Consultation with Radiation Oncology

July 19th, 2005 we had a consultation with the Radiation Oncologist
Her diagnosis: MRI shows some enhancement in spinal cord which they believe is surgery residue. Spinal Fluid has no cancer. Bone Marrow has no cancer. Assuming the MRI is clear, she is standard risk medulloblastoma in the cerebellum.
The doctor recommend: Standard treatment which includes chemotherapy and radiation to the entire brain and spinal cord. The surgery removed most of the tumor which put her in the category of standard risk.
These are my notes from our meeting
Why do radiation? Unwanted side effects. Tumor can spread to other parts of her brain.
Using a high-dose chemotherapy along with the radiation looks positive. 80% cure rate. She would be sedated everyday for 6 weeks of treatment. The plan is to radiate the target area with radiation of 2,240 for two and a half weeks followed by three and a half weeks of radiation to the entire brain and spine. This is a 5 minute treatment, but because of the sedation, it will take two hours.
Side Effects: Short-term- tired, headaches, vomiting, need steroids, skin redness, dryness, decrease bone marrow (may need transfusions). Long-term- Permanent hair loss on target area (the back of her head), developmental problems (it will happen, she might need special care all of her life. Memory and learning will be affected and will need special education. Growth problems- shortening of the spine. Affect hormonal production. Could cause second cancers.
Survival Rates: 5% survival for radiation on tumor only.
15% survival for radiation to tumor and spine. 50% survival for entire brain and spine.
After this meeting, we had a very quiet drive home. Making a decision like this for a 3 year old was difficult. All we could do was pray for wisdom and trust God for his guidance. We agreed that this would not be the best option for her at this time.