The cancer has metasticised to my brain

Over the past week Nate has had headaches during sleeping hours that would subside soon after waking up. On Friday his headache worsened as the day progressed so we paged our oncologist who recommended an immediate MRI (brain scan), which required us to go to the Karmanos ER. We arrived at the ER around 2:30pm and Nate was treated with a steroid to reduce the swelling in the brain. Fortunately his headache subsided about one half hour after getting the steroid drug (Decadron) and he finally was taken for the MRI at 10pm. The scan showed a large tumor (4x4x5cm)behind his right eye near the back of his skull, sitting on top of the right hemisphere of his brain. He was admitted to Karmanos and was taken up to a room at 2am.

On Saturday we met with a team of neurosurgeons who showed us the scans and gave us information on various options to treat the brain tumor.


1) I can have the tumor surgically removed which will required a sizable hole drilled through my skull. This method will enable the neurosurgeons to remove approximately 90% of my brain tumor b/c the last 10% would potentially damage healthy brain mass and critical blood vessels for proper blood flow to my brain. Unfortunately leaving this amount of cancer will likely result in the tumor continuing to grow. Unfortunately tumor growth in the brain tends to be fairly rapid for Melanoma cancer. The recovery time for this surgery would be 2-3 days in the hospital.
2) Following surgery I would have the option of high dose targeted radiation (gamma knife) to kill off remaining cancerous material. More frequent subsequent MRI scans would determine if additional radiation is necessary. The tumor size must be small for the gamma knife technology. None of my other tumors are eligible for surgery or radiation treatments for various reasons. The risk of high dose radiation is that healthy cells in my brain utilized for motor function and healthy blood flow could also be damaged which could cause numerous health issues
3) My final option would be to use medication like steroids and pain killers to manage the headaches and brain swelling, but this would not reduce the size or slow the growth of the brain tumor. The neurosurgeon's best guess would be 1 to 3 months before I would drop into a coma from the pressure on my brain stem if I went this route.

The latest CT scans (neck to abdomen) from 2 weeks ago showed that the mets in my liver and lungs are still growing, so I am no longer taking the phase 1 clinical drug. At this point there really aren't many systemic (i.e. root cause) options for the treatment of my cancer. I have tried multiple conventional and alternative therapies each of which offered approximately a 10% chance of effectiveness.

We obviously have a difficult choice to make regarding how to treat this new tumor in my brain, since we most likely won't be treating my cancer systemically it is likely that the tumors in my liver, lungs, and brain will continue to grow. Please pray for us to have wisdom in our decision and that which ever route we choose that the best possible treatment will be delivered by the medical team. We will likely make our decision in the next few days, once things settle after the holiday weekend.

Thanks to all who continue to let us know how loved and cared for we are. I wish I had the energy to answer all of your thoughtful messages individually, but please know that each and every one of your notes and responses to my blog lift our spirits and touch our hearts.

God bless,
Nate and Deb