My goodness, how quickly things change.
When we met with Jeff’s radiation oncologist, he advised that it was unlikely neurosurgery would elect to do surgery. He stated they are very selective with whom they do surgery on and since Jeff has more than 1 tumor and in different areas, he probably wouldn’t be a good candidate for surgery. “They can’t go in and get them all.”
We left the appointment Monday with the understanding that Jeff would proceed with targeted radiation. However, the radiation oncologist wanted a consult with neurosurgery prior to setting that plan in motion.
We met with neurosurgery today. The neurosurgeon explained that Jeff’s largest tumor wasn’t in his brain, but on the dura pressing into his brain.
Due to the size of the tumor, if Jeff opted for radiation, it wouldn’t reach the entire tumor. If left alone, the tumor will continue to grow (at an unknown rate of speed), potentially causing disruption or impairment to his motor skills, memory issues, possible strokes or seizures, and brain bleeds.
If surgery is performed after symptoms present, the goal would be to remove the tumor in hopes that symptoms don’t worsen. It’s not likely that symptoms would resolve.
Jeff has elected to undergo brain surgery to have the biggest tumor removed. Tentatively speaking, surgery will be on September 17, 2021.
Since Jeff isn’t having symptoms and the scans show minimal swelling, the neurosurgeon doesn’t think the tumor is stuck to Jeff’s brain. If they find it is stuck, this will complicate his surgery, but the surgeon believes there would be more aggravation if stuck. Neurosurgeon maintained that he felt like the tumor was ‘only’ pressing into Jeff’s brain.
Once the surgery is performed, Jeff will meet with another radiation oncologist that specializes in brain metastases/cancer.
They will radiate the area where the tumor is removed in hopes it doesn’t come back. Additionally, they will radiate remaining tumors. It’s unknown at this time as to which radiation will be performed. (Ie: whole brain, targeted, gamma knife)
We also met with the medical oncologist who is onboard with Jeff’s surgery. He advised Jeff to continue with the Zytiga/Prednisone. He wants Jeff on Zytiga/Prednisone for at least a month before deciding if his treatment plan needs to change.
Much to our surprise, Jeff’s insurance actually approved the PET scan, which was supposed to be done today. However, the medical oncologist canceled it. His oncologist advised that regardless of what the scan showed, the course of treatment would not change. Fantastic news though, when Jeff needs the PET scan going forward we know it’s available.
Currently Jeff is not experiencing any symptoms from the brain metastases. Should that change prior to tentative surgery, he is to let them know right away.
As Jeff’s pain is managed, he is feeling pretty good these days. Bless his heart, he was worried about missing work to have brain surgery. As if worrying about brain surgery isn’t enough.
(PS: the neurosurgeon noted that Jeff has multiple skull mets. That didn’t surprise us. What did surprise us is that the neurosurgeon believes the brain tumors came from the skull mets. If any of you find this concerning, please know the neurosurgeon also noted this is very rare. There’s a 1-2% chance that men with prostate cancer with mets to skull will also have brain metastases.)
#teamjeffgallagher