Fighting the Dreaded Chemo Brain

Mai is a 66-year-old female diagnosed with IV NSCLC (with multiple large brain metastases) EGFR exon 19 deletion (C34.90). Mai experienced headaches, weight loss, nausea, and vomiting. A very recent CT scan revealed multiple brain metastases, which are large, and throughout the cerebral hemisphere including both of the cerebellums. Mai is being treated with radiation, decradron and high-dose steroids, but still experienced disease progression. The denial states that Mai must try to fail Tarceva, Iressa and Gilotrif, however due to the highly acute, tumor burden brain metastases, with Tagrisso as a front-lien treatment it will actively fight against exon 19 deletion and more importantly, good CNS activity. Given these results of Tagrisso,

These benefits included finding a doctor in the area. Few weeks after discussing and researching with her family, she finally decided to see the doctor. Mrs. Sofia then had to make an appointment with the doctor in order to do her physical and health history. During her physical exam, the doctor asked her if she does an annual self-breast exam once a month. Mrs. Sofia told the doctor that she never checks her breast and she do not know how to do a self-breast exam. Upon physical assessment the doctor found a large lump in Mrs. Sofia’s breast. The doctor orders a diagnostic mammogram that shows that the area of abnormal tissue (lesion) is more skeptical and a biopsy should be done in order to determine if it is

Neuro-Oncology is the study of cancer in the brain, skull base, or spinal cord. They can also treat genetic disorders of a certain type such as Neurofibromatosis. Neurofibromatosis is tumors that grow in the nervous system that is caused by a genetic disorder. The main purpose of the research was to gain information on Neuro- oncology, general information on brain tumors, and general information on specific tumor types. Central nervous system tumors include various gliomas such as glioblastoma multiforme, astrocytoma, brainstem glioma, ependymoma, and oligodendroglioma. Furthermore, meningioma and vestibular schwannomas. Other conditions neuro-oncologist can treat are central nervous system lymphoma, metastic disease to the spine

Brain cancer develops from cells within the brain. The brain controls the vital functions of the body, including, speech, movement, thoughts, feelings, memory, sight, hearing, and more. Brain cancer affects people in many different ways. Brain cancer is diagnosed at the local stage in 76.6% of people. The 5-year survival for localized brain and other nervous system cancer is 36.3%. Brain cancer will cause anything from headaches to balance and walking problems, changes in your vision, muscle twitches, memory problems, and nausea and vomiting.

To say that this incident was the defining moment as to why I chose medicine would be an exaggeration, but it had undoubtedly been an affirmation of my decision. To embark on a career in Medicine was not an easy decision, and it was certainly not something that I had aspired to be from a young age. In fact, it took nearly half a decade of careful consideration and exploration before I reached this conclusion. My motivation to become a doctor stems not only from my love for science, but also from the special connection that is established between a patient and a doctor during diagnosis and consultation. The opportunity for devoting a lifetime to alleviating illnesses stands as my inspiration. I believe that there is no other profession that can be compared to one which utilizes one’s acquired abilities to bring about a more immediate impact on someone’s life, just as this experience had

The American Cancer Society states that a common side effect of Chemotherapy is “Chemo Brain”. It is defined as the mental cloudiness that is caused by unknown factors in the treatment. Examples of it include trouble concentrating, short attention span, remembering details,  slow thinking and processing, and trouble remembering common words. Chemotherapy patients can have Chemo brain from the time treatment begins and can continue for years after which can prevent the patient from doing mental strenuous activities like going to school or work.

Sitting in the waiting room at the doctor’s office, 7-year-old me swung my feet back and forth under the generic, time-worn furniture and anxiously wrung my sweaty palms. I’d been to the doctor’s before, but with each returning yearly visit the dread that sunk to the bottom of my gut never shrunk. “Jillianne Carrasco?” The nurse called. My stomach turned. I began to shoot my mother a pleading look, but she wasted no time in grabbing my hand and leading me to the smiling nurse waiting at the door, and we both followed her through the pasty white halls to a customary exam room. The nurse closed the door behind us and asked me to take a seat on the crinkly tissue paper cot. She smiled warmly, likely taking note of my nervous breathing and shaky hands.

“Hello. I will need you to fill out these papers and turn them in and the doctor will be ready in a minute.” The receptionist said. My mom, dad, and I sat down in the quiet waiting room as my mom filled out the papers I began to fell more

Lying in the hospital bed, scratchy sheets gathered at my torso and a needle that could be hooked up to an IV was stuck into the bend of my elbow. I was looking out the door to the hall, watching the other kids in the pediatric ward that were not bedbound dress up in colorful costumes and hold a various assortment of items, most of them carrying small baskets or pillowcases as they went to the various nurse’s stations, calling out the ever cheerful “Trick or treat!” Before moving down the hall. I could not have been much older than four, watching the kids that were roughly the same age as I, pass through the hallways with small bags of candy. My mom came to me, a small pink bunny costume in her hands. I got dressed in the outfit quickly, eager to roam about the halls in my mom’s arms, to talk with the nurses and to get little fun sized candy packages. Each nurse that I came up to greeted me as though they had known me for my whole life, and for many of them it was true. I was in and out of the hospital when I was much younger, My illness had been discovered about the time I turned two months, I had a surgery called a Kasai procedure almost immediately after. The surgery allowed my body to drain the bile my liver produces into my intestines so that the buildup of bilirubins doesn't cause liver damage.

All personal information has been changed and there are no identifiers that could reveal the location of the two hospitals and the staff that took care of this patient to protect the confidentiality of all involved. Adele is a seventy-two year old wife, mother of five, and grandmother of ten. Adele is happily retired and lives on a large acreage with her husband Ron and their dog Perky. Adele

After seeing several patients the team finally went in to see my eighty-three year old female who was in the hospital after suffering an ischemic stroke. As always I went in prepared: I had read about ischemic strokes, brushed up on my pathophysiology and was ready to make suggestions about what further work-up would be necessary! Our team, which was made up of a pharmacist, social worker, two geriatric fellows, and an attending geriatrician, all filed into the room as we did every day for rounds. However, instead of talking about the tests that we would run today and the lab results that had returned this morning, we all looked at each other and began to sing “Happy Birthday.” The patient’s face lit up and I remember feeling this overwhelming sense of happiness. Yes, I had arrived at the hospital before the sun was up, and tucked in my white coat was my perfectly crafted plan, which I was prepared to recite chapter and verse, but instead there we were a team of healthcare professionals, all singing. As I stood there singing I looked around the room and I was overcome with relief; because in that moment I knew these were the type of people I wanted to sit with at the lunch

     My mom drove me to what would become my last visit to the doctor’s office before giving birth to my daughter. Dr. Dermer observed me and then told me to be at the hospital around six thirty that evening. He advised me to eat a good dinner before departing for the hospital. Dr. Dermer had decided to induce my labor, due to the fact that I was two weeks past my due date.

The brain is made up of millions upon millions of cells. These cells are formed from before birth, up until about 7 years old. Once these brain cells stop dividing, they are never meant to divide again. You can see that the division of brain cells is under strict regulation and control. When this control is lost in a single cell, then it starts dividing in an uncontrolled manner. All of the data obtained through research on cancer shows that this disease is caused by a rapidly dividing cell, with no regulators to stop it from dividing. As the cell makes more and more copies of itself, it grows to form a tumor. This is known as cancer.

My doctor explained that there wouldn’t be any way to know if the cyst was cancerous until she operated. This was another shock to me; I’d be going under the knife! That freaked me out! I had never needed surgery before so a variety of scenarios were zipping through my head. The only way the doctors could see if the cyst was cancerous was to get a sample which would happen during removal in surgery. My dad, unlike me, was keeping his composure pretty well. Without surprise, he immediately had questions.

“Miss, may I speak to you for a moment in private,” the handsome thirty one year old doctor asked. He was the same oncologist from five months ago, and I could tell by the expression on his face this was not good news. I stared at him, opening my mouth slowly but nothing came out. My head nodded. This was it.