Fighting Cancer, Part 8: Remission?

Last time, I went over Mom's radiation. We needed radiation because, after chemotherapy, the tumor was still very large and very active:

That image is from a PET scan on September 4, 2014.








Mom had radiation each day for one month. Part of the radiation was WBRT: Whole-Brain Radiation Therapy. WBRT can have serious side-effects, as your whole brain, including healthy brain cells, are being irradiated. They did the WBRT to kill any cancer cells that may have spread.

The rest of the radiation was directed to just the site of the tumor, which is much safer.

Mom's last radiation was on October 2, 2014.

Was the radiation effective? We'd have to wait six weeks before doing Mom's next MRI.

Here's the MRI, from December 1, 2014:

The tumor looks much smaller!

The MRI was accompanied by a report: The tumor used to be 30 x 39 x 40 mm, but it was now 9 x 21 x up to 20 mm. The report said this was a "marked decrease in size" and a "partial response to therapy."

I'll take a partial response over no response. =)

As it was only a partial response, I was worried about the tumor growing back again quickly. The doctors were accommodating and Mom had another MRI on December 30, 2014:

In that one month, the tumor had not grown. As there had been no treatment during that month (chemo or radiation), this was good!






Mom was supposed to have another MRI in 3–4 months. So she had one on March 27, 2015:

The tumor still had not grown! Whew! In fact, it had even shrunk! The doctor is hopeful that the remaining bright spots are not living cancer cells but more like scar tissue.

Mom will have another MRI in July.

We hope that the next MRI will show an even smaller tumor, or at least no growth. Would such a result mean Mom is cured?

Sadly, no. Cancer doctors rarely speak of being "cured." Instead, they use the term "remission." From the dictionary:

"A diminution of the seriousness or intensity of disease or pain; a temporary recovery."

From that definition, we might say Mom is in remission now: The tumor is much smaller, and she's not showing side effects from the tumor. But note the keyword "temporary." Remission is temporary.

One problem with cancer is that it can always come back. This is called "relapse." Months or years may pass, and one day the cancer will be found again. When they compare this second cancer to the first cancer, they often find that it's exactly the same cancer: the same type of cells, the same DNA. It's a clone. Somehow, even after chemo and radiation make all the tumors disappear (from our view), a small number of cancer cells remain dormant in the body.

Also, for reasons I don't understand yet, the cancer's second time is often worse. The chemo doesn't work as well, or the body can't take any more radiation.

Some cancers are more likely to relapse than others. Sadly, my mom's cancer—PCNSL, Primary CNS Lymphoma—has a high rate of relapse. Data from 2006 indicate that approximately 35–60% of PCNSL patients relapse, mostly within 2 years.

On the bright side, there have been a lot of improvements in treatment and diagnosis in the past 10 years. Remember the radiation machine they used on my mom, the one that looks like an alien device?

That machine arrived just a few months before Mom's treatment! We're very lucky to have access to such technology.

Perhaps Mom has a high chance of having a relapse. But maybe that works in reverse, too. PCNSL makes up 3% of brain cancers, so it was unlikely that Mom would get that type of brain cancer, let alone any brain cancer. So maybe we'll get lucky and she'll be one of those people who live for 25 more years! Sometimes it happens!

Either way, we shouldn't wait around for the cancer to return. That's silly.

With permission from my mom's doctors, my mom and sister teamed up to plan a once-in-a-lifetime trip: A cruise along the Danube River!

Next time: The Hom Family's European Vacation!

Sneak peek: