Most of what shows in the MRI is interpretted as post surgical changes and radiation damage. Damage from radiation sometimes doesn't show up for months after treatment. The swelling is reduced right now. However; they believe there is some tumor in the back part of his brain.
There won't be any surgery. The area affected would significantly impair his ability to read, do math, and any complex thought. As one doctor put it, he would wake up from surgery a very different person than he is today, and there would still be some cancer left. Since he is functioning well now (moving, feeling, thinking, speaking, etc), surgery has much more down side than up side at this time.
Four options have been presented. Two are amped up versions of his current chemo treatment. Both would increase the frequency of his chemo, and add an additional medicine with it that increases effectiveness. Two are clinical trials. One is a different chemo medicine that is in the last stages of trials, and shows more effective in brain tumors. The other is a virus therapy. They would inject a modified cold virus directly into the tumor. It has been modified to reproduce and kill cancer cells, and then quit.
He has an appointment on Friday to choose among the options. We have literature to read on each in order for him to make a decision.
Of the four options, only the virus therapy has shown to cure cancer (in animals), but only three human patients have taken this road so far (it is in the very first stages of trials). Of the three patients, two have responded well. The other three options have been shown to keep things at bay, but you have to switch between options as the cancer adapts to each treatment. He would have to be qualified for either trial, so those may end up not being options in the end.
The doctors here don't see any problems with Tony's flying, so depending on the option he chooses, we may be able to go back to Alaska. The surgeon here has a colleague in Anchorage he would work with to monitor progress.
The immediate plan is to ramp up on his current seizure medicine, and ramp down on steroids. His current seizure medicine won't affect his eligibility for trials. Other medicines might.