After Angela's surgery on July 27, she was declared to be in deep coma. July 30, 2009 at 08:45 PM, Angela gave up...
My niece's journey was short yet full of wonderful memories and lessons we have learned. Angela taught us to smile inspite of all the pain, to laugh inspite of fears... to be strong in facing the reality of life.
Thank you for sharing wonderful moments with us, mornings will never be the same without you...
Now, its our turn to be strong in facing our daily lives without you..
I know your watching over us while your sitting next to the Big Guy, anak, please tell God to help us move on and accept this reality.
I Love You, We will Miss You....
Monday, August 10, 2009
Wednesday, July 29, 2009
July 26, 2009
My sister said Ela wants to see us all, so we went there to visit. I brought along Kuya Gilbert, Mac, my little brother and his Girlfriend Jona, Elmer and my little Margaux. Mari was there when we arrived, she said she is about to donate blood and that they are expecting Cai to come and do the same too. I was honestly hesitant about givng out blod because needle is one of my biggest fear, but i realized that Ela is about to undergo more painful procedure and so after I was screened, i donated blood for her. It was raining hard that day, we got home very late.
Monday, July 13, 2009
July 13, 2009: Angela's MRI
Monday noon, she was scheduled for MRI and the resutl will be available the next day at 5PM, hope it will bring good news. I couldnt visit her to the hospital because I am spending time with my daughter who stayed with my inlaws for 2 weeks (i missed her soo much).
We continue to pray for better result, thanks to my workmate Mark Rolvin Javier for listing Angela for mass intention last Sunday.
Angela misses home and wants to leave the hospital. Sunday (July 12) she called from the hospital and wants to talk to her cousins, i can feel her desire to go home, I mean.. there's not much to do in the hospital, no TV's radio and cellphone charging is not allowed, so she couldnt play on the cellphone 'cause they're saving the battery charge for phone calls and texting. Mom brought her some coloring books, crayons and and a "brick game" to play with but she already got bored with those. When I was there for two days, we did some coloring, played with the brick game, play some dolls, i put her on the wheelchair and walk around the hospital and the goes back to bed.
I hope the doctor will just say "she'll undergo radiotheraphy" and not another surgery, i know, i saw her before when she was sent to the ICU after her surgery,and i don't to see that again and I know nobody wants that, I know Angela don't want that too... Let it be just "radiotheraphy"
We continue to pray for better result, thanks to my workmate Mark Rolvin Javier for listing Angela for mass intention last Sunday.
Angela misses home and wants to leave the hospital. Sunday (July 12) she called from the hospital and wants to talk to her cousins, i can feel her desire to go home, I mean.. there's not much to do in the hospital, no TV's radio and cellphone charging is not allowed, so she couldnt play on the cellphone 'cause they're saving the battery charge for phone calls and texting. Mom brought her some coloring books, crayons and and a "brick game" to play with but she already got bored with those. When I was there for two days, we did some coloring, played with the brick game, play some dolls, i put her on the wheelchair and walk around the hospital and the goes back to bed.
I hope the doctor will just say "she'll undergo radiotheraphy" and not another surgery, i know, i saw her before when she was sent to the ICU after her surgery,and i don't to see that again and I know nobody wants that, I know Angela don't want that too... Let it be just "radiotheraphy"
Tuesday, July 7, 2009
Desperately in need of any help you can extend to my niece Angela
Angela Melvinne or "Ela" is the only daughter of my older sister Marianne, a single parent, and they both are living with my parents. Ela is now 9 years old, when she was 6, she was diagnosed with Medulloblastoma, a malignant central nervous system tumor of childhood. We don't know how she got it, we just noticed that she often cries for severe headache, starts to vomit and has double vision.
SideStory: Our home was devastated by the typhoon Milenyo before this happened, my lil brother forced to stop college because of this.
December 28, 2006.Yeah, it was my birthday, if I remember it right when she was admitted to St. Luke's. We celebrated her birthday at the Hospital (December 29) and I brought her favorite cake (SansRival) to celebrate it was late when I found out that she is not allowed to eat in preparation for her operation. On December 31, 2006, she was in the operating room, I remember, calling friends in the middle of the night to call hospitals who may have Ela's blood type A+ because doctor's said she's running out of some. Thank you to the HSN folks who did text birgades to help us out, for those who dropped by for blood testing, specially my bestest friend Janeth. She called ups some hospitals and told me that UMC have it. While everyone is celebrating New Year, we were there hoping and praying for the success of the operation. Thanks God it was, she was then transferred to the ICU and man, I was crying while I was lookign at her. Her tiny body with tubes all over, she couldn't move nor speak. When she was finally released, she underwent RadioTherapy and it was supposed to be followed up by ChemoTherapy but we don't have ways how we can support such medication. After this, my sister Marianne couldnt come to work until she resigned and had difficulty finding for a new one because her daughter need most of her time.
Note: Assistance we got from former Rosario Cavite Mayor Renato Abutan, we also got Php 9,000 fromPCSO, our 13th month pay, donations and loans everywhere.
Days, weeks, months passed, still we can't afford to give her Chemotherapy. We know for a fact that she really needs it but where in the world can we find the money to expense for it (around 50K/session and she needs more that 10). May 2008, she started vommitting and experience severe headache. There was also one time when she complains that she couldnt see anymore. I couldnt forget that day, it was evening, Ela was in bed, she was crying, screaming "nasaan kayo.. wala akong makita..." and we were all there, helpless, just crying and just gave her Mefenamic to releieve her pain and tuck her to sleep. The next day we are all restless, walking around looking for anyone who can lend us money. Together with my mother, they went to "Bantay Bata" hoping that they can get antyhing from that charity. While they are waiting, Ela starts to vomit and complains for headache. The nearest hospital there was PCMC, she was admitted right there and then. I don't know how but we managed to survive medications and her operation. Yes, she had another surgery. Surprisingly, her NeuroSurgeon in St. Luke's was the same surgeon who took care of her, Dra. Sy. After the successfull operation, again, we were advised that Ela should undergo Chemotherapy. We tried but we don't know how, where we can get that amount of money.
SideStory: House is still devastated, my father's ATM is pawned, my brother got scholarship for college but still couldnt go to school because we don't know if we can support at least his daily allowance. I am taking most part of their daily expenses.
Days, weeks, months passed, still we can't afford to give her Chemotherapy. We know for a fact that she really needs it but where in the world can we find the money to expense for it (around 50K/session and she needs more that 10). Last week, to our greatest fear, symptoms starts to show again. Just today, we sent her to PCMC for a check-up but her doctor strongly suggest to admit her and prepare her for MRI.
SideStory: House still devastated, my lil brother starts to take short course for Welding (hope we can financially support him all the way through as he plans to work abroad after), Marianne got a call and started her Training last Monday. Today, after her Training she went straight to the Hospital, the money I was saving for my daughter was withdrawn, ATM is still pawned.
We are hoping for the the best, holding tight on our faith, fighting together with her 'cause we see how Ela struggled and fought for surviving all these. I don't know if this is something that we can still take, but we still keep our faith.
SideStory: Our home was devastated by the typhoon Milenyo before this happened, my lil brother forced to stop college because of this.
December 28, 2006.Yeah, it was my birthday, if I remember it right when she was admitted to St. Luke's. We celebrated her birthday at the Hospital (December 29) and I brought her favorite cake (SansRival) to celebrate it was late when I found out that she is not allowed to eat in preparation for her operation. On December 31, 2006, she was in the operating room, I remember, calling friends in the middle of the night to call hospitals who may have Ela's blood type A+ because doctor's said she's running out of some. Thank you to the HSN folks who did text birgades to help us out, for those who dropped by for blood testing, specially my bestest friend Janeth. She called ups some hospitals and told me that UMC have it. While everyone is celebrating New Year, we were there hoping and praying for the success of the operation. Thanks God it was, she was then transferred to the ICU and man, I was crying while I was lookign at her. Her tiny body with tubes all over, she couldn't move nor speak. When she was finally released, she underwent RadioTherapy and it was supposed to be followed up by ChemoTherapy but we don't have ways how we can support such medication. After this, my sister Marianne couldnt come to work until she resigned and had difficulty finding for a new one because her daughter need most of her time.
Note: Assistance we got from former Rosario Cavite Mayor Renato Abutan, we also got Php 9,000 fromPCSO, our 13th month pay, donations and loans everywhere.
Days, weeks, months passed, still we can't afford to give her Chemotherapy. We know for a fact that she really needs it but where in the world can we find the money to expense for it (around 50K/session and she needs more that 10). May 2008, she started vommitting and experience severe headache. There was also one time when she complains that she couldnt see anymore. I couldnt forget that day, it was evening, Ela was in bed, she was crying, screaming "nasaan kayo.. wala akong makita..." and we were all there, helpless, just crying and just gave her Mefenamic to releieve her pain and tuck her to sleep. The next day we are all restless, walking around looking for anyone who can lend us money. Together with my mother, they went to "Bantay Bata" hoping that they can get antyhing from that charity. While they are waiting, Ela starts to vomit and complains for headache. The nearest hospital there was PCMC, she was admitted right there and then. I don't know how but we managed to survive medications and her operation. Yes, she had another surgery. Surprisingly, her NeuroSurgeon in St. Luke's was the same surgeon who took care of her, Dra. Sy. After the successfull operation, again, we were advised that Ela should undergo Chemotherapy. We tried but we don't know how, where we can get that amount of money.
SideStory: House is still devastated, my father's ATM is pawned, my brother got scholarship for college but still couldnt go to school because we don't know if we can support at least his daily allowance. I am taking most part of their daily expenses.
Days, weeks, months passed, still we can't afford to give her Chemotherapy. We know for a fact that she really needs it but where in the world can we find the money to expense for it (around 50K/session and she needs more that 10). Last week, to our greatest fear, symptoms starts to show again. Just today, we sent her to PCMC for a check-up but her doctor strongly suggest to admit her and prepare her for MRI.
SideStory: House still devastated, my lil brother starts to take short course for Welding (hope we can financially support him all the way through as he plans to work abroad after), Marianne got a call and started her Training last Monday. Today, after her Training she went straight to the Hospital, the money I was saving for my daughter was withdrawn, ATM is still pawned.
We are hoping for the the best, holding tight on our faith, fighting together with her 'cause we see how Ela struggled and fought for surviving all these. I don't know if this is something that we can still take, but we still keep our faith.
Medullobalstoma.. Help my niece win this battle
What is a medulloblastoma?
Medulloblastoma is the most common malignant central nervous system tumor of childhood. It accounts for 15-20 percent of pediatric brain tumors. These tumors are located in the cerebellum, the part of the brain that controls balance and other complex motor functions. Within the cerebellum, medulloblastomas are most often seen in the region of the fourth ventricle/vermis, or the central part of the cerebellum, and less frequently they arise within the cerebellar hemispheres.
As you read further below, you will find general information about medulloblastoma.
What causes a medulloblastoma?
There are no identified predisposing factors that lead to the development of medulloblastomas. Current research is focusing on understanding some of the possible genetic pathways that may be involved in the development of medulloblastomas, because there are rare genetic conditions in which medulloblastomas may arise with a slightly increased frequency.
What are the symptoms of a medulloblastoma?
The following are the most common symptoms of a medulloblastoma, however each child may experience symptoms differently. Medulloblastomas have a peak incidence between the ages of 3 and 8 but can be seen anywhere from the newborn/infant up into adulthood. Common symptoms may include:
increased pressure within the brain. These symptoms include:
headache (generally upon awakening in the morning)
vomiting
fatigue
lethargy
The duration of these symptoms is relatively short, up to several weeks, and often children are diagnosed with the "flu" or a viral illness.
imbalance and lack of coordination
a neck tilt or double vision
rarely, medulloblastomas spread within the nervous system and/or within the spinal canal, causing loss of strength in the lower extremities or significant back pain
The symptoms of a brain tumor may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
How is a medulloblastoma diagnosed?
Diagnostic procedures for a medulloblastoma may include:
neurological exam -a test of reflexes, muscle strength, eye and mouth movement, coordination, and alertness
computerized tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. CT scans are more detailed than general x-rays. For medulloblastoma, a CT scan of the brain is done.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. For medulloblastoma, MRIs of the brain and spine are performed. It is important to obtain a spine MRI prior to surgery to evaluate the extent of disease and the presence/absence of spread of the tumor within the nervous system. This information helps determine the initial management of this tumor.
7 magnetic resonance spectroscopy (MRS) - a test done along with MRI at specialized facilities that can detect the presence of particular compounds produced by the body's metabolism within sample tissue that can identify tissue as normal or tumor, and may be able to distinguish between different types of brain tumors.
magnetic resonance spectroscopy (MRS) - a test done along with MRI at specialized facilities that can detect the presence of particular compounds produced by the body's metabolism within sample tissue that can identify tissue as normal or tumor, and may be able to distinguish between different types of brain tumors.
biopsy - in rare cases, a tissue sample from the tumor will be taken through a needle during a simple surgical procedure performed by a surgeon to confirm the diagnosis.
A lumbar puncture, or spinal tap, is never performed in patients with medulloblastoma because such a procedure can lead to catastrophic deterioration in the child's condition.
What are the treatments for medulloblastoma?
Specific treatment for a medulloblastoma will be determined by your child's physician based on:
your child's age, overall health, and medical history
type, location, and size of the tumor
extent of the disease
your child's tolerance for specific medications, procedures, or therapies
how your child's doctors expects the disease to progress
your opinion or preference
Ventriculoperitoneal shunt (click to enlarge)Treatment may include (alone or in combination):
ventriculoperitoneal shunt (also called a VP shunt) - a bypass, usually a type of tubing, that is placed in the head to drain excess cerebrospinal fluid (CSF) from inside the brain to space in the abdomen. A VP shunt helps control the pressure inside the brain. On rare occasions, it may be necessary to place a shunt or some other drain to relieve intracranial pressure prior to operating on the tumor. This is indicated in situations when the children are experiencing extreme symptoms from intracranial pressure problems and awaiting definitive surgery, which should be performed on an emergency basis.
surgery - the goals of surgery are to establish a diagnosis, relieve hydrocephalus (swelling on the brain) and remove the tumor. It has been shown through national studies that outcome is correlated with the degree of removal, and therefore an attempt is made to completely remove the tumor, without compromising the child's neurologic function.
Following surgery, lumbar puncture is performed to determine the presence/absence of tumor cells in the spinal fluid, which determines the grade of disease. An MRI of the brain will also be obtained to assess the degree of surgical removal. Typically, medulloblastomas are divided into three groups: infants (children under the age of 3), standard risk (no evidence of disease outside of the posterior fossa of the brain with a complete removal of the tumor) and high risk (evidence of incomplete removal or tumor spread elsewhere in the nervous system). Further treatment is then determined upon the grade of tumor.
radiation therapy and chemotherapy - radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors. Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it is being used to treat.
While chemotherapy can be quite effective in treating certain cancers, the agents do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help the care team, parents, and child prepare, and, in some cases, prevent these symptoms from occurring, if possible. Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill cancer cells. Chemotherapy can be given:
as a pill to swallow
as an injection into the muscle or fat tissue
intravenously (directly to the bloodstream; also called IV)
intrathecally - chemotherapy given directly into the spinal column with a needle
Children with standard risk medulloblastoma are treated with craniospinal irradiation (radiation to the brain and entire spine) over a course of 4-6 weeks. This is followed by chemotherapy.
Children with high-risk medulloblastoma are treated with pre-irradiation chemotherapy followed by craniospinal irradiation, then more chemotherapy.
Infants are treated with chemotherapy until they reach the age of 3 at which time craniospinal irradiation is offered and given.
Throughout their therapy, children are monitored closely by their caregivers with frequent neurologic evaluations and routine MRIs of the brain and spine to monitor response to therapy. A multi-disciplinary team consisting of a neurosurgeon, neuro-oncologist, radiation therapist and neurologist coordinate the management of children with medulloblastoma. In addition to these physicians, there are specialized nurses and social workers that are part of the team managing the child's care. Post-operative care also involves closely physical, occupational and speech therapists.
Post-operatively some children may have difficulties related to coordination, weakness in their extremities and imbalance. These typically resolve over a course of several weeks with the help of physical and occupational therapy. A rare complication is that of "posterior fossa mutism" where children will awake from surgery appearing well but within 24 hours will develop an inability to speak and difficulty with swallowing. This is often associated with large tumors and recovers over several weeks up to several months. In approximately 15 percent of the children diagnosed with medulloblastoma hydrocephalus may develop, requiring the placement of a shunt to drain spinal fluid into the peritoneal cavity.
What is the expected outcome after treatment for medulloblastoma?
The outcome for children with medulloblastoma has improved dramatically over the past several decades. Children with standard risk medulloblastoma have an expected 5-year survival of 65-80 percent. For high-risk medulloblastoma, that number is slightly lower, at 60 percent 5-year survival. The results in infants are disappointing and many studies are being performed to evaluate treatment strategies in infants that will improve overall outcome. Some include administering aggressive chemotherapy and only local irradiation of the posterior fossa to minimize the deleterious effects of radiation on the developing brain.
The long-term effects of treatment include hearing loss related to chemotherapy, loss of height secondary to the radiation and, in some patients, endocrine dysfunction from irradiation of the pituitary gland/hypothalamus. In some patients, secondary tumors (most often high-grade gliomas) develop in areas of the body that received radiation therapy, usually 8-12 years after treatment. The follow-up of patients with medulloblastoma consists of yearly evaluations by the multidisciplinary team with detailed physical and neurologic examinations, audiologic evaluations, endocrine assessments, neuropsychologic testing and MRIs.
What about progressive or recurrent disease?
In the case of relapse, there has not been shown to be an effective curative therapy. However, radiosurgery and chemotherapy are used which can provide long-term comfort with few side effects.
Medulloblastoma is the most common malignant central nervous system tumor of childhood. It accounts for 15-20 percent of pediatric brain tumors. These tumors are located in the cerebellum, the part of the brain that controls balance and other complex motor functions. Within the cerebellum, medulloblastomas are most often seen in the region of the fourth ventricle/vermis, or the central part of the cerebellum, and less frequently they arise within the cerebellar hemispheres.
As you read further below, you will find general information about medulloblastoma.
What causes a medulloblastoma?
There are no identified predisposing factors that lead to the development of medulloblastomas. Current research is focusing on understanding some of the possible genetic pathways that may be involved in the development of medulloblastomas, because there are rare genetic conditions in which medulloblastomas may arise with a slightly increased frequency.
What are the symptoms of a medulloblastoma?
The following are the most common symptoms of a medulloblastoma, however each child may experience symptoms differently. Medulloblastomas have a peak incidence between the ages of 3 and 8 but can be seen anywhere from the newborn/infant up into adulthood. Common symptoms may include:
increased pressure within the brain. These symptoms include:
headache (generally upon awakening in the morning)
vomiting
fatigue
lethargy
The duration of these symptoms is relatively short, up to several weeks, and often children are diagnosed with the "flu" or a viral illness.
imbalance and lack of coordination
a neck tilt or double vision
rarely, medulloblastomas spread within the nervous system and/or within the spinal canal, causing loss of strength in the lower extremities or significant back pain
The symptoms of a brain tumor may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
How is a medulloblastoma diagnosed?
Diagnostic procedures for a medulloblastoma may include:
neurological exam -a test of reflexes, muscle strength, eye and mouth movement, coordination, and alertness
computerized tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. CT scans are more detailed than general x-rays. For medulloblastoma, a CT scan of the brain is done.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. For medulloblastoma, MRIs of the brain and spine are performed. It is important to obtain a spine MRI prior to surgery to evaluate the extent of disease and the presence/absence of spread of the tumor within the nervous system. This information helps determine the initial management of this tumor.
7 magnetic resonance spectroscopy (MRS) - a test done along with MRI at specialized facilities that can detect the presence of particular compounds produced by the body's metabolism within sample tissue that can identify tissue as normal or tumor, and may be able to distinguish between different types of brain tumors.
magnetic resonance spectroscopy (MRS) - a test done along with MRI at specialized facilities that can detect the presence of particular compounds produced by the body's metabolism within sample tissue that can identify tissue as normal or tumor, and may be able to distinguish between different types of brain tumors.
biopsy - in rare cases, a tissue sample from the tumor will be taken through a needle during a simple surgical procedure performed by a surgeon to confirm the diagnosis.
A lumbar puncture, or spinal tap, is never performed in patients with medulloblastoma because such a procedure can lead to catastrophic deterioration in the child's condition.
What are the treatments for medulloblastoma?
Specific treatment for a medulloblastoma will be determined by your child's physician based on:
your child's age, overall health, and medical history
type, location, and size of the tumor
extent of the disease
your child's tolerance for specific medications, procedures, or therapies
how your child's doctors expects the disease to progress
your opinion or preference
Ventriculoperitoneal shunt (click to enlarge)Treatment may include (alone or in combination):
ventriculoperitoneal shunt (also called a VP shunt) - a bypass, usually a type of tubing, that is placed in the head to drain excess cerebrospinal fluid (CSF) from inside the brain to space in the abdomen. A VP shunt helps control the pressure inside the brain. On rare occasions, it may be necessary to place a shunt or some other drain to relieve intracranial pressure prior to operating on the tumor. This is indicated in situations when the children are experiencing extreme symptoms from intracranial pressure problems and awaiting definitive surgery, which should be performed on an emergency basis.
surgery - the goals of surgery are to establish a diagnosis, relieve hydrocephalus (swelling on the brain) and remove the tumor. It has been shown through national studies that outcome is correlated with the degree of removal, and therefore an attempt is made to completely remove the tumor, without compromising the child's neurologic function.
Following surgery, lumbar puncture is performed to determine the presence/absence of tumor cells in the spinal fluid, which determines the grade of disease. An MRI of the brain will also be obtained to assess the degree of surgical removal. Typically, medulloblastomas are divided into three groups: infants (children under the age of 3), standard risk (no evidence of disease outside of the posterior fossa of the brain with a complete removal of the tumor) and high risk (evidence of incomplete removal or tumor spread elsewhere in the nervous system). Further treatment is then determined upon the grade of tumor.
radiation therapy and chemotherapy - radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors. Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it is being used to treat.
While chemotherapy can be quite effective in treating certain cancers, the agents do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help the care team, parents, and child prepare, and, in some cases, prevent these symptoms from occurring, if possible. Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill cancer cells. Chemotherapy can be given:
as a pill to swallow
as an injection into the muscle or fat tissue
intravenously (directly to the bloodstream; also called IV)
intrathecally - chemotherapy given directly into the spinal column with a needle
Children with standard risk medulloblastoma are treated with craniospinal irradiation (radiation to the brain and entire spine) over a course of 4-6 weeks. This is followed by chemotherapy.
Children with high-risk medulloblastoma are treated with pre-irradiation chemotherapy followed by craniospinal irradiation, then more chemotherapy.
Infants are treated with chemotherapy until they reach the age of 3 at which time craniospinal irradiation is offered and given.
Throughout their therapy, children are monitored closely by their caregivers with frequent neurologic evaluations and routine MRIs of the brain and spine to monitor response to therapy. A multi-disciplinary team consisting of a neurosurgeon, neuro-oncologist, radiation therapist and neurologist coordinate the management of children with medulloblastoma. In addition to these physicians, there are specialized nurses and social workers that are part of the team managing the child's care. Post-operative care also involves closely physical, occupational and speech therapists.
Post-operatively some children may have difficulties related to coordination, weakness in their extremities and imbalance. These typically resolve over a course of several weeks with the help of physical and occupational therapy. A rare complication is that of "posterior fossa mutism" where children will awake from surgery appearing well but within 24 hours will develop an inability to speak and difficulty with swallowing. This is often associated with large tumors and recovers over several weeks up to several months. In approximately 15 percent of the children diagnosed with medulloblastoma hydrocephalus may develop, requiring the placement of a shunt to drain spinal fluid into the peritoneal cavity.
What is the expected outcome after treatment for medulloblastoma?
The outcome for children with medulloblastoma has improved dramatically over the past several decades. Children with standard risk medulloblastoma have an expected 5-year survival of 65-80 percent. For high-risk medulloblastoma, that number is slightly lower, at 60 percent 5-year survival. The results in infants are disappointing and many studies are being performed to evaluate treatment strategies in infants that will improve overall outcome. Some include administering aggressive chemotherapy and only local irradiation of the posterior fossa to minimize the deleterious effects of radiation on the developing brain.
The long-term effects of treatment include hearing loss related to chemotherapy, loss of height secondary to the radiation and, in some patients, endocrine dysfunction from irradiation of the pituitary gland/hypothalamus. In some patients, secondary tumors (most often high-grade gliomas) develop in areas of the body that received radiation therapy, usually 8-12 years after treatment. The follow-up of patients with medulloblastoma consists of yearly evaluations by the multidisciplinary team with detailed physical and neurologic examinations, audiologic evaluations, endocrine assessments, neuropsychologic testing and MRIs.
What about progressive or recurrent disease?
In the case of relapse, there has not been shown to be an effective curative therapy. However, radiosurgery and chemotherapy are used which can provide long-term comfort with few side effects.
Monday, July 6, 2009
Music Lovers
Folks... I suggest you visit www.tonetsdaily.com and get the chance to listen to good music. It caters good sets of playlists that suits your mood. I personally like the "easy Listening" playlist, in fact, i downloaded the whole playlist in my computer and i keep it playing while at work.
...let's keep the music playing!!!
...let's keep the music playing!!!
Monday, June 29, 2009
Ask her out
My husband's call woke me up last Saturday afternoon (while he's at work), he's asking me out to watch Transformers and I said "no." Sunday afternoon, he called again and asked the same question.. this time I said yes. An girl, it feels so good!!!. It brings back the feelings when you are still Boyfriends/girlfriends.. Normally, married couples are having difficulty finding time to go out like when you are not yet wed. I am just so happy and lucky that my husband never changed. We are together for two years, you may think it's too early to say, but I am just amazed how things stayed the same.
Ask your wife out once in a while until it becomes your habit.... It will keep the fire burning...
BTW, TRANSFORMERS is an AWESOME movie, watch it!!! I just didnt like the part when Sam almost or died and the Primes talked to him.... watch it..
Ask your wife out once in a while until it becomes your habit.... It will keep the fire burning...
BTW, TRANSFORMERS is an AWESOME movie, watch it!!! I just didnt like the part when Sam almost or died and the Primes talked to him.... watch it..
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