gamma gamma gamma light

hey y’all.  we went to see the radiation oncologist. he and his team were awesome.  he said the tumors have likely only been active for a year or less.  which is kind of scary and just goes to show how aggressive melanoma is.  i am lucky and thankful to have found it this early. he presented us with several options all of which had pros and cons.

on friday 05.12, i am going to get gamma knifed.  it’s basically the radiation equivalent of a sniper rifle instead of a shotgun. each tumor will be precisely mapped and then, one after another, bombarded with 192 low power beams of ionizing radiation.  if the gamma knife kills all the tumors, then i’m done. otherwise i’ll also be treated with a melanoma specific immunotherapy. this option has a high likelihood of success with minimal long term complications. seems reasonable to me.

fingers crossed on my left hand, and that was impossible before they dug that ping pong ball out of my noggin.

option one would be to use immunotherapy only.

pros: kills all the tumors without radiation. even ones that might not show up on the scans.

cons: since there are so many tumors it would require several high dose treatments and one likely side effect would be to develop an autoimmune disease.

option two: whole head radiation.

pros: likely to kill all the tumors.  even ones that don’t show up on the scans.

cons: multiple treatments, will prematurely age the brain and cause permanent short term memory problems after about six months and could cause other kinds of cancer.

option three: gamma knife procedure

pros: will kill all the known tumors in one treatment with virtually zero secondary damage to healthy brain tissue. sounds space age cool.

cons: will not affect any tumors that the scans miss and depending on the quality of the scans could miss small amounts of diseased tissue, requiring more post op monitoring and repeated procedures.

option four: gamma knife paired with optional immunotherapy.

pros: eventually gets everything, lower dose immunotherapy with less likelihood of negative autoimmune response.

cons: more post op monitoring, multiple procedures

option two seems like the worst case scenario for me. i already can’t remember proper nouns for shit, and a bad short term memory makes for a horrible computer programmer.

option one isn’t horrible, but the higher potential for autoimmune issues doesn’t seem ideal.

four is really just three with an immunotherapy step if needed. not really sure why they were presented as distinct, but seems like the best overall with a high likelihood of a cure and the least probability of negative side effects.

with all that in mind, i’m headed to the hospital on 05.12 to get gamma knifed. the procedure will entail high detail mris, installing a temporary halo like device on my noggin to keep it immobilized in a reference frame while i get bombarded by 192 beams of ionizing radiation focused onto each tumor one after the other. the setup, planning, and bombardment will take most of the day.  over the next few weeks i’ll get more mris and some pet scans. if those show dead tumors and no abnormal cellular activity, i’ll be done.  otherwise, i’ll move on to the low dose immunotherapy.  then more mris and pet scans.  i suppose they rinse and repeat until all the scans come back clean.  then it’ll just be occasional prophylactic scans looking for any new signs of disease.

this seems like a totally reasonable plan to me that wipes out the cancer and preserves normal brain function.  i am pretty excited about getting it done and getting back to normal.

fingers crossed (which i can now do again with my left hand, whoo hoo).