a plan

So - we had the long awaited appointment - and I know people are anxiously awaiting news.

We are a bit overwhelmed and tired - but I will do my best to  reiterate what we heard today.

Our appointment was at 2:30 at the Cancer Agency.  We had lunch beforehand (I tried to give Stefan my best pep talk) - and we arrived nice and early for the appointment.  This gave us a chance to walk over to the Inspire Health Clinic to take a look.  It's a clinic that offers integrated health services with the cancer agency.  They offer items like naturopathy, massage, nutrition service, yoga etc.  They have a doctor on staff and look at the holistic view of treating cancer.  Definitely something we will check out.

Our appointment started a bit after 2:30 - first with a medical student who took all of Stefan's history and did a physical exam.  Then we saw Dr. M - the radiology oncologist - our new 'cancer' doctor.  I guess our eagerness to get in the door had things a bit mixed up - as he was surprised we hadn't heard the pathology report yet (our follow-up with the surgeon is on the 18th).  He took his time with us - and gave us LOTS of information.  Much of it I was familiar with through my readings from the cancer agency website.  After the Dr. - we also met with a nurse and a social worker - all in all - a 3 hour appointment.

Here are the main points:

1. Confirmation that the tumour is primary (that means started in the brain and contained in the brain - didn't develop from elsewhere in the body).
2. Confirmation that it is an Astrocytoma - grade II - this is a slow growing tumour - benign
   (we didn't get into the survival rates, expected life expectancy, etc.  I already know it - if you really want to scare yourself silly - knock yourself out - it's all on the BC Cancer Agency website - I'm not going to post it here - because we are going to make our own statistic!)
3. The cancer Dr. said the pathologist said the specimen (tumour extracted) was small - inconsistent with what the surgeon had said (dr. said he spoke to the surgeon and surgeon sounded surprised at that too).
4. Based on point #3 - we are going to need another MRI (would need anyway one before starting radiation) - to determine if more surgery is needed (can more of the tumour be safely removed?)
5. Options for treating a grade II astrocytoma are a 'wait and see' approach or treat (with radiation) sooner rather than later.  While the radiation (treating sooner) can delay progression of the tumour - the impact to average life expectancy is about the same under both options (um - ok)
6. He recommends radiation sooner due to the 'bulk' of the tumour
7. Radiation is basically x-rays used as treatment - with the x-ray focused on the tumour
8. Next steps:
    - get MRI - look for indication whether further surgery is needed
    - get fitted for mask worn during radiation (guess we don't have to worry about a Halloween costume this year)
    - get a cat scan done (cat scan and MRI are used to target the radiation - images put into a computer and Dr. inputs target areas)
    - start radiation
9. Radiation treatment is once per day, 5 days a week for 5 and a half weeks.  Stefan would be in the building for about 45 minutes
10. Side effects to radiation include:
     - hair loss
     - irritated scalp
     - hearing can decrease
     - loss of appetite
     - nausea
     - fatigue (this is the biggest)
11. Dr. doesn't think Stefan will return to work before the end of spring (probably not this school year) - when he does return to work - may want to do gradual return due to fatigue
12. The brain tumour is NOT curable - since it can't be removed completely with surgery
13. Treatment is to limit the tumour effects
14. Stefan can exercise to his hearts content (of course he asked)
15. I asked "is it possible that I will have Stefan for another 30 or so years" - Dr.'s reply was "yeah" (with a similar tone people give me when I ask "is this the winning ticket").  Still - i'll take it.

I know this is a very hard pill to swallow.  BUT....it's important to remember:
 - we have heard such positive stories of "I was given 6 weeks - that was 10 years ago", "I was given 6 months - that was 30 years ago"
 - we all know Stefan is healthy, fit and determined - and he has promised me he will be around for a very long time (he keeps his promises)
 - we have a great team
 - Stefan is a superhero

So - that is my summary - I already have a number of new questions (I'm sure you do too).  Stefan is taking this all in stride and would like to start treatment asap.  He is determined to beat this thing!

A note on Superchuck - we didn't take her in for her bloodwork today due to the snow - will take her in Friday morning.