Tuesday April 17, Information Overload

We got Ingram's pathology report today, after ten days of torturous waiting.  He also had a full day at St. Jude again, having an MRI, a lumbar puncture, and an echocardiogram.  The results are somewhat mixed but net-net we are encouraged.  The most important piece of the report is that he tested negative for a 1Q gain, a chromosomal marker that is indicative of the hardest ependymoma to cure.  Furthermore, it appears that the surgeons were able to totally resect the tumor which is one of the really important determinants of success; and, there are no cells in the spine or spinal fluid according to today’s lumbar puncture.  There was one spot on the brain that the radiologists were concerned about but Dr. Klimo, Ingram’s neurosurgeon, said that it was unlikely to be the tumor.  The cells are aggressive according to the pathology report which is why they categorize it as Grade 3, anaplastic.  We already knew this but they confirmed it today.  Our treatment protocol involves six weeks of localized radiation and possibly four months of chemotherapy (we will know about chemotherapy next week).  We have discussed photon radiation (the traditional method) and proton beam therapy (a newer method) and have decided to use the photon method.  There are several reasons why.  One of them is that the radiation oncologist at St. Jude, Dr. Merchant, has treated more ependymomas than anyone in the country, as we understand it.   As he said, paraphrasing, “the type of gun may be less important than who is aiming it.”  In addition, there is too little empirical data on the long-term benefits of proton beam therapy over traditional radiation in children over three years old.  This is not to say that there is not a compelling argument to be made for proton beam, but we have decided that we prefer the risk-reward profile of photon at this point.  We have some significant decisions to make about his treatment over the next few days.  I am praying that God would give us clarity of mind and discernment.

All of this stuff is taking a toll on Ingram.  He is really tired and was unhappy with the doctors today who were trying to use his IV.  It looks like it is taking on toll on Ashley already also, based on the fact that she has fallen asleep on the couch tonight.  Ingram is pretty emotional right now and easily agitated.  Please pray that God would give his little body strength, and for discernment for all of the people involved in designing his treatment.  Please also pray that He would help us make wise decisions.

We are very blessed to live in Memphis and have St. Jude at our fingertips.  The doctors there are some, if not the, most respected in the world in the treatment of childrens’ cancer.  We have complete confidence that God is in control of this.  It is very reassuring to a father that I can rest knowing we have the best doctors available, and that I don’t have to go out searching for the best treatment for my son. 

Thank you all for your continued prayers and messages.   Craig     



Tired of It All.