Monday, 23 November 2015

MRI results... we have shrinkage (!)

Hi - !
Today marks 3 weeks post chemo/radiation and our first post treatment MRI.  The tumor perimeter was visibly smaller.  The NO took a measure of the 9/17 MRI which was 49 (mm? cm?) and then took a measure of today which was 40 of the same measurement.  He also commented that the tumor center looked like it was dying.  I'm not sure how he could tell but my mom is an RN and said she could tell too.  The NO believes this all to be the work of the Avastin - which we have had 2 doses of to date.  When I asked if the Temodar or radiation were also helping he said that it was clear to him that this was the work of Avastin.  I still don't fully understand why he concluded that other than experience.  So now he wants us to stop Temodar (or rather not re-start Temodar) and just keep the Avastin.  Is this wise?  I feel really uneasy about that.  The reason being - Dad is feeling crappy and the NO believes the Temodar exacerbates his symptoms through extreme fatigue, poor appetite, body pain (Dad is in a wheel chair or seated all day - body cramps up).  That's really it.  I thought Dad tolerated the Temodar fairly well (no nausea).  What do you guys think?  Should we stop Temodar?  Dad will keep taking it if it is indeed helping.

Thanks -


  1. I can't give you opinion regarding your questions, but I am sending you big happy for your shrinkage! May the good MRIs continue :)

  2. Shrinkage is always good news, glad to hear that. Avastin does tend to have quick, beneficial effects, which was the main reason it received accelerated FDA approval with only phase 2 trial data.

    The 5-day TMZ schedule uses twice (or more) the daily dose of the daily schedule during radiation (150-200 mg/m2 versus 75mg/m2). His fairly good tolerance of the medium-dose daily schedule doesn't mean he'll tolerate the high-dose 5-day TMZ as well. And without information on MGMT status there's no guarantee it will be beneficial. You could perhaps put off the monthly TMZ cycles for a bit and see if his condition improves before trying the high-dose TMZ.

    How has his overall health changed since the end of radiation?

    Apart from chloroquine, DCA, CBD, and honokiol (HonoPure) could be good additions to make Avastin more effective.

  3. Thank you Stephen, appreciate your insight. Overall health is OK. His right side is still weak but he can grasp things with his right hand which is a big improvement. He doesn't have pain and has regained some of his appetite. I asked Dr. Chamberlain's office about another try at the MGMT and they said there is not enough tissue. Given my Dad's age (63) it's highly likely that he is unmethylated. I think I have to work off of that assumption. We'll continue with the cocktail and Avastin. I have ordered HonoPure today. Hadn't heard of that one before. I'll have to read about it.

  4. My support for honokiol in combination with Avastin comes from a mouse study that combined it with radiation. Honokiol inhibited hypoxia inducible factor 1a (HIF-1a), which is upregulated in response to radiation, and also Avastin.

    It has also shown efficacy in mouse models of glioma.

    1. Hi Stephen, do you know the estimated dosage for honokiol? Thanks!

    2. On the HonoPure label it says 2-4 capsules 1-4 times daily for cellular health. Each capsule is 250mg. I've suggested 2 capsules twice daily as starting dose (1000 mg per day), but this isn't based on any human evidence.