Just a quick note to wish everyone a very happy Thanksgiving.

Sometimes the holidays arrive, and we can get a bit reflective about how reality doesn't always match our ideals. For me this means that life is often bittersweet. It is this "yin-yang" effect that challenges us to see, and appreciate, how life does bring us balance. We need to be patient, as perhaps our "yang" just has yet to arrive!

My "yang" this year is the awareness that everyone on this list, and many beyond, have contributed to our feeling supported and cared for. This alone brings me great joy.

With gratitude and love.

Dan, Mike, Arianne, Dante & Remy.

Greetings from 19 Roscoe.

This last week was filled with many planning appointments, which included the two radiation simulations, and an appointment with Mike's oncologist.

The radiation appointments went well, and Mike is set to begin the process tomorrow. I was invited into the radiation room, so that I would have an idea of what his treatment entails. At the initial simulation appointment they made a mesh mold of Mike's glorious head. At the second appointment they had Mike lie on a large metal table, and then used the mesh mask to secure him into place. This allows them to target specific areas of the brain which will receive the radiation. It also stabilizes the patient so that there will be little to no movement during each session. Hats off to Mike for tolerating this confining situation. Once he is secured, the session should last only 5-10 minutes. Mike was told to expect to have increased fatigue as the treatments progress. He was also told that there may be an initial period where his symptoms of swelling and headaches may recur.

On Thursday Mike and I met with his neurological oncologist,Dr. Peak, at Kaiser in Redwood City, . This was a two hour appointment, where a very patient Dr. Peak answered all of our questions, and then in detail, went over the plan for chemotherapy and the trial medication. Earlier in the week I had dragged, okay, more like guided, Mike to a support group. This is a brain tumor support group that meets once a week. They usually have each participant share what they are going through, then offer support or information. Unfortunately, on the evening we attended they had a planned speaker, a neurological psychologist. The speaker was very informative, yet the topics raised played out like more of a "don't let this happen to you" scenario. We walked away with more concerns rather than any reassurances. Anyway, back to Dr. Peak. Dr. Peak gave Mike the much needed reassurance that he should come out of his treatment without any cognitive impairments. He then addressed the two options for treatment at this point.

The initial option is to proceed with the standard treatment recommendation, which is 6 weeks of radiation and chemotherapy. Chemotherapy is in the form of a pill, Temodar, which Mike would take daily for the initial 6 weeks, then continue for two weeks out of every month.

The second option is to proceed with standard treatment with the addition of the drug trial for Avastin. This is the option chosen by Mike. Avastin is an antibody that inhibits the blood supply to the tumor. It is administered intravenously every two weeks. Avastin is not a localized medication, meaning it works throughout the whole body, so we must be aware of any changes in Mike's health, as there are many significant side effects. Avastin has already proven to be very effective for colon and lung cancer, and is often utilized for brain tumors when a patient does not fully benefit from the standard radiation and chemotherapy treatment. In these cases Avastin has shown to inhibit tumor growth in 60% of patients. So the current trial is looking into the benefit of introducing Avastin earlier in one's treatment.

By joining the study Mike agrees to follow their protocol, have weekly blood analysis and meet with Dr. Peak every two weeks. Mike if free to withdraw from the study at anytime, and if he experiences any significant side effects, will be dropped from the study. After the 6 weeks of radiation/chemotherapy, they will follow up with a new MRI two weeks later. He will also then continue with the Temodar (chemotherapy) for the first 5 days of each month. If doing well, Mike can remain on the Temodar for 2 years, and remain on the Avastin indefinitely.

There you have it, more information about cancer treatment than anyone should have to know. My best to all of you. Please keep Mike in your thoughts and/or prayers.

Dan

Hi Everyone.

I was going to wait until the end of the week to write an update, but sensed that some of you may be wanting to know how Mike is doing. Currently he is doing great. We are keeping him in good supply of his requisite daily serving of ice cream (low fat for those concerned). For the past few weeks our friends and coworkers have been sending meals over occasionally to help with our busy schedule. Some have sent desserts, which appear to draw Mike in like a fly to a flame. Out of concern for some dietary balance, my daughter, Arianne, took matters into her own hands, and left him notes of caution throughout the kitchen and freezer.

This has been a very busy week, with multiple planning appointments. I will write more about these appointments, and Mike's upcoming treatment, at the end of the week. For now he is trying to gear up physically, and emotionally, for his six weeks of treatment.

I'm sharing with Mike all your well wishes. Please feel free to send him a quick note now and then to remind him of your support by way of email (michael6677@hotmail.com) or by mail at 19 Roscoe Street, SF, CA 94110.

Love to all.

Dan

Hi Everyone,

This is coming from Dan, and for those who have not met me, I am Michael Lowrie's partner. As all of you know by now, Michael is going through a difficult life challenge with his recent diagnosis of glioblastoma multiforme (brain tumor). As many family and friends have been calling to inquire about his condition, and as he is obviously loved by so many, I have decided that the best way to keep everyone current is by way of a group email. I hope that everyone will understand my intention, which is to share important information, so that Mike doesn't have to repeat the information with each call.

I want to encourage everyone to continue calling and visiting when possible. Mike loves to hear from each of you, and will benefit from your optimism and affection. I just know that he is easily fatigued these days, and will likely be more so in the near future.

As a starting point, Mike has already had surgery to remove the tumor. With this type of resection, 95 percent of the tumor is removed, yet cancer cells always remain. Today we met with the Radiation Oncology Department at UCSF. The doctor explained that prior to beginning his treatment, Mike to need two planning appointments.

The first appointment will likely be at the beginning of next week, and is called a "simulation." At this appointment they will take x-rays and CT scans of Mike's head. They will merge these with the prior images to form a radiation plan. Also at this appointment they will mold a mask of Mike's head which will assist them in planning where to position the rays. The idea is for them to have Mike in the same position everyday of radiation treatment to hit the correct targets.

The second appointment if considered the "dry run." Mike to go through all the paces of a radiation session, yet will not receive any rays that day. He will lie on the radiation table to match up with the computer images.

Mike's radiation treatment will consist of 30 treatment days, which are usually Monday-Friday. Each session will take about 20 minutes, yet the actual radiation takes only about 5-10 minutes.

All of Mike's treatment will run concurrently for 6 weeks. This will consist of radiation, chemotherapy, and Avastin. The chemotherapy is an oral medication, which has proven to be quite effective, and has few side effects. Mike will also participate in a protocol of Avastin, which is another medication which is given by way of an infusion every two weeks. This medication takes away the blood supply to the tumor, essentially starving the cancer.

So far we are very pleased with the medical care Mike is receiving. The doctors have been very thorough in their explanation at each phase. At today's appointment, the radiation oncologist gave us a good healthy dose of optimism. She said that Mike is currently symptom free, and in great health. She has several patients with similar a similar diagnosis who are doing quite well. She stated that what is consistent in each patient who is out-living their initial prognosis is that they are young and healthy like Mike.

Well, this is a lot of information, and I hope I have not overwhelmed all of you. Please keep in mind that I am reporting information as I am being educated at these appointments with Mike. I may not always fully comprehend what is being shared by the doctors, and I'm sure I have my own internal filters working to protect my heart and mind. Please feel free to give out my email address to anyone who is interested in being added to the group.

Thanks for all your love and support.

Dan Cano