Loose Strife

After talking to a friend who follows this blog by email, it occurred to me that many of you haven’t read all the comments on the previous post. So let me recap: Laura and I went to the ER at Brigham-Women’s Hospital in Boston (the hospital affiliated with Dana-Farber Cancer Institute, across the street) on Friday night. She had a new full body MRI and cancer progression was found to have affected the nerve roots at the base of her spine and her troubles walking were consistent with this finding. This is also a common tumor site for leptomeningeal cancer metastasis. (I’ll start calling it CSF (cerebrospinal fluid) mets.)
We didn’t actually see her neuro-oncologist, but he reviewed her case including the latest radiology reports remotely and agreed with the attending oncologist, neurologist, and radiation oncologist that the best treatment is steroids to reduce swelling in these nerve roots and directed radiation to kill the cancer cells there. (I used the word palliative yesterday, which was a poor choice. Sorry to alarm some of you. Besides reducing pain, the radiation may stop the cancer progression at this site and with physical therapy Laura may be able to recover some of her lost muscle control.) Chemotherapy was not believed to be an appropriate treatment at this time.
Radiation physicians are hesitant to start radiation on a patient who has received radiation from another doctor because it requires the transfer of copious records and still runs the risk of over-radiating an area due to overlap from previous treatments. And we didn’t want to do radiation in Boston because the treatment is a prolonged daily process. Since there was no immediate need for attention from any of the other specialists at BWH/DFCI, Laura was transferred to Cooley-Dickinson Hospital, our local hospital in Northampton, where she has received the rest of her radiation treatments.
Due to poor communication and coordination, Laura didn’t arrive in Northampton until Sunday afternoon. But once there she immediately began the radiation treatment and was admitted to the hospital. I don’t know any details about the treatment plan because I haven’t had time to talk to her. She did indicate that a day and half of steroid injections hadn’t seemed to improve her leg pain or control. But it’s not apparently worse either.
Simultaneous with Laura’s arrival in Northampton, Naomi had her little birthday party. And afterwards, the girls, Laura’s parents and I went to visit Laura in the hospital. She’ll be in the hospital at least another day for observation, pain management, and coordination with her local doctors. I forgot to write down the phone number, but you can reach her via the switchboard at 413-582-2000.