In the case of radiation necrosis, you would give a patient oral or IV steroids to decrease inflammation (hopefully decreasing compression around the spinal cord) and give symptomatic support.
But for tumor relapses, well- the only options are chemotherapy, surgical resection and/or more radiation.
So for radiation necrosis, you obviously wouldn't re-irradiate. But you wouldn't give steroids for a growing tumor, either.
It saddened my heart so much that April, knowing that with the information we had, we did not know for sure. Looking back, it still makes me sad that we didn't figure it out. And as more time passed, sadly, Addison lost more and more function. By the end of April, she was completely paralyzed below the waist again and was unable to have anyone touch or move her legs without excruciating pain. She had also lost complete control of all her bowel and bladder faculties.
Taking care of Addison daily while watching her slowly lose most of the neurologic function below her waist was unlike any experience I have ever had. It was unspeakable, really. I cannot describe how horrible it was- for Addison, for her parents, and for everyone who loved her. There was such pain in my heart every morning, going in to see her- knowing that something else very real and precious might be gone. And upon arrival, often was.
It was then, the beginning of May, that some of us taking care of Addy began to really argue for tumor relapse. Treating her for necrosis obviously had not worked; at the very least, a few docs argued, we should try to biopsy a piece of the "enhancing" area to get the truth.
But we were overruled; and a few days later, on Tuesday, I said goodbye to Addison.
By Saturday I was married and had left on my honeymoon.
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