Relatively speaking…
Relatively speaking, I got good news from a doctor’s appointment yesterday.
Under most circumstances, being told that you’re going to need to undergo six 6 weeks of radiation therapy to remove or stop the growth of a tumor in your spine would not be good news. The radiation therapy can have side effects like nausea and upset stomach, burned skin and fatigue and going to the hospital every day is a big pain in the ass. But when you go into that doctor’s office expecting to be told that you’ll need to have intensely invasive spinal surgery and then follow up the surgery with radiation therapy, walking away with “just” radiation therapy is a relief and definitely counts as good news.
The brief version of the backstory is that in 2003, while trying to figure out why I was having sciatica-like pains in my legs, an MRI found a benign tumor (ependymoma) in my spine near L1. In July of that year, I had surgery to remove it. In 2007, I wrote a blog post reflecting on that surgery. It’s one of my favorite posts on this blog. In early 2010, an MRI showed that the f-er had grown back and I had a second surgery in the same area later that year. Here are some posts I wrote about the second surgery: when I found out I’d need surgery, some explanation and a photo of that tumor. A few months after that second surgery, I had six weeks of radiation therapy to (hopefully) make sure that it didn’t grow back again. At the time of the 2010 surgery, the doctors also noticed a strange image in a lower area of my spine, near L5. I have annual spinal MRIs to monitor both areas of my spine and this year, they said the “new” area has noticeably grown and we need to deal with it. (The good news is that the area of my prior surgeries is still all clear.) That set in motion appointments with the radiation oncologist and my neurosurgeon.
Going into yesterday’s appointment with the neurosurgeon, I expected him to recommend surgical removal of the tumor. Instead, he recommended radiation. For two reasons. First, he’s not confident that surgery will be able to remove the whole thing. It’s too close to some nerves (the cauda equina) that dangle down into that area of the spinal column. So, surgery has a high risk of damaging the nerves and might not even be successful. Second, this tumor is probably the same kind as my last one – an ependymoma – and that type of growth usually responds well to radiation therapy. And since I’m not having any symptoms, even if all the radiation did was stop the tumor from growing any more, I could probably live with it for the rest of my life. Of course, hopefully it will both reduce the size and stop it from growing back. And, if radiation doesn’t work and it becomes a bigger problem, I can consider having the surgery in the future.
If you’re curious, here are two images of the little bugger.
The top image is from the MRI I had a few weeks ago; the bottom image is from my annual MRI in July 2013. And in case you can’t read an MRI, I’ve circled the growth with a yellow line in both images. The red line is a marker you can use to see how the tumor grew in those 14 months. If you look closely, there’s a small black dot on the vertebrae just to the “left” of the tumor. In the bottom image, the top of the tumor is about even with the bottom of the black dot. In the top image, the top of the tumor is now above the black dot. It’s hardly scientific, but it is pretty clear.
So that’s that. Barring any new, different opinions, I’ll meet with the radiation oncologist soon and figure out timing for the radiation. It won’t be before Thanksgiving and at this point, I’m tempted to wait until the beginning of the year. Radiation will be a hassle, but thankfully, it shouldn’t have a big impact on my life. When I went through this in 2011, I remember looking around the radiation waiting room every day and noticing that I was almost always the healthiest person in the room. It’s impossible to feel self-pity under those circumstances. Everything is relative.
Love you.