Trick or Treat at Kellogg Cancer Care Center

Tim's oncologist, Dr. G., isn't one to let grass grow under his patients. He had us come in the very next day (October 31) to begin treatment. At this point, all we knew was that Tim had leukemia cells in his spinal fluid. While leukemia is a cancer of the blood, it sometimes happens that the cancer cells will cross the blood-brain barrier and take up residence in the central nervous system.

Treatment for a CNS relapse, as it is called, is intrathecal chemotherapy. That means having chemotherapy injected directly into the spinal fluid. This can be done one of two ways. The first involves doing a lumber puncture and injecting the chemotherapy into the base of the spine. The patient then lays on his back with his head below his feet to encourage the drugs to spread evenly throughout the spinal fluid. This is what Tim had done on Halloween.

The second method for intrathecal chemotherapy is to insert an Ommaya reservoir under the scalp and inject the chemotherapy into the reservoir. An Ommaya reservoir (named for Dr. Ommaya, the inventor), is a plastic pouch attached to a catheter. The catheter is threaded into the ventricles (spaces) in the brain through a small hole in the skull. The reservoir sits just under the scalp and is full of the patient's spinal fluid. The oncologist can both inject chemotherapy into the Ommaya and withdraw spinal fluid for analysis.

When we left on Halloween, Tim had an appointment to meet a neurosurgeon to discuss installation of an Ommaya reservoir. We also had an appointment for November 5 for a third lumbar puncture and a second intrathecal chemotherapy treatment.