Home » Brain Tumor Centers

Quote of the Day:

Few things are impossible to diligence and skill. Great works are performed not by strength, but perseverance.
- Samuel Johnson

UC Davis Talk

UC Davis 1 Comment »

As memtioned, I gave a presentation at the May Meeting of the UC Davis Brain Tumor Group. The subject was using iPhone apps to help manage treatment. The following videos capture the presentation if you care to watch. There is a 10 min limit with youtube so I cut it up into 3 segments – approximately 5-8 mins long each.

Also, keep in mind this is far from a professional film production! I had a podium, a PowerPoint presentation being projected on to a large screen and no mic. One annoyance is there are times when I move out of the picture to clarify items on the slides but the camera doesn’t follow – it would have been too disruptive to do so. The objective was to connect and present the information, not film it. Nonetheless, you’ll still glean most everything as if you were there.

More to come!

UC Davis Brain Tumor Talk Part 1 of 3

YouTube Preview Image

UC Davis Brain Tumor Talk Part 2 of 3

YouTube Preview Image

UC Davis Brain Tumor Talk Part 3 of 3

YouTube Preview Image

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

UC Davis Info

Blog, UC Davis No Comments »

I’ve received a number of requests for more info regarding tomorrow night’s meeting.  Here is a PDF w/ info.  Thanks for your support!  It should be a fun night.

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

November 12 2008 Update

Brain Tumor Centers, DCVax, Sutter Neuroscience Institute No Comments »

It has been a few days since I’ve updated the blog here and for good reason!  We have had so much going on in terms appointments.  I guess when you have about 6 doctors, add a few more and sprinkle in some physical therapy, a seizure and some DMV red tape life can get busy!  But we are good in spite of this.  I must admit I have been up and down since my last post emotionally.  It’s hard to fully accept this diagnosis.  Jumping from a grade 3 to a grade 4 is a big deal and the enormity of the situation coupled with the pace of treatment options needing evaluation can become a blur.  All of this aside, the diagnosis is bleak but this is why we have a very talented team in place headed by my Neurosurgeon, Dr. Edie Zusman, who has performed both of my craniotomies.  Thanks to her, I am walking with a cane and can walk fairly well without it now!  Physical therapy is helping tremendously.  And, we know that God is in the middle of all of this.

By the way, the Sacramento Bee ran a terrific story on Dr. Zusman in this last Sunday’s paper.  The gist is she’s the only female member of the Amercian Board of Neurosurgery and is ranked in the top 37 best neurosurgeons in the country.  Pretty comforting and if you read this story and what she went through as a woman dealing with a sexist, sometimes discrimantory and very male-dominated environment, she has accomplished much more than what she does in the operating room.  I’m proud to have her as my neurosurgeon.

So I digress.  I have been up and down but mostly up.  With regard to my condition and what’s been happening:

DCVax-Brain Vaccine

The vaccine is being manufactured.  Such a blase’  term for something so important but nonetheless it should be ready shortly.  The “red tape” we are working through is some last minute FDA paperwork.  There was a lot of FDA paperwork up front and approval from the Neuroscience Hospital Board.  With that behind us, they has to approve my use of this which is a formality really.  So, I should be able to get and see the Neuro Oncologist who will be performing the infusions either the end of this week or the beginning of next.  There is no sense in seeing him until the FDA paperwork is finished. 

UCSF Trip

We went to the UCSF Brain Tumor Center on Friday of last week.  This was marginally helpful at best.  UCSF doesn’t push vaccine therapy and based on this meeting doesn’t even believe in it.  Therefore, they discounted the entire approach and basically told me that they don’t  believe it will be helpful to me at all.  The Neuro-Oncologist basically wished me luck but said once you do this you’re cutting yourself off from a lot of other options.  This is a very true statement with any trial you decide to enroll in because with most trials, you have to have not been treated before – otherwise, how are they to tell whether or not their drug is working and / or whether or not the previous treatment has hindered the trial drug?  However, this world is also full of politics.  A goal is to get patients enrolled in trials.  Well, it turned out to be a single trial that he could offer.  He had one.  A new one.  No data, no information about survival rates – nothing.  When I told him about UCLA/Cedars Sinai using the same vaccine I was planning to use, and Dr. Black’s program down there which uses the DCVax vaccine whic does have available data, the neuro-oncologist really touted his own trial.  He also indicated that tumor was left behind.  About 10%. Not true.  Sutter’s Neuro-Radiologists confirm this is post-op changes – meaning scar tissue, swelling, etc.  Interesting.

Well, that said it all and he suggested we spend 1/2 hour with his nurses acquainting us with the trial.  He sent us to another room.  When the nurses arrived we asked for paperwork to read up on it and decided to depart.  We are not discrediting UCSF at all.  This is a wondeful institution.  They have some of the best neurosurgeons, neuro-oncologists, etc. in the world but this just wasn’t a fit for us.  That was about it.  So, we came back home and ruled that out.  We really were more interested in a backup plan anyway so we’ll put that together and it may or may not include UCSF.  We’ll just have to see.

Other Updates

On Saturday morning I had a pretty bad seizure.  As usual, I didn’t lose conciousness but it was pretty scary.  My left shoulder and arm were involved instead of my leg which was odd.  I took a few ativan with Rachael’s help and that did the trick.  It last about 5 mins but it was a bit ugly.  Oh well – it’s part of the territory.  The tumor removed was about 2cm x 3cm so that’s bound to result in this activity.  My concern moving forward is once these neural pathways are opened up by having a seizure, it’s easier for your brain to “find it’s way” so-to-speak to another one.  However, I’m comforted in knowing that after my first surgery in 2007, I had one serious seizure and then nothing. 

The DMV is pushing for a “reexamination” of my driving.  This is pretty standard for what they refer to as a “brain injury”.  So I had to fill out paperwork and my Neurologist does as well.  Again, it’s just red tape.  You’d think they just ask about the surgery, my deficits as a result, etc but I guess this allows them to open the door on everything!  All diseases, issues, etc.  Funny.  Are you an alcoholic?  Do you have heart disease?  Issues that have nothing to do with my brain surgery.  Well, ok.  The worst case is I take a driving test but my concern is the time it will take because let’s face it, our government operates like an old rusty Chevy El Camino that’s been rotting in a junk yard for 30 years.  Slooooow.

My company is the greatest organization.  My wife told me today that they called and want to bring us a “Thanksgiving Feast”.  Basically you can get these complete meals for so many people and everything is cooked and ready to go – turkey, stuffing, cranberry sauce – you name it.  I am so blessed to work for a company that is just so caring and supportive.  Both times I have had to go on leave our CFO, whom I report to, has told me just to focus on what I need to do and my family and that they will make sure that Rachael, Keegan and Aidan are taken care of.  How wonderful and what a blessing it is.  Words aren’t even enough to describe how much this means to Rachael and I.

Aidan and Keegan are doing good.  Aidan got his very first trophy last week for soccer!  He put it right next to his bed on his bookcase so he could look at it as he wesnt to sleep.  He’s had 6 goals this season and is thrilled  The last soccer game is Saturday.  That’s where I was heading last Saturday when my little problem cropped up! 

Anyway, that is about it for now.  This week and next should once again be busy.  Hopefully one of the appointments will be to get started with the vaccine so we will be praying about that.

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

UCSF Appointment

UCSF 1 Comment »

We are all set with UCSF and our appointment tomorrow at 11am.  I picked up my pathololgy slides yesterday and CDs that contain about 15 MRIs.  The rest of the data was sent to UCSF by the Neuroscience Institute (dictations, sugical reports, etc).  UCSF has a number of trials taking place at any given time including some that are vaccine-based. 

Of course, the purpose of this consult is to continue building a strategic roadmap for my treatment plan.  I need to have this in place.  I’m used to operating this way in life anyway, albeit mostly in business.  Regardless, I’m not going to find myself in the middle of the DCVax-Brain vaccine trial, have something go wrong – whatever that might be, and then be forced to figure out what’s next or fall back on the standard of care.  That is the worst case scenario -  being forced to make a monumental decision on a dime.  So, to have this somewhat figured out, exploring the landscape, having a sense of what is out there makes a lot of sense and will feed the plan.

I’ll certainly post some good information about the appointment over the weekend. 

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

Neurosurgeon Appointment

Brain Tumor Treatment, Brain-Surgery, Sutter Neuroscience Institute 3 Comments »

I mentioned that Rachael and I had an appointment with my neurosurgeon to go through our strategy moving forward.  Rather than go into a lot of detail regardint the hour-long discussion, here is what came out of it:

  1. We knew I had been “accepted and approved” into the DCVax-Brain program.  The final hurdles were a) did they have enough tumor to manufacture the vaccine and b) did I have the genetic markers necessary for this to work.  The answer to boh questions is YES!
  2. We were asked about treatment options.  First is conventional.  You perform surgery then use standard chemo.  The second is a clinical trial that has been established.  The third is experimental (the vaccine)
  3. We have opted for the vaccine, however, we have also decided to do a consult at UCSF to see what other phase I/II trials they have so we aren’t putting all of our eggs in one basket.

As with anything, experimental is just that – it could yield amazing results but there could also be side effects.  Regardless, we have to be aggressive so that is why we are going with the vaccine

More to come on all of this.  It will take 4 weeks to manufacture the vaccine so in the meantime I’ll rehab my left side and spend time with my family…

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

UCSF Preliminary Info

Chemotherapy, UCSF 1 Comment »

Although I am still waiting for formal documentation, I had a discussion with the Department of Neuro-Oncology at UCSF on Friday evening.  After going through all of my information they are in agreement that the tumor is stable  and that it is in no way worse.  This is great news!  He also indicated that they concur that staying on for another six months would be the right course given my tolerance of Temodar, the stability of my tumor and the fact that my blood work is allowing my body to withstand continuing treatment.  They agree that stopping at a year makes sense, primarily due to the side effects – namely leukemia. 

I asked what course should be taken at a year – of course that is the million dollar question!  They recommend that I stop and if there is growth after that, surgical intervention is likely the best course given the location (primary motor cortex) and the fact that I had a 0% resection in my last surgery.  As long as I am neurologically in tact, which I have been throughout, that is the last thing on my mind and on the list. 

I will have a comprehensive report hopefully tomorrow or Thursday but this gave me all I needed to continue Temodar – cycle 7 started last night.  On we go.  I’m sure there will be some details in the report that will give me more information and I’ll share that here but at a high level, this is what I was after.

Again, second opinions are important.  This one came in consistent with my Neuro-Oncologist’s recommendation.  The interpretation of my MRI scans, too, were consistent.  Great – I have the assurances I need to move forward and it I feel 100% confident that I am moving on with a treatment plan that is the best for me, my lifestyle and my family.

More to come….

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark

Chemo Strategy

Chemotherapy, UCSF No Comments »

At this point I’m in full research mode on chemo.  The conservative recommendation is to continue on my alternative 7-day regimen through the 1 year milestone.  However, there are no studies or hard data to suggest that it improves survival rate.  The problem so far as I can see is that all of the research centers around and has resulted in the “standard of care” which is 6 months of “pulse therapy” post-surgery and radiation.  Once you get there, it’s up to your Neuro-Oncologist to set you on the right course.  Stop chemo altogether, switch to something else such as Tarceva, keep going with Temodar or if you have growth take more aggressive action obviously including surgery – both traditional and stereo-tactic radiosurgery.  So, no one of course can predict. 

My conversations have gone sort of like this:  So if I were to continue therapy, what has your experience shown in terms of liklihood of tumor growth vs. management for a grade 3 mixed glioma?  Well, it depends.  Sometimes they grow, sometimes they don’t.  And if I don’t continue?  Same result.  And I continue to the year marker and stop?  It could grow after that or not.  There are patients that stop and it’s stable for years and then some patients have aggressive tumors that grow quite quickly.

The bottom line for me?  It is a) in God’s hands at the end of the day but b) I have to research this just as I did with my decision to have surgery to make sure that I am making the best decision for me and for my family.  I am going to UCSF and having the look at my film again.  I am also having their Department Head of Neuro-Oncology look at my case and provide a second opinion (the conservative recommendation I have is to continue).  I am also digging around at Harvard for another opinion.  In concert with all of this, I am performing my own independent research.  As I have always maintained, you must be your own advocate – no one will do it for you.  I can go to my doctor and sit in a room and just shake my head yes or I can go out there and get good, solid info from some of the most imminent sources in the field.  The latter is what I want.  This is my life on the line.

That’s it for now.  For now, though, I have been off for a week and as a special present I am taking a second week off of chemo – yeah!  This is not a big deal since I have been by the book for 6 months.  Back on it a week from Monday but this is a welcome break.

Thanks again for all of your thoughts and prayers regarding my MRI.  They are SO appreciated.  The comments and all the emails I received mean so much to me.  You have no idea.  Thank you.

Subscribe by EmailSubscribe by Email RSS Subscription RSS Subscription

  • Share/Bookmark
   © 2010 Mark L. Miller, All Rights Reserved
   www.markmillermusic.org / Site Map