Tom will start his radiation on Thursday paired with chemo. Chemo technically starts Wednesday night, he takes the pill before bed. Chemo will be every day for two weeks and radiation will be each weekday, so 10 days. We had a nice weekend. Got lunch with our nephew today and went out for some treats this afternoon/evening. Tom is still contemplating the cyclocross race on 10/20!

Just a brief update. We met with Tom’s radiation oncologist today. We liked him and he handles most of the radiation for recurrence for Providence. Tom’s scan from Friday shows that the LIT procedure was successful and likely had a complete resolution of the tumor but we all agree we should still proceed with radiation and chemo given how aggressive this tumor can be and that this is a recurrence. He will only have to do 10 days of radiation paired with chemo and then will do just chemo cycles for 9-12 months after that. He will get fitted for his radiation mask this week and start late next week or early the week after. Thanks for all your good vibes and prayers. They are appreciated!

We’ve been busy waiting since Tom’s surgery. Waiting for Providence to get it together and get a treatment plan together for Tom. They refused to do it without another MRI but did not have any type of priority scheduling for it. So his MRI is today and we can FINALLY meet with the radiation oncologist next week and them hopefully he will start his chemo and radiation the week after but we have no idea for how long. Tom is feeling good and anxious to exercise hard again. He should be released back to regular activity the week of the 14th as well. He wants to race on 9/20 at Coyote Run, a new course at PIR, he may have just finished his first week of treatment but wants to race anyway. We’ve also been busy living: anniversary dinner(s), planting a tree, hiking, biking slowly, dancing with Zumba celebrities, spending time with friends and a fun Pitbull concert!

We got the pathology report on Friday. It’s missing a few things that we should have in the next week or so but there was enough info to move forward and meet up with his oncologist earlier than planned, so we met with him today. It’s odd to pray for a genetic mutation, but we had been hoping that the sample would contain the IDH1 mutation that his prior tumor had which made it susceptible to chemo and thankfully it does have that again. It appears that it is very genetically similar to his last tumor. Therefore his oncologist has proposed the same treatment as before, radiation and chemo. He will also likely wear the Optune device again when he finishes radiation. He would also continue the chemo cycles he did before likely 9 mos to a year post radiation.

The chemo that Tom would take is Temodar, it comes in pill form and is shown to be effective used in conjunction with radiation and again the IDH1 mutation makes it more susceptible.

We also learned something new. They continually change the classifications of these tumors as they learn more about them and right now genetics drives the classifications. Because Tom has this IDH1 mutation, they now classify tumors with that mutation as astrocytoma grade 4. It’s still genetically the same tumor he had before, but a different name and also carries a higher median survival rate, moving from median 18 mos to 3 years. We all know Tom will be an outlier again and while it seems like we have a long road ahead, Tom is healthier than last time and doesn’t have the heavy surgery recovery and vertigo he had last time.

Finally, there is one additional drug that may be an option because of the IDH1 mutation. It has had good success and was just approved by the FDA for grade 1 and grade 2 tumors last month: vorasidenib.

We hope to get going with the chemo and radiation as soon as possible. Ideally we will meet with our new radiation oncologist next week, get their treatment plan (radiation would be either 3 or 6 weeks long) and get started.

This is still somewhat hard for both of us to reconcile as Tom is doing so well physically and has no symptoms. We are doing our best to keep him active at a heart rate of 120 or less until his surgeon clears him in 3 more weeks.

As always, thanks to all of you who have shown support and reached out.

Had two week post surgery follow up today. Incision and healing is good there, still want me to restrict activity for another 4 weeks. At least I can get back on the trainer if I keep my heart rate low. They don’t want any increased activity or pressure in the area trying to heal. Any high intensity activity will do that and could cause additional problems. AND no weight training ☹

So low and slow HR training for me.

First race goal will be Cross Crusade – Coyote Run!

Hey y’all. Just wanted to post an update since we are getting inundated with texts 🤣. No news is good news. Tom is doing very well one week post op. He is restless from the lack of exercise. We will be waiting a few more weeks for the pathology and will know his treatment then. We are so lucky to have so many people looking out for us. Thank you!❤️

Finally got around to getting a picture up. As you can see much smaller than before and in the resection pocket. From what I understand, it was a straight shot right into the tumor so not other brain tissue to go through. Still feeling great, minimally invasive was true!

We’ve had Tom home for about 24 hours and everything is going really well! He does not have any pain and is already frustrated by his activity restrictions. We are thrilled with how much easier this part has been than last time! He is okay for visitors and if you come by don’t feel pressured to bring food or anything other than your walking shoes as he may want a walk!

Huge thanks to Torgy for meeting me yesterday with a latte and food the second they took Tom away 🥹. Suzanne came by too and the time flew by with the good company I had with me. Thank you both!

What’s next? We have two weeks (no strenuous activity!!! Tom are you reading this part???) until his follow-up appointment but that is just surgical and we likely won’t have any news on the pathology yet. He is on steroids for 10 days and anti-seizure medication for a week. Once they have the genotyping done on his tumor we can discuss treatment options. Likely this will involve immunotherapy but could also involve other things like more chemo and radiation, perhaps the return of the new and improved Optune he wore 8 years ago. He also told me he still wants to race the Cross Crusade series again this year!

If you want to read more about the pathology they are doing, this is a great article!

Q&A with a Pathologist (Part One): Keith Ligon, MD, PhD

Thanks for all your messages of support!

Brain Surgery at 8:30, going home at 3:30. Modern medicine is amazing. Oh, and staff are Providence StV is awesome.

Tom’s surgery is complete. All went well! He should be awake in 45 min to 1 hour.