Pre-emptive strike

Earlier this year I likened 'The Terminator' to a terrorist movement. The better I get to know it the more the metaphor fits.

Following the mild but persistent reports of increased activity, Ingrid and I spent recent weeks reviewing the battle plan against this agent of fear. The adversary remains a relatively stable ping-pong ball sized hub on the left. More concerning: a couple of tiny new rogue elements on the right; one the size of a pin-head, the other even smaller. Physically, I couldn't tell you any of the three are there.

The problem: to borrow from Donald Rumsfeld (you know it's desperate when you paraphrase him!) cancer cells throw up all kinds of known knows, known unknowns, and unknown unknowns. Once they get the upper hand, good luck taking back control.

So we've decided it's time to launch the next offensive. 

A low-risk drone strike
It will begin next Wednesday with a 'Gamma Knife' surgical strike on the bogeys harboured on the right hemisphere. It's a relatively routine procedure that will zap (the knife is a laser; there should be no blood!) these focal points with radiation waves; hopefully weakening them, ideally eliminating them. 

Beyond that? We'll cross that bridge when we get to it. But to give you an idea of our thinking.

A ground attack
A more intrusive approach will be needed to cripple the hub on the left. This will take the form of physical surgery with  a real knife. That means the risks go up but so do the upsides. Surgery should kill a lot of the bad guys. Secondly, ... well let me take a step back.

Chemical weapons
How is it possible for focal points to have sprung up on the right side, totally 'unconnected' from the tumor on the left? Because GBM is a diffuse condition. My brain is full of roving rogue guerillas that could at any moment convert free, healthy brain cells into the biological equivalent of suicide bombers. This is why the chemotherapy, with its indiscriminate toxicity, is both so powerful and horrifying. The chemo will be making at least a temporary comeback.

A revolution?
Returning to the second advantage of physical surgery. It opens the door to a less toxic and more sustainable future through immunotherapy--a vaccine that teaches the body to fight the cancer. Like training local forces to fight the local rebels; or like using soft power to ignite a revolution. The catch? Getting your hands dirty. With GBM the vaccine requires a physical sample of the tumor--hence physical surgery.

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This is all quite bellicose but in the words of Mr Rumsfeld's boss: 

I just want you to know that, when we talk about war, we're really talking about peace.