28th October 2021
This is an update from the previous one just a week ago – the next steps are now much clearer.
Radiation to the brain completed
A 5-day course of radiation (cyberknife) to my father’s brain was completed yesterday (26 October) to deal with six cancerous lesions that had started causing significant issues (MRI of the brain for anyone interested in technical details). The next MRI is due after 6 weeks to re-assess the cancer in the brain.
The supervising doctor advised that it will take at least a week for the brain to heal from the trauma of the radiation, so no chemo should be given before that. Chemo, planned to start from today, has therefore been pushed back a week.
Chemo from 3 November 2021
A light and carefully structured dose of chemo will be administered to my father for nine weeks (one injection per week) from 3 November 2021. The course will only be completed if my father can tolerate the drugs without excessive side effects.
Chemo won’t directly shrink the cancer in the brain due to the blood-brain barrier but will slow down the further spread of cancer across the rest of the body (it has spread to almost every organ and lymph node by now). Through that mechanism, chemo could help reduce further metastasis to the brain.
Risks: There is 20-30% chance that chemo won’t work for this cancer. There is a 10-25% chance that chemo itself could kill my father due to a wide range of side-effects. But if it works (70-80% chance), it could give my father a chance of survival into the medium term. This is a calculated risk that must be taken since there are no other options left.
Actively managing basic things
A lot of active management will continue, such as medicines and a number of supports. But the management of simple things like food, water, salt, sleep is also crucial, since the body no longer has the capacity to self-regulate. E.g. massive weight loss from cancer means there is no bodily insulation and ability to sense ambient temperature – this has already caused serious grief through three episodes of dehydration.
Each episode that leads to the hospital causes further muscle atrophy. A few weeks ago he was starting to walk a bit and even climbed two flights of stairs – after a gap of 3 months, but there have been further setbacks, so he’s now barely able to do 20 metres of walking within the house. Rebuilding the atrophied muscles is therefore a key goal.
Then there are the structural symptoms of cancer. Two of them have already led to Emergency admission (urinary retention and brain edema and heaviness). Let’s hope these reduce in the future.
My time availability
Subject to successful ongoing active management of my father’s needs, I expect fewer medical trips to doctors/hospitals in the coming weeks than I’ve had in the past 2 1/2 months.
This means, that I can resume work on a number of other things. (Of course, once again, there is a lot of ongoing paperwork to claim reimbursements from the government insurance scheme).
If all goes well, I’ll not need to update my father’s health for another 10 weeks or more.