After discussing the pros and cons of a spinal tap for further diagnosis my wife decided to go with the docs recommendation and not do it. Even if the tap confirmed the melanoma was in there, it would not alter the treatment protcol she is on – which is a last gasp effort anyway. The chemo she is on, Abraxane, is one he really wants to have given a good shot at slowing or halting the melanoma overall. As it is, her blood counts were down yesterday, so she was only able to get a 1/2 a dose.
After discussing the pros and cons of a spinal tap for further diagnosis my wife decided to go with the docs recommendation and not do it. Even if the tap confirmed the melanoma was in there, it would not alter the treatment protcol she is on – which is a last gasp effort anyway. The chemo she is on, Abraxane, is one he really wants to have given a good shot at slowing or halting the melanoma overall. As it is, her blood counts were down yesterday, so she was only able to get a 1/2 a dose. The idea of doing a direct port into her spinal fluid (Ommaya reservoir) was discussed but quickly dropped.
She's doing relativley well on the Abraxane; fatigue and unsteadiness being the main side effects. Of course she wanted to know if the 1/2 dose would affect her hair loss – the doc wasn't too sure it would (i.e., he thinks it will still occur on schedule).
What this all means for her symptoms is that we stay focused on treating the pain as best we can, while hoping the chemo has some effect. Her arm and shoulder pain are being well managed by the gabapentin (nerve pain reduction med) and increased steroids. Her lower back has really started hurting quite a bit more over the last several days. Unfortunately where she indicates it hurts, is in an area she has had tomotherapy radiation, and there can be no further treatment there. So it's pointless to scan to see if it's more cancer. He said it's possible the radiation is still working and could reduce the spinal tumors there – I think that's unlikely as it has been six week since the conclusion of the tomotherapy. So he's upped the dose of gabapantin and added another anti-inflammatory and pain med. We are still in the pre-morphine zone, so that's good, but if the chemo doesn't work that is where we are headed.
To top a lousy week off, today she has a brain MRI and we meet with radiation oncologist to discuss results and game plan.
Nick
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