Andrew’s kyphoplasty on Tuesday went very well. Immediately following the procedure, he felt no back pain. Since then, it’s crept back in a little bit but is well controlled with Tylenol and steroids. Before the kyphoplasty, he was taking a muscle relaxer and IV opioids around the clock.

We were discharged from the hospital on Wednesday morning and went straight to outpatient chemo. Andrew’s palliative doctor came by and stayed a long time. She said we are entering a new phase where it’s appropriate to evaluate more often whether his treatments are providing more benefit than downsides. She and the oncologist reiterated that the prognosis has worsened. What exactly that means will depend heavily on the effectiveness of chemo. 

Andrew now has a new subspecialist on his team, a neuro oncologist, who we met this afternoon. He was optimistic about the radiation and thinks there’s a good chance it will meaningfully extend his life. There’s strong suspicion that disease is in the spinal fluid, which circulates throughout the brain and spine. Doing radiation to the whole brain and spine is thought to be the best way to prevent quick recurrence. 

The doctor also offered an explanation for how the cancer got into Andrew’s brain: It was likely in bones that sit very close to the membrane encompassing the central nervous system, and you only need a few cells to break through. Overall this was an encouraging visit. We’ll check in with him after radiation ends or if Andrew needs symptom control related to headaches or seizures. 

In the meantime Andrew has several days to rest and get ready for next Thursday. We are taking Vivian to a Broadway show tomorrow and are focused on spending as much time as possible with family and friends.