Update 10.24.08

Yesterday Tom and I celebrated his first day after radiation by spending eight hours at Methodist (I was hoping for dinner at some overpriced bistro but alas…)

We met with Dr. Kew (Oncology) and Dr. Blacklock (Surgery) about Tom’s upcoming insertion of the Ommaya reservoir. Here is an edited summary based on answers.com.

The Ommaya reservoir is a plastic, dome–shaped device, with a catheter (thin tubing) attached to the underside used to deliver chemotherapy, in Tom’s case, to the cerebrospinal fluid (CSF). As the picture shows,



the CFS is created in the center of the brain and then flows through all the cracks and wrinkles in the brain providing lubrication, nutrients, and again in Tom’s case, possible little cancer cells. We must stop this from happening.

(Back to the article)
Chemotherapy may be administered to patients by various methods, depending on the type of cancer being treated. Some cancer types respond well to chemotherapy given by intravenous (IV) injection, and some cancer types may be treated with oral medication. In both cases, the chemotherapy reaches its target site systemically (carried by the blood). Cancers that affect the Central Nervous System (CNS) pose a special challenge. Systemically delivered drugs seldom reach the CNS because of a network of blood vessels that surround the brain. This protective shield is called the blood–brain barrier. It acts as a filtering device for the brain by blocking the passage of foreign substances from the blood to the CNS.

To avoid the obstacle created by the blood–brain barrier, alternative delivery treatments must be used. These treatments are collectively called intrathecal chemotherapy treatments. These treatments require injecting the chemotherapy directly into the cerebrospinal fluid (CSF). The CSF is the clear fluid surrounding the CNS. The Ommaya reservoir may be used in several ways. Its primary function is to facilitate the uniform delivery of the intrathecal chemotherapy. By implanting the Ommaya reservoir, multiple rounds of chemotherapy may be given through a single access site.

Placement of the Ommaya reservoir requires a minor surgical procedure with the patient placed under general anesthesia. The procedure is performed in the hospital by a neurosurgeon. The reservoir is placed under the scalp with the catheter positioned into the cavity of the brain where the CSF is formed. Once in place, chemotherapy treatments using the Ommaya reservoir may be conducted as outpatient visits either in the hospital. To perform an Ommaya reservoir tap (CSF sampling and chemotherapy delivery) requires 15–20 minutes with little or no pain to the patient. (end of article)

We are looking forward to a quick procedure and an afternoon watching old movies. I'll write more next week.

Please keep Tom in your prayers.

Love Theresa