't his followups good? Yes.  After the June 2014 followup MRI, Vince had another one in December 2014.  The results of that one were ambiguous.  They weren't sure of it was scar tissue or new tumor. There was nothing to do but wait and pray, do another MRI three months later and compare.  March's MRI was good.  They said it was scar tissue.  This tumor is a new development.

2.  What are the risks of surgery again?  He has the same risks as before, chiefly speech issues (since this is in the area of the brain that controls speech) and motor issues on the right side.  He did not have any regression last time with these, but these are the risks of the surgery.

3. Is the brain tumor in the same spot? Yes.  It is in the left frontal lobe, the area of the brain that controls speech. Is it smaller? Yes.  It's a grape now and it was a golf ball before.

4. Will he receive radiation? No, just chemo is what the oncologists have told us.

5. Is it cancerous?  Why are they planning chemo? Cancerous is a subjective term.  His last tumor was a pilomixoid astrocytoma.  It was a phase two tumor and usually phase one & two are considered non-cancerous while phases three and four are.  They had given it a 5% chance of growing back.  They believe this tumor to be the same type as the other, but they won't know for sure until they do the pathology.  The World Heath Organization considers all brain tumors cancerous because they wreak so much havoc, no matter what.  Chemo is necessary this time to get rid of it because surgery alone didn't work last time.

6.  What is the general plan?
  • Vince is having his brain tumor removed on July 27th.  He'll be in the hospital for five to seven days afterwards. 
  • After he is healed enough to go home from the actual surgery, he'll be evaluated to see if he needs rehab (they call it something else for little kids, intensive in-patient therapy, maybe).  If he needs rehab, he'll receive that also at Children's Hospital as an inpatient.  This could be speech therapy and/or physical therapy, and this depends on if the brain surgery has affected him these ways or not.  (Pray that it doesn't.)
  • One they remove the tumor and run a pathology report on it, it will be time for chemo.  We won't know the details of the chemo plan until they know what they are dealing with, that is, have the pathology report (which they cannot do until after removal). 
7.   Had Vince been showing any outwards signs of this?  No.
In the past three months when this tumor grew, Vince had been making rapid gains in his speech.  Kevin and I were amazed, actually.  It seemed every day almost he was saying more and more words that he didn't say before, longer sentences, telling more stories, etc.  Everything was clicking for him, really since March. I had been saying (I'm not a neurosurgeon of course) that it took his brain a whole year to heal, as it was exactly a year after the first tumor removal in his left frontal lobe (the speech area of the brain) to really get his speech going.  Prior to a year post surgery, Vince had been making some speech gains, but he had been chugging along slowly.  From March 2015 until now, he's just amazed me, although he still has a way to go to be up to proper speech for his age. 

8.  How old is Vince now?  He'll be four before surgery, on the Feast Day of St. Vincent de Paul on the old calendar.  St. Vincent de Paul, pray for us! 

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