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Deals and Shenanigans. Ring Smart Home Security Systems. PillPack Pharmacy Simplified. Amazon Renewed Like-new products you can trust. The surgeon at Fox Chase did not feel that further treatment with chemotherapy was indicated. However, the ideas of our local home town Medical Oncologists were different from the Thoracic Surgical Oncologist who excised the tumor from her diaphragm.
My wife received postoperative chemotherapy by these medical oncologists, seven months after having that metastatic tumor surgically excised. She did not have any cancer tumor markers indicate any cancer within her system. Some tumors send out microscopic outposts while most do not. However, medical oncologists cannot tell which ones do, so they want to give chemotherapy in nearly every case.
The type of chemotherapy she received was the hit fast, hit hard type combination chemotherapy of Taxol with Carboplatin second-line chemotherapy. It is usually given in big doses, with breaks of several weeks between doses to let the body try to recover or else it can kill a patient.
Patients who develop recurrent ovarian cancer more than 6 months after first-line chemotherapy in my wife's case, 24 years , can experience another remission following treatment with the identical first-line chemotherapy that was previously used in her case, Chlorambucil.
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It has not been shown that platinum-based combination therapy is superior to single agent alkylator therapy. No substantial benefit has been found in giving ovarian cancer patients second-line chemotherapy. Clinicians have found that the toxic effects of this treatment can cause a lower quality of life for these patients. In recent years the incidence of central nervous system CNS metastasis has increased. A NCI observational study in reported experience in their clinic where recurrent systemic disease occurred in all patients for which they received dose intense paclitaxel Taxol therapy.
Brain metastasis was the only site of disease recurrence, presenting with headache, dizziness, unsteady gait, nausea and vomiting. It was our family doctor that found her second metastatic recurrence to her cerebellum in not the medical oncologists at our local home town hospital. She was presenting with headache, dizziness, unsteady gait, nausea and vomiting. A large 3. The tumor was excised from her brain by a Neurosurgeon at Hershey Medical Center. Histologic features were consistent with metastatic papillary adenocarcinoma with extensive necrosis from the ovary.
The treatment protocol recommended for brain metastases of large solitary tumors exceeding 2cm in diameter is surgical resection followed by 5 fractions of local radiation to the tumor bed. At the same time, she should receive an MRI of the spine because of suspicions of either another tumor, on her spine or a herniated disc, causing her leg problems. However, the ideas of our local home town Radiation Oncologist were different from the Neurosurgeon who excised the tumor from her brain. The Radiation Oncologist took it upon himself to give my wife 5 fractions of focal radiation to the local tumor bed, plus 20 fractions of Whole Brain Radiation over a 35 day period.
The risk of neurotoxicity from Whole Brain Radiation is not insignificant and this approach is not indicated in all patients with a solitary brain metastases, particularly when platinum drugs lower the tolerance of the CNS to radiation. Whole Brain Radiation Therapy has been recognized to cause considerable permanent side effects in patients over 60 years of age. My wife was 66 years of age while receiving Whole Brain Radiation Therapy.
During radiation treatment, my wife received an Unenhanced MRI to the spine that showed a 1cm lesion. However, a Regular Bone Scan cannot distinguish what a lesion represents and cannot differentiate between a tumor, an infection or a fracture a Triple Phase Bone Scan may occasionally be helpful in determining benign from malignant lesions. Enhanced contrast agents increase the sensitivity, conspicuity and accuracy of an exam. The agent most commonly used is Gadolinium. An Enhanced MRI was not performed and the Radiation Oncologist told us the lesion was nothing and not to worry about it.
He also ignored my complaints about her having seizures during radiation therapy.
Nine months later, my wife was admitted to our local home town hospital during the Memorial Day Weekend of , for a week of testing and evaluation for unexplained falls and light-headiness. After two weeks of failing to find out what was wrong with her, I took her by ambulance to Hershey Medical Center for proper medical treatment.
At Hershey Medical Center, we found out by a medical onocologist and a neurologist that she had Leptomeningeal Carcinomatous remember the undiagnose tumor of nine months prior, not further evaluated? An Enhanced MRI showed now three 3 metastatic tumors on her spine.
Spinal metastases can grow into adjacent structures, such as into the meninges from the spine.
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The largest of these tumors grew into the meninges on the spine into the spinal fluid, hence Leptomeningeal Carcinomatous. This was confirmed by a spinal tap. With the damage already done to her by our local home town hospital, the doctors at Hershey Medical in order to save her life or at least give her some time had to administer Intrathecal Methotrexate along with systemic radiation to the spine Admitted June 19, When both therapies are performed at the same time it doubles the theraputic dosages of each therapy increasing the neuro-toxic effects on the brain.
However, the cancer cells were eradicated completely from her central nervous system by this protocol. Ever since the second spinal tap at Hershey when methotrexate was already being administered , all of her spinal taps were negative for 10 consecutive times up until January 14, Adverse Side Effects of Treatments: My first experience with the side effects of combination chemotherapy and whole brain radiation was when she was at Hershey Medical Center in The doctors showed me the Enhanced Brain MRI from her previous year's cerebellum excision and the one done in The scans showed the progressive deteriation of her white matter white matter disease.
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These reactions are due to changes in the white matter and death of brain tissue caused by radiation-damaged blood vessels. This clinical syndrome generally occurs 6 months to 2 years after radiation therapy. Symptoms include decreased intellect, memory impairment, confusion, personality changes and alteration of the normal function of the area irradiated all symptoms my wife had over the past year. Radiation Necrosis can be fatal!
It causes pathological changes that impair vascular integrity. Delayed radiation injuries result in increased tissue pressure from edema, vascular injury leading to infarction stroke , damage to endothelial cells and fibrinoid necrosis of small arteries and arterioles. My wife suffered a stroke to the left basal ganlia area of the brain in January , confirmed by an enhanced MRI.
My wife had developed necrotizing leukoencephalopathy a form of diffuse white matter injury that can follow combination chemotherapy , confirmed by an enhanced MRI in July of at Hershey. The white matter is the covering of the nerves within the brain. Its function is to speed up the passage of impulses along the nerves. Necrosis is simply a cell dying, all of its coordinated activities going wrong and things shut down.
If a cell gets too much heat or is poisoned by a toxic substance or exposed to chemicals that damage its proteins and membraines or radiation that breaks its DNA molecules, that cell can just stop functioning. An EEG showed generalized diffuse slowing that was significant with global encephalopathy.
It is most commonly seen in toxic metabolic and degenerative conditions. There appeared to be a real amount of focal right sided slowing which would indicate cortical dysfunction on that side.
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