Dr. Holdhoff Says to Hold Off

From James:

Short version: Dr. Holdhoff is recommending against chemotherapy; radiation “practice” starts tomorrow, with the real thing starting on Monday; and our house is full of light.

Long version: We met with our medical oncologist, Dr. Mathias Holdhoff (an impressive-sounding name), today. Medical oncologists specialize in using approaches like chemotherapy to treat cancer and tumors.

I was skeptical that the meeting would accomplish anything, since low grade tumors aren’t usually subject to chemotherapy, but this turned out to be one of the best consultations we have had. Dr. Holhoff spent a great deal of time asking questions about and discussing So Young’s case. He gave us a long-term view of what So Young’s treatment is going to be like. He also did an impromptu analysis of the growth of So Young’s tumor over the past few weeks and described many aspects of her MRIs in detail.

The main result from the visit is that So Young will not be undergoing chemotherapy in addition to radiation. Initially, we wanted to participate in a chemotherapy trial, but it would have caused delays. I still wanted to address the possibility of chemotherapy with Dr. Holdhoff, however, because of the “worrisome” dividing cell (that’s the pathologist’s word for it) found in the biopsy. If the small sample taken in the biopsy missed a large number of malignant cells, chemotherapy would be advisable.

Dr. Holdhoff reemphasized that the tumor really shows a lot of signs of being of the low grade variety: it didn’t “light up” on the MRI, it doesn’t appear to have grown much over the past three weeks, and the sample revealed a small number of dividing cells. If it truly is low grade and we treat it with chemotherapy now, the treatment may not reach that small number of cells effectively. Also should the tumor become malignant in the future (which is possible for low grade astrocytomas), the effectiveness of chemotherapy might be lessened by the resistance of the tumor cells to the chemotherapy.

I was very interested in his discussion of long-term treatment. After this initial round of radiation, the size of the tumor will be monitored regularly, starting very frequently and decreasing over time, but never getting below a couple of times a year for the rest of her life. If the tumor becomes malignant or continues growing, chemotherapy may be called for, and radiation will continue to be an option, as long as enough time has elapsed since the previous radiation treatment.

The doctor also showed us a side-by-side comparison of the November 12 and November 29 MRIs. The tumor really is large, and it is amazing that it hasn’t affected So Young more. Very rough measurements that Dr. Holdhoff performed on the spot showed no growth and perhaps some decrease in size.

Dr. Holdhoff was very patient and spent a long time with us, fielding our questions and describing everything clearly. The compassionate care he provided is typical of what we have experienced at Johns Hopkins. Today was an 8+ hour visit including the drive, but he made it worth it.

In other news, it turns out that Friday’s appointment is going to be a “dry run” rather than actual radiation therapy. They just need to bolt her head to the table (no joke) and aim the radiation beam at the correct spot, and bingo! Real, live radiation will start on Monday.

Today, the electrician finished the new lighting that Mom and Dad provided for us. The main level is unquestionably well-lit because of their generosity and the electrician’s hard work. The electrician (Wayne) of Marway Electric is very professional and skilled at what he does. So Young and I honestly don’t feel like our thanks can keep up with the generosity we have received from my parents for so long.

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4 Responses

  1. This sounds like good news on so many fronts. We will continue to pray!!! Amazing what God does!

  2. It’s wonderful to meet with a physician who is compassionate and caring. Gives one hope. It sounds like his prognosis sounds good. Good luck with the dry run today. We’re praying.

  3. Thank you so much for the updates. So Young, please know that you are in my thoughts and prayers daily. God is in full control…let’s continue to allow Him to lead your treatment.

  4. I read this post and all I see, over and over again is RUBY GETS TO KEEP HER BEAUTIFUL HAIR!!

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