Results of today's consultation

The consultant we saw today is a radiotherapy specialist with particular interest in skin and brain lesions, so could hardly be more appropriate for the current situation.

We first looked at the MRI results; of the six visible tumours the largest are in areas of the brain affecting speech, the sight of one eye, and emotions/personality. What effects these could have in combination doesn't bear thinking about, although some of you may think I've had them for years:-). I am currently symptom-free, and the size of the lesions is relatively small, which hopefully means we have caught them early.

We then discussed four treatment options:

1. Do nothing
2. Whole brain radiotherapy
3. High power, localised stereotactic radiotherapy or radiosurgery
4. A combination of options 2 and 3

Option 1: Do nothing

It is impossible to predict an outcome of doing nothing as any one of the brain lesions, or a fresh one elsewhere could develop.

Option 2: Whole brain

Because of the number of tumours present the odds are that others will develop in the same region. Whole brain treatment is the best way of preventing latent tumours from developing, but it only has a 50% success rate with larger lesions.

The main side-effects are hair loss and tiredness, which is occasionally extreme.

Option 3: Stereotactic radiosurgery

This is a relatively new form of treatment. It is available in Bristol under the NHS, but only for up to two tumours. This is because tumour numbers higher than this usually suggest that more will develop, and it is therefore not seen as cost-effective overall. I can but agree with this.

It is available privately at places such as the Cromwell in London, and also in Sheffield (although there it may be a similar but different technique called Gamma Knife radiosurgery.

Option 4: Combine options 2 and 3

I am very fortunate in having medical insurance, although 99% of my treatment to date has been NHS, and we cannot praise it too highly. We therefore decided to select this option, which will involve two week's daily treatment in Bristol, and to ask for an opinion at the Cromwell about the advisability of having option 3 thereafter. If we go ahead it is likely to start next week, and we will stay over in Bristol to cut down the impact of travelling.

We also asked at what point it would be appropriate to transfer to a centre nearer home, and discovered that Taunton will soon be staffed to cater for my needs. I intend to pursue this as the time, cost and wear and tear implications of travelling to Bristol are quite high.