Skip to main content

"What's the prognosis?"

The examination under anaesthetic last week revealed that the tumours in Asa’s eyes have halved in size in the left eye and more than halved in the right eye since he began chemo.

Retina scans showing tumours before and after the first two cycles of systemic chemotherapy.

The retcam images show how the tumours have shrunk, and also changes in texture from diffuse blobs to gnarly, calcified masses.
This is encouraging, but there’s still a lot of cause for concern.

For one thing, systemic chemo has its greatest effects in the first cycles.  So unfortunately we can’t expect this rate of shrinkage to continue through the remaining 4 cycles of chemo. As the ophthalmologist told us, the remaining chemotherapy is to prevent relapse.

The other cause for concern is seeding. 

In the images, the constellations of little spots around the tumours are “seeds”: tumours-in-the-making that, if they’re not attacked, will grow bigger.  These are a worry because (a) they’re so many of them and (b) they’re not well supplied by blood vessels, the way the big tumours were, so they won’t respond as well to systemic chemo, which relies on the circulatory system to deliver the drugs.

The seeds can be attacked in a variety of ways, including laser and cyrotherapy.

But there’s a delicate balance to be struck between the benefits these treatments can bring in terms of destroying the seeds, and the collateral damage they can cause in the process.  Aggressive use of laser, for instance, might inactivate the seeds, but could also further detach the retina, which would cause problems of its own.

This is part of the reason why, after this first course of chemotherapy ends, Asa’s going to need to be examined under anaesthetic every month or 2 months for the next few years.  The doctors will be trying to keep these seeds under control, using an appropriate level of focused therapy.

Where we are now

The day after the examination under anaesthetic, Asa received his third dose of chemo.  

Now we have three down; three more to go.

Asa and parents at the new Royal London Hospital, in Whitechapel


  1. Hang in there and stay positive. You're doing the very best you can and Asa is so lucky to have such great parents. Lots of love xxxxxxm

  2. Hello you three,
    Gee, I don't need to add to your learning about chemo - the very word frightens me... But I can hope, hope hope, and add to all the other hopes, that little Asa will get through this as cured as possible. His youth could be a great advantage. Hugs to all! JP


Post a Comment

Popular posts from this blog


Spring. Bulbs and buds burst into flower. Things come back to life.
Ayya's namesake Anne was born in Spring, in Nashville, Tennessee, on March 25th (also known as Lady Day, or the Annunciation), the day when people in Medieval Europe thought the world began.

What threads connect Anne to Ayya? What affinities, beyond a name, and a fraction of shared genetic material?
As a young woman, Anne lived in Africa for five years. She had just married a Frenchman, Jean-Paul, and accompanied him to Cameroon, where he was to work as a teacher in lieu of military service. She was a new mother at the time (she carried my cousin Miriam with her), and it was there that she gave birth to her second child, Eric.
One of my favourite works of anthropology is a study of infancy in West Africa. Among the Beng of Cote d’Ivoire, children are understood to come from the Afterlife. In their way of thinking, people’s spirits enter a sort of limbo when they die. When babies are born, they gain passage back into l…

Cataract / VI

At about 4 o’clock this afternoon, Asa came around after being under anaesthetic for a cataract operation. It was the first time he’d had surgery – indeed, anything but routine eye exams – for more than a year.
Selam and I felt more anxious than we’d expected to be about this operation. It brought back memories of difficult times. Times – there had been dozens of them – when we waited, with a mixture of fear and hope, for news of how the procedure had gone. There had been a few times when we’d felt we we were close to losing him – like that time when he was on second-line chemo, and I was in Congo, and Selam told me over the phone that his Hickman line was infected. Or that time, during the third course of chemotherapy, when he went into anaphylactic shock.
Compared to those occasions, this cataract operation was low-risk. And, thank goodness, it went smoothly.
As Asa gradually regained consciousness, he put his fingers to the plastic shield taped over his right eye to protect it. Sela…


Maybe it's all the to-and-fro'ing we've done on the trains between London and Birmingham for his eye exams, or maybe it's due to some kind of innate fascination with large moving things, but Asa loves trains.

I post these drawings of his partly to cheer myself up. It's been a pretty rough week, watching the US elect a con man as President.

Asa is an American citizen, and in 13 years time he'll be eligible to vote. I'm grateful that he's healthy, and that he stands an excellent chance of living a full life. But I worry about the world that he and his generation will inherit.

Let us pray for wisdom in our leaders, and for strength and resolve for those who resist them in the cause of the greater good.