Good Afternoon, Friends!
The last few weeks have been a whirlwind (or a dumpster fire on a train wreck).
But first the good news: All cancer in my body (minus head) is gone! This is a better than hoped for response. The chemo hell has worked!
Now the bad news: I have numerous tiny (5mm is the biggest) brain mets and cancer in my spinal fluid. At this point we know it is Larry the Lung Cancer, and that I am an EGFR Register (targeted therapy didn't work very long).
The current plan is to get a plan. I'll have a full spinal MRI (Atavan take me away!!!) and a meeting with the expanded brain trust at St. John's on Tues. I also should have the results from my second (technically third -- one missed) spinal tap.
As I understand my options, they are:
1. Whole brain radiation
2. Chemo poured directly in my brain via a port.
3. Immunotherapy. (I'm currently on the ipi/nivo combo)
I am not a fan of whole-brain radiation. At this point in time, I don't have any neurological deficits that are apparent, anyway. WBR would leave me with some. I have no earthy idea why I would do this at this point in my life.
Chemo poured directly into my brain makes sense, but it's kind of forever, and I have to imagine that my quality of life is going to take a significant hit. But, if I understand it right, if it works, it works fast. I'm just not sure about the math. If I spend 6 weeks in chemo hell again what does that buy me? 6 months of good life? 3 months?
I am a big fan of immunotherapy. This is probably my melanoma bias. I know it crosses the blood brain barrier, and I know it works in the brain and CSF. And I have tolerated it fairly well. It's not hell and it's manageable. So life would be reasonable. But I also know it takes a while to work and that it may make things bigger before getting better. This doesn't sound like what is currently needed. Also I'm not finding anything on immunotherapy and lepto disease in NSCLC. I suspect this is because brain involved peeps don't make good ratties.
So, friends. Am I thinking right? Talk to me.
Peace to you!