• Karen

Chemo cycle 14 started... two steps forward, one step back

Updated: Oct 10, 2019

One of David's wonderful pen and ink drawings

David had his 14th IV chemo treatment (Herceptin plus steriods) on 10/3. He is still on the antibiotic (Flagyl) to fight the C diff. infection. We were hoping he could get off it, but C diff. is one tough bug; it hasn't been eradicated yet even though David has been on Flagyl for six weeks now.

About three weeks ago, David started have balance problems and being unsteady on his feet. Then he started being nauseaous. We thought it might be vertigo, which he is prone to, or a side effect of the Flagyl. Dr. Oh thought it would be unusual for the balance problem to be due to the Flagyl, and if it was vertigo, it should have resolved. So she had a brain MRI done on 10/2. The MRI showed three brain tumors. The largest is about 1 inch in diameter and is in the cerebellum, which is a part of the brain at the back of the head coordinates voluntary movements such as posture, balance, coordination, and speech. Another smaller tumor is nearby, and a third even smaller tumor is at the top of David's head on the left side.

Needless to say, we are grateful that Dr. Cindi Oh caught this, but we are in shock for several reasons, one being that when his CEA tumor marker was checked on 9/12, it was in the normal range. So we were assuming the cancer was not growing or spreading and he was still stable. Also, prior to the balance and nausea issues, David was improving on several lab tests. For example, his hemoglobin increased to 13.1, which is right around the low end of the normal range for a male. It hasn't been that high for over a year; it was only about 6 when his cancer was diagnosed in Nov. 2018.

We met with Dr. Brooks on 10/3 and he said the brain tumors have probably been there for a while and were caused by the gastric cancer spreading through David's blood. Apparently, chemo is not very effective on brain tumors. He referred David to a radiology oncologist, Dr. David Vonk, who plans to do stereotactic radiosurgery, a highly precise form of radiation therapy that uses several precisely focused radiation beams. It is less damaging to surrounding tissue than whole-head radiation therapy. We will meet with Dr. Vonk on Tues. 10/8. Then we will know more about what he plans to do.

In the meantime, Dr. Brooks said he's optimistic that the radiation could keep the brain tumors under control for 6 to 12 months. This is good news, relatively speaking, because he also said that without treatment, David would probably not be able to walk within a few weeks. David is now using a walker to help with his balance, and he's taking steroids to reduce brain inflammation. Both have helped reduced his nausea, which is welcome relief.

After the radiation treatment is done, Dr. Brooks plans to start a different IV chemo regime using a drug called Taxol. He will do another CT scan as a baseline prior to starting that. If Taxol is not effective, he will switch to Keytruda, an immunothereapy. So some treatment options are still available.