Mason - MRI and Schedule

During the MRI, Dr. Gallie examined Mason's tumor.  Visually,  the tumor appears to have 'flattened' where there used to be a bulge.  One small area is still white, but the remainder of the tumor appears 'yellow.' These are good signs.

According to the MRI, the tumor really hasn't changed.

If you remember last visit - it was a battle between oncology and Rb specialists, and ultimately it was decided to begin the chemo immediately.  Now that the tumor is a little more stable, the oncology team would really like to know what kind of cancer they are up against, even though it is most likely Rb.  They want a DNA sample from the actual tumor.

Tomorrow, Mason will have this tumor biopsied.  The Dr.'s will not be removing the entire tumor, but they will take a small sample.  This will help them determine the DNA of this tumor and how best to fight it.


It has been determined that Mason will undergo 5 rounds of chemo, and after those 5 rounds he will have a stem cell transplant (bone marrow transplant).  Between rounds 2 and 3 of chemo, they will harvest the stem cells.  I will do my best to explain all this below.

Mason will begin chemo this coming Monday (11th)
Chemo will take 2 days.
Then he may return home...(13th)
He will return to Toronto around the 22nd to begin high dose shots of G-CSF (neupogen) which will boost his white blood cell counts. They need to be at their highest level in order to harvest the stem cells.

On the 25th they will insert a double line that will be used to harvest his stem cells.
Harvesting will begin the 26th (May take multiple days because he is so young and small).

Once the cells have been harvested, and his body is ready, he will then begin his next round of chemo (round 3), then he will continue on with rounds 4 and 5 (every 21 days).

Once the 5 cycles are completed, they will assess the tumor and see if it is dead.

Then, no matter what, they will do a stem cell transplant, or what the Dr. referred to as -
"the big blast".

The point of this "blast" is to wipe out any remaining molecules of cancer that may remain.  This is basically a round 6 of intense chemotherapy.  It includes 6 days of high dose chemotherapy intravenously.  The body's cells will be so wiped out, they will not be able to regenerate themselves, so this is when the harvested stem cells will be put back into Mason's body.  His body will not be able to fight infection at this stage.  Therefore, he will be in isolation for 14-21 days in the hospital.  Following that will be followups that require him to be here near the hospital.

So basically, the "blast" (round 6) will occur in about 4 months time, and they will remain there for the following few months.  (Just in time for Christmas)

If at this point there are any living cancer cells found, the plan is to do radiation as well.

This is serious.  Leslie came to grips with things last time, when they discovered the cancer was outside the eye cavity.  In her mind, she now thinks of it as - we are fighting for Mason's life.

Questions we had:

What is a stem cell transplant?
A stem cell transplant — also called a blood or marrow transplant — is the injection or infusion of healthy stem cells into your body to replace damaged or diseased stem cells.

How is the stem cell harvested?
The two most common ways to do this are:  
Peripheral blood stem cell harvest - or - Bone marrow harvest

(hoping for the first, not the latter!)

Peripheral blood stem cell harvest:

Three to five days before the harvest, Mason will be given daily injections of G-CSF.  This protein helps move the blood stem cells from the bone marrow space into the blood stream.

The doctor will also insert a temporary central venous line (CVL) into the femoral vein, which is the large vein in the thigh. This is called a femoral line catheter.

During the procedure

1. Blood is withdrawn from your CVL. In addition to stem cells, the blood contains many other types of cells, such as red blood cells, platelets, and white blood cells.
2. Your blood runs through the flexible tubing which is attached to a machine that separates out blood cells. This is called an apheresis machine. It separates the stem cells, while returning the rest of the blood back into your body. The entire procedure usually takes about four hours to complete.
3. The stem cells are mixed with a preservative called DMSO. The cells are then frozen at very low temperatures (cryopreserved), until the day of  transplant. (After 5th round of chemo in Mason's case)

Bone marrow harvest:

The procedure usually takes place in an operating room.

To take bone marrow cells:

1. The donor will be given a general anesthetic so he will not be awake during the procedure. 
2. The hips will be scrubbed with a disinfectant and the surrounding area covered or draped with sterile sheets.
3. The doctor inserts a needle through the skin until it touches the top of the hip bone.  This is the largest and uppermost bone in the pelvis and contains a large amount of bone marrow.
4. Once the needle touches the hip bone, the doctor pushes the needle through the hard outer layer of the hip bone and into the bone marrow space.
5. A syringe is then attached to the needle to draw out a small amount of the red liquid bone marrow. The physicians do multiple injections to collect enough of the bone marrow.

In Mason's case, he is still very young, and very small.  It would be difficult to collect enough cells this way.  It could possibly take up to 200+ pokes to harvest enough.

PRAYING ALL GOES WELL AND THE PERIPHERAL BLOOD STEM HARVEST IS THE ROUTE THAT WORKS FOR MASON!



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While all this has been going on, Luke just went in for his MRI.  
There is very little downtime for these guys...

Luke and Grandpa Grow

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We know there are a lot of natural remedies out there.  We've received many emails and we are happy for those of you that have tried this route and had success with your tumors.  Leslie and Richard feel confident in the Dr.'s that are treating their babies.  The chemo and stem cell transplant are to save Mason's life.  The cancer has spread outside the eye cavity.  If you feel a need to criticize the methods of treatment, please be empathetic to their already heavy hearts...and don't go there.  :)