Erica and I have had a very active month—which I hope to write about in a near-future post. But today, I am sharing a medical update. So bear with me as I get a little more technical in this entry.
When an area of the brain has been radiated more than once, the possibility of long-term effects such as brain fatigue and necrosis increases. These effects can manifest 1 to 3 years after the radiation. That is what occurred in Erica’s cerebellum, the region of the brain that controls motion and balance (including speech). Since Erica underwent whole brain radiation in 2023, any additional radiation, regardless of how targeted, would be a second hit to that area. Erica’s whole brain radiation in 2023 was miraculously successful. However, she had additional tumors in her cerebellum that needed targeted radiation in 2024. These multiple radiations, along with the cancer that had been there, rendered her balance, mobility and speech permanently compromised.
I give that background so that you better understand our specific concern heading in to scans this week. The doctors have been focused on her cerebellum for nearly two years now. This has been the only area of any concerning cancer activity. We have been watching the cerebellum closely for necrosis and cancer progression, knowing that there are few options left to combat either.
Having been off all treatment for three months with renewed appetite and energy, Erica and I went into her scans assuming that if there was progression, it would be in the same area. If so, resuming chemo treatment would be the only option. A decision would have to be made—would Erica want to continue feeling well and let nature take its course or live with the extreme fatigue and appetite challenges from chemo? This was an A or B situation. So we thought.
Let me digress from the medical update and get personal for a moment…
Vampire Weekend (the band, not a 3-day Halloween party) sings a lyric, “I don’t want to live like this, but I don’t want to die.” When you are facing an A/B situation in which your choice determines your fate, faith becomes fact in your decision process. Is life after death a theory or a truth? Your position on this question must be factored into the equation. During an heartfelt discussion the night before Erica’s MRI, God presented an interesting question: Are you scared of death or scared of dying?
This profound question presents that to be scared of death is fear for the future beyond our human life. The testing of our faith is whether we make decisions believing that life beyond the living body is a possibility or a reality. Compare this to retirement, a significant life-changing event. We never know exactly what that time may look like until we get there, but from our first paycheck we anticipate and plan accordingly.
On the contrary, to be scared of dying is fear of the moment when this human body no longer functions. If there is eternal life, then dying is only a temporary moment in time—a transition from one season of life to another. Compare this to adolescence, often difficult, but every adult has gone through it and has been transformed from the person they were previously.
Erica’s answer to the question? “I’m scared of dying.”
In that moment. The weight of what we were facing became lighter. If we had to make a decision, it no longer carried the same permanency. It was not a decision toward an end, rather a plan to manage a transition. It would be a choice on how to make the most of the time and situation we’ve been given.
I don’t want to make light if this by simply saying, “Yay!”, but living with this peace of mind is worth celebrating and praising the Savior who made it possible.
So, back to the medical update…
The CT scan of chest, abdomen and pelvis was conducted last Thursday (under circumstances which are a whole other story). The results once again confirmed no evidence of disease. In fact, these body scans have been so consistent for years that her oncologist has elected to extend cadence from every three months to every six. (Yay!)
The MRI initially presented good news showing the cerebellum to be stable. (Yay!) However, very small new tumor activity was discovered in the upper part of her brain. One of those tumors had been evident in previous scans. The neuro-oncologist had been using that tumor as a marker for more than a year—as long as that tumor was stable or shrinking, we knew that the chemo was working. The MRI showed that the marker tumor has grown very slightly but remains under a centimeter. In addition, several much smaller tumors have also appeared. Comparing previous scans on chemo to this one off chemo will give the oncologists very good information about the effectiveness of the treatment and the cancer activity without.
This new development presents a new option. The neuro-oncologist feels that, due to location and size, a small dose of targeted radiation would be highly effective at very low risk. This option could give Erica an extended “treatment holiday”.
What’s next?… These scans were read very quickly as soon as they were taken. So over the next week, the scans will be reviewed more thoroughly, including overlays with previous scans, to ensure that nothing was overlooked. Our oncology team will consult with one another and agree to the options. At best, we will hear from the doctor on Thursday, after which Erica will have to make a decision to which path she chooses. She has peace in knowing that she has time to decide and that there are options.
Earlier this week, I was expressing to my father my stress over the anticipation of being faced with an A or B decision. He advised that, based on his long care-giving experience, when it comes to medical situations we should not assume we know all the options. To do so is an attempt to control things that we have no control. He was right.
Thank God for fathers and their wisdom—including our Heavenly Father. Happy Father’s Day.
YAY! Through The Valley 
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