latest scan after vaccine trial

Mark had his last injection of the dendritic cell vaccine on 5/26/06. On 06/07/06, he had a blood draw, MRI and a meeting with the neuro oncology team at UCLA. According to the doctor, the scan looks fine , the cavity still seems to be about the same size and there is no new contrast enhancing areas that show up and appears to be stable; however, there does seem to be an increase of edema (swelling), but doesn\u2019t necessarily mean that there is tumor activity. It could be radiation changes over time, could be swelling from brain remodeling itself, could be related to dendritic cell vaccine, or could possibly be non-enhancing tumor, but they don\u2019t think it is that at this point. Mark and I were a little uncomfortable with this increase in swelling and are planning to have a DOPA PET scan that can highlight tumor cells that can\u2019t be seen in MRIs, to rule out possible non-enhancing tumor activity and just as a precaution. Dr. Liau says that she has seen increased swelling in some dendritic vaccine patients, and getting a DOPA PET scan is a good idea. We're hoping that it means the blood is in that area fighting the cancer cells! The other odd thing we found out in this appointment is that Mark's nutrophil (figher blood cells) count is too low. His overall white count was low 2.4, but his nutrophil count is 1.3, and needs to be above 1.5 before he can be cleared to start up chemo again. So he can\u2019t start temodar until we get it back up. We are revisiting the natural suggestions for boosting counts from Jeanne Wallace (i.e. leafy greens, protein, supplements, etc) to make sure we're doing what we can. He will have a blood test again next week to see if his counts go up. His counts have actually been borderline since the surgery and going on chemo the initial time, which is an indication that we may have trouble on chemo. If the counts go back up, he will only be on 300mg of temodar for 5 days then off for 23. If his counts can't handle that, then we'll probably switch to a lower dose, but extend the period for 14 days on, 14 days off. The last time he took chemo (before vaccine 3 months ago), his body did tolerate the 5/23 dose...so we're going to have to see how things work out. The addition of neurontin seems to have helped seizure activity, so we\u2019ll stay at the dosage we\u2019re currently at for Keppra and Neurontin. If counts go up, we\u2019ll also be on temodar, kytril (nausea) and miralax (constipation). Besides the supplements suggested from Dr. Wallace, Mark is also taking a homeopathic approach (based on studies from Dr. Banerji) and taking Ruta GR.6C, Calcarea Phos and Cuprum Metallicum...the combo has several positive stories backing it on the brain tumor sites and chats.

What's next:
06/12/06 \u2013 blood draw (to check levels for temodar)
?? DOPA PET SCAN
?? evaluation with neuro-psychologist (Dr. Ingalls)

06/28/06 \u2013 blood draw
07/?? MRI, meeting at UCLA
08/30/06 \u2013 blood draw
10/25/06 \u2013 blood draw
01/10/07 \u2013 blood draw
02/21/07 \u2013 blood draw
04/25/07 \u2013 blood draw