The plan

After talking with our Oncologist, we have a basic treatment plan.  In concept, it’s so simple:

1. Cyberknife the remaining brain tumor.
2. Maybe Full Brain Radiation
3. Chemo-cocktail of Tykerb and Xeloda
4. Bimonthly brain MRI’s and/or Pet-CT’s to monitor condition
5. If any further brain tumors arise, Cyberknife will be used to attack them

 
I went online and got more information about Cyberknife.  I got it confused with Gammaknife which is a multi-source Cobalt system that uses a frame screwed to your head and a helmet device that focuses the radiation on a single point.  The Cyberknife is a highly accurate robotic device that uses a single source linear acclerator to shoot a single beam of radiation to a specific point.  It may sound a bit sadistic but I think this thing is just amazing.  The technology really appeals to the engineer in me.  Take a look at this video to see what I’m talking about:  http://www.accuray.com/videos/redefining_radiosurgery.aspx?video=ACCURAY_Redefining_Radiosurgery

Full brain radiation is the old-school solution to metastatic brain tumors.  There are pro’s and con’s to it.  We have an appointment to see a Radiation Oncologist on Monday to discuss it in detail.

I did a bit of research on the proposed chemo-cocktail of Tykerb and Xeloda.  Tykerb is similar to the Herceptin that Satomi was on most of last year in that it is designed to block the HER2 receptors.  As I mentioned in other posts, Herceptin is quite effective except it does not pass the brain-blood barrier and therefore cannot effectively treat the brain.  Tykerb is a much smaller molecule and does pass the barrier to treat the brain.  Xeloda is the actual chemo portion of the cocktail and is designed to destroy the cancer cells.

According to some medical articles I’ve just read, the Tykerb/Xeloda mix has little effect on existing brain tumors however, it has seen positive results when used prophylactically.  After the Cyberknife does it’s thing, the Tykerb/Xeloda mix should help prevent further tumors.  That’s the idea anyway.

Ignoring the potential effectiveness of the Tykerb/Xeloda cocktail, the chances of a brain tumor returning is notable.  The present plan is to monitor the condition of Satomi’s brain every 2 to 3 months with an MRI with an intermittent Pet-CT scan of her entire body for good measure.  If anything is found in her brain, another Cyberknife procedure will be used.  

Sounds simple huh?  Too simple if you ask me.  I am a firm believer that nothing is free.