Cracking The MRI Riddle

Tara and I at her cancer appeal night in October

Tara and I were sitting in her oncologist’s office this week for the latest MRI scan results. Looking on the computer screen there didn’t appear to be any tumour left in Tara’s brain. AWESOME. But… the actual MRI report says that there is some residual non-enhancing tumour there, which has “slightly less mass effect” than the last scan. What does this actually mean?

Less mass effect means that what’s left of Tara’s tumour is continuing to shrink. We took non-enhancing to mean ‘inactive’, but weren’t quite sure and, in our excitement, didn’t think to ask the oncologist in front of us for clarification. Tara has an excuse for the brain fade. I do not.

To clear things up I reached out to a friend who is a neuroradiologist (brain scan reading expert), to find out exactly how to decode the MRI report riddle. This is what Dr Frank had to say -

The term ‘non-enhancing tumour’ does not map exactly with ‘inactive tumour’ , as a non-enhancing tumour can grow. It is still likely that there are ‘viable’ tumour cells there, but they are not doing much.

Enhancing tumour is the one you need to be most worried about. It’s the one that grows rapidly and is difficult to control. Non-enhancing tumour is usually lower grade and more indolent in biological behaviour, sometimes remaining stable for many many years.

So in the scale of what you hope to see:

  1. no residual macroscopic tumour visible (best) — in many instances microscopic residual tumour is present even then
  2. non-enhancing tumour — not growing
  3. non-enhancing tumour — growing gradually
  4. non-enhancing tumour — developing areas of new enhancement
  5. enhancing tumour — not growing (uncommon unless you scan really frequently and can’t detect change)
  6. enhancing tumour — growing

So, Tara’s at #2 on the awesome scale. There’s good reason to be happy about this, and there’s also hope that the remaining cycle of chemotherapy will take us even closer to level 1 awesomeness.

Chemo itself has been a bit of a battle, but has not been as terrible as it is for a lot of people. The worst part is when the pills make Tara nauseous. When she does vomit I’m not allowed to clean it up, or even hold back her hair, because the spew is so toxic. I just stand by feeling about as useful as a bald man’s barber. Tara takes it like a trooper though. Apart from that, bouts of fatigue, sensitive skin, weakening enamel on her teeth and occasional trouble concentrating, things are tip top. She has managed to keep her hair, which is a bonus. After wrapping up this round of chemo, there’s one more ‘six week’ course to go. Considering frequent delays due to low platelets in Tara’s blood, it’s likely she’ll be finished around March 2017.

In the meantime, she’ll keep soldiering through, staying upbeat and looking forward to resuming a normal life, whatever that might be.

Thanks again for everyone’s support. You’ve all been nothing short of amazing.