Tuesday, 17 October

Today was a long, long day. The appointment with Dr. Galleshaw went quickly, she thinks Karen’s eye involuntarily closing and the numbness experienced in July are extremely troubling and may signal a more serious problem. She feels Karen most likely has carcinomatous meningitis. I explained this in an earlier update but if you missed it here it is again. Carcinomatous meningitis is caused by cancer cells getting into the thin sheets of body tissue that surround and protect the brain and spine. These sheets are called the meninges. Meningitis means inflammation of the meninges. Carcinomatous just means acting like a cancer. It comes from cancer in other parts of the body that spread to the lining (meninges) of the brain and spinal cord, the parts of the body that make up the central nervous system.

The cause for concern is the inexplicable loss of feeling Karen had in her face and lower torso in July and now the problem with severe headache followed by loss of ability to use her right eye. These are all symptoms of carcinomatous meningitis. Diagnosis generally comes from removing a sample of cerebrospinal fluid, looking at it under the microscope, and finding cancer cells. This procedure is called a lumbar puncture. It is common for doctors to have to do several lumbar punctures before a firm diagnosis can be made. Yesterday, Karen endured a third lumbar puncture. We should have the results in a few days.

If Karen has carcinomatous meningitis treatment options are either radiation or intrathecal chemotherapy. In radiation therapy, high-energy, penetrating waves or particles such as x rays, gamma rays, or proton rays are aimed at the spot where the tumor is located. The goal is to destroy the cancer cells or keep them from reproducting.

Intrathecal chemotherapy involves injecting chemotherapy drugs directly into the CSF. Drugs are injected either through a lumbar puncture or through an Ommaya reservoir located on the skull. The goal is for the drugs to kill the cancer cells, although some normal cells are also killed. Since repeated MRI scans don’t show a specific tumor to target this would most like be the treatment offered at this time.

Carcinomatous meningitis is an advanced form of cancer that usually leads to denegration of the nervous system and then to death. The chance of recovery is very slight. In a more encouraging moment in our discussion, Dr. Galleshaw told Karen to feel free to be the exception to the rule, if diagnosed with the condition.

At this point Karen has been handed off from the oncologist to a neurosurgeon. The oncologist does not plan any further treatment of the known cancer until information is available on what is going on with Karen’s eye. She is scheduled to see Dr. Chris Tomaras (Neurosurgeon) on Monday, 22 October.

Much of news we have shared is heavy and discouraging but don’t be dismayed. Pray. God has brought Karen from a life altering initial diagnosis with the possibility of just months to live to many happy occasions spent with family and friends over the past 2 years and 4+ months. No matter what the diagnosis please continue to pray for healing and a long healthy life for Karen. God is able to do exceeding abundantly above all that we ask or think.

Until next time…