The Fight is ON!

This afternoon, Kevin received another MRI to check on the progress of the tumor. When to get another MRI has been a point of contention in our family for the last several weeks. Kevin and Kathlin would like to see an image frequently to reassure them that their hard work isn’t all for naught. However, the rest of us hold that the scan shouldn’t be the deciding factor as to whether Kevin decides to keep working so hard. His immense progress over the past couple of months is excellent proof that his hard work is paying off and that the tumor is most likely shrinking. In our eyes, clinical progress (improvement in his symptoms) is just as reliable a sign as anything the MRI will show.

To cut to the quick, the scan today reaffirmed our suspicions and showed that the tumor has shrunk significantly. Yes, it is still there, and it will take many months, possibly years, for everything in that area to completely reabsorb into the brain stem. However, this is the first scan that has shown significant reversal of the tumors’ growth. At the moment, Bob and Steve are retreating!

Some of you with excellent memories may ask… but what about the last MRI in May, after Kevin had a seizure in the Dominican rehab facility and had to be admitted to the main Dominican Hospital for a few days? That MRI showed growth in the tumor, right?

All of that is correct. Bear with me while I try to explain. Yes, the previous MRI had shown that the affected area of Kevin’s brain stem had grown. However, the “growth” as seen on MRIs after radiation therapy doesn’t necessarily mean the tumor is growing. It could also be the agitation of the tumor, and a sign that the tumor is breaking apart. In fact, the “growth” on those post-radiation MRIs could even mean better long-term success in eliminating the tumor. Go figure. So, growth on the MRI can apparently mean that the tumor is agitated and will break apart in the future, or it could actually mean tumor growth. See why we like to trust his symptoms as better signs of his overall progress? We certainly don’t want Kevin to get discouraged from growth on a MRI scan if that “growth” may mean eventual success.

Whether the growth on the previous MRI was actual tumor growth or a sign of the tumor’s agitation, the pattern of growth has reversed for the first time since November 2009. The growth as seen on the previous MRI has disappeared. Two characteristics have significantly improved; the edema (swelling) and the mass effect (how much the tumor is pushing on other structures in the area). The decrease in edema is especially wonderful, seen as Kevin is on an extremely low dosage of steroids. Therefore, this decrease in swelling simply means that things are getting better; the steroids are no longer helping much to reduce the edema.

Furthermore, the tumor’s mass effect has dramatically improved. The tumor used to be pressing against other structures in Kevin’s brain stem such as a ventricle that holds cerebrospinal fluid (remember back to February when he had a “brain drain” tube in to help with the drainage of that ventricle?). Now, the tumor is not nearly as threatening to other items in the brain stem.

The MRI also showed decreased enhancement (structure) of the tumor. An especially dangerous tumor would have a lot of circulatory enhancement, but the MRI shows that there’s not much structure to this tumor. The Avastin chemotherapy is most likely helping on this front, since the Avastin attempts to shut off circulation to the tumor.

Overall, the MRI confirms that the tables have finally started to turn Kevin’s way. While this is excellent news, it also means that Kevin needs to fight even harder. As I said before, if all goes well, it could take years for all the tissue, blood, etc. in the affected area to reabsorb. It could take longer for his nerves and muscles to rewire, overcome atrophy and regain their normal function. This turn in the game means that Kevin needs to fight harder and truly take ownership of his conquest over Bob and Steve. Think of it as a 49-0 score in the first quarter of a football game, with Steve and Bob obnoxiously scoring touchdown after pompous touchdown. Well, now Kevin has scored about four touchdowns of his own, and it’s only the start of the second quarter (I guess this is turning out to be a very high-scoring game). Bob and Steve are still winning 49-28, but this turn in the tables motivates Kevin even more and makes us cheer even louder. The game is far from over. As Dad told Kevin when he came out of the MRI, “the fight is on!”

We see this as also meaning that you, as cheerleaders, have been doing something right for the past couple months. Now is certainly not the time to quit supporting Kevin—we need to keep up what’s been working, if not double our efforts to really get Kevin’s momentum going. The reaffirmed breakdown in the tumor is giving Kevin more reason to fight, and it should give us more reason to cheer him on. Thank you for all your cheerleading over the past 9 months, and please, keep it up!!!