Sorry that it's been a while since I updated, the truth is I simply haven't felt inclined. I have no good news to impart. Since returning from America we have discovered that Adam has significant bone marrow disease, to the extent that the vaccine trial we had targeted in the US is not a viable option at present.
Adam finished a round of Temozolomide and Irinotecan combination chemotherapy on Saturday. We must now make a decision about what to do when his blood counts have recovered, a process that should take two to three weeks. This chemotherapy might reduce his disease, but there is no guarantee that it will even halt the progression. We could do a second round with the intention of rescanning afterwards, or elect to move to a potentially more potent combination straight away. The downside of this, of course, being the impact on Adam's quality of life and the potentially catastrophic impact on his blood counts that could leave us with very few options even if the chemotherapy itself proved effective. We have to remember that Adam has already been massively pre-treated, having been on continuous therapy for nearly three years.
Thankfully Adam remains pain-free and appears fairly well in himself. He was a bit battered after the bone marrow extraction and surgery to fit a new central line, but tolerated chemotherapy well apart from sporadic nausea during it, and some diarrhea once it had finished.