Another Surgery

We met with the neurosurgeon on Tuesday and discussed the MRI. Since his last scan 2 months ago, there is a new small 6mm metastatic nodule in the right orbital surface of the frontal lobe. Additionally he pointed out that there is an increase in growth in the postsurgical cavity. The smallish markings that have been present since the surgery (and have been stable for the last year) were presumed to be "scarring", but this new and sudden growth is indicative of a recurrence.
He explained the new growth is in a fairly insignificant region of the brain. The left part of the orbital surface of the frontal lobe controls primarily "higher cognitive functions" and the right side is the "back-up" for the left side. It is highly unlikely for tumors in this region to cause any seizures or physical/mental impairments other than the effects it causes by getting larger and putting pressure on the brain in general. However the area where the recurrence is (right side frontal lobe) will most likely cause seizures (as we saw last year) and could affect control of left side of his body. So it was determined that Kev should have surgery to remove the recurrence (scheduled for June 25) and a month later will have stereotactic radiosurgery (which is a very precise delivery of radiation) on the new growth. If the stereotactic radiosurgery is not effective (determined by stabilization at 6 months post treatment) then a real surgery will be scheduled. It is felt that we have more time with the new growth to try a less intrusive procedure first, before resorting to "brain surgery".
Additionally, the neurosurgeon offered to remove a larger tumor (approx 3cm) in Kev's neck at the same time as the recurrence. It's not necessarily causing him any problems now but could present eating/breathing issues if it started to grow quickly.
Tomorrow (Friday) Kev get his 2nd weeks treatment of Abraxane as part of his 4th cycle.