Jen's latest MRI

So Jen had her latest MRI today.  It seems as if it is a mixed bag.  The contrast areas, which are used to assess the cancer for determination of clinical trials, progress, etc. seem to be unchanged.  The MRI without contrast however, reveals a substantial increase in edema.  The fact that Jen has not had a pronounced change in physical or cognitive function since the last MRI is a good sign though.  This could resolve itself or it could not.  It is also possible that this latest scan reveals pseudo progression, which is almost like a false positive due to the lingering effects of the radiation.

http://www.braintumour.ca/1649/ask-the-expert-psuedo-progression-gbm

Apparently, an MRI is not always an exact picture of what is going on in the brain.  We are to stay the course and Jen will have her next MRI in 4 weeks.  Meanwhile, we are seeing the head of neuro oncology at Cedars Sinai tomorrow for a follow up with them as well.  Although UCLA is Jen's primary treatment center, we have been following up with Cedars at various points as well for their insight and possible different treatment approaches.  So far, they have been in agreement with everything that UCLA is doing.

Jen is set to resume chemotherapy as well on Christmas eve.  For those of you who are unaware, Jen had a really rough go with her initial dosing of chemo.  Her blood levels tanked and she had to stop 5 weeks into a 6 week regimen.  She required 2 platelet transfusions and 1 hemoglobin transfusion.  It took an additional 5 weeks for for her to completely recover to the point where she could resume chemo.  Apparently this can happen sometimes and is more common with small framed women.  Anyway, her last round of chemo was started the day before Thanksgiving and only lasted 5 days.  She did well with this round, although it was at a lower dose than would normally be prescribed due to the way she responded with the initial round.  This next course beginning Wednesday will be at a higher dose and if she handles this one she will titrate up to an even higher dose for the following round.  Her schedule for the foreseeable future will be 5 days on, followed by 23 days off as long as she can continue to tolerate the chemo.