Kevin here again....

Greetings everyone! Kevin is back on the job tonight!  It has been a few weeks since I have posted on the blog.  I promised Jenny that I would do the next post. First and foremost, Jenny is doing quite well and I continue to notice improvements everyday.  Her energy levels seem to grow stronger as every day passes.  I was a little worried about going on our little hiatus to the Biltmore Estate but she was a trooper.  While I was geeking out about the technology this home had in the late 1800's (power -dc current-, central heating, telephones, etc, etc) she was patiently waiting!  Everyday continues to become more normal.  

I know everyone is waiting to hear the news about our meeting with the Radiation oncologist- so here you go....

We had our initial consult with Dr. Mark Henderson.  He is part of the Mel and Bren Simon cancer center team.  They have multi-disciplinary teams that focus on specific parts of the body.  Dr. Henderson primary focus is Head/Brain/Neck issues.  Both him and his resident were super.  They took time to answer our questions and address all of our concerns.  As everyone knows, Jenny's friend was considered an 'atypical' meningioma.  I guess they are pretty rare but they have a higher chance of localized return (ie. return in the same area) so the theory is to radiate the area where the tumor was located.  This includes the tumor bed, plus a marginal radius of 2-5mm around the tumor to nuke any of the cells that might still be lurking about.  The basic premise is that by hitting this area with "fractional" daily doses of radiation the abnormal cells DNA are more delicate than normal cells.  Also, the normal cells can repair the damage inflicted by radiation whereas the abnormal cells cannot recover and die.  So they typically will administer these fractional doses daily over the course of six to eight weeks.  However with any treatment there are always risks.  Radiation is no different.  Exposure to radiation -large or small amounts- can cause problems 15 years down the road.  The indirect exposure to x-rays since they travel through the human body could cause problems down the road.  Think of it like this, if you point the x-ray at the left side of your head then they will continue through your brain and exit the right side.  This wake of radiation exposure can cause problems. The particular course of treatment our Doctor recommended was Intensity Modulation Radiation Therapy (IMRT).  For an overview here is a helpful link.

However, being located in Indianapolis we have another option that our Doctor recommended called Proton therapy.  This stuff is really amazing!  Finally we have a choice for change.  The only problem is that the center is located in Bloomington Indiana next to the Nuclear Cyclotron facility.  Instead of utilizing X-rays this treatment uses protons which do not travel through the human body (if you want a detailed explanation... go find a physicist).  The protons are highly focused beams of energy that only travel 1-2mm beyond the tumor plus the beams can be highly shaped to focus all of the energy on the shape of tumor.  Our Doctor explained that the long term risks are lower with proton therapy.  But the down side is that Jenny will have to travel to Bloomington everyday for seven to eight weeks.  Our initial reaction was the IMRT would be easier and it would not make that much of a difference.  After further discussion however, we both started thinking about the fact that this facility is literally in our back yard.  I will mention that there are only 6 or so of these facilities in the United States.  Here is a link to their website. These facility cost around $150M - $200M to build and the technology is amazing.  So after having one of the best neurosurgeons in the country do the surgery why would we turn our back on this option!  As I have said to Jenny in the past, only the best for my love...  So, Jenny emailed the Doctor Monday evening and told him that she wants to get the ball rolling on Proton Therapy ASAP.  

Over the next week Jenny will probably have another MRI and CT scan to map out the treatment.  She will be fitted with a Hannibal Lecter style mask for the treatment which completely limits her movement while being treated (I promised I would not make any comments about fava beans and a nice glass of Chianti).  The margin of error in the targeting process for proton therapy is limited to 1mm whereas IMRT is around 3mm.  I would rather be safe than sorry here!  I don't want them missing the target and blasting her ear off or something!  The treatment process will probably start the last week of March or the first week of April.  So finally there is an end in sight...  

I have decided that once she starts her treatment, I will purchase some fluorescent tubes and hold them next to her and see if they glow!  If they do, I will definitely figure out a way to get a picture posted online!

I should also add that Jenny is starting to get really antsy at home and cannot wait to get back to work albeit part-time starting off.  I would be remiss if I didn't mention how supportive her office has been throughout this entire ordeal.  This has been a tremendous weight that was lifted off our shoulders on day one of this journey and we are both so grateful to everyone at Jenny's office.  You all know who you are and you are all making a difference in the jobs you do everyday.

Anyways, sorry for the lengthy post, but I wanted to catch everyone up on the progress... till next time.