"Singapore's data is more detailed than that of Japan!" said Dr. Tabei, my attending doctor. On February 3rd, he said to me, "the temozolomide works because your gene xxx as shown positive." I, however, couldn't hear the part of "xxx", and on March 17th, two consultations after the Feb 3, I asked what "xxx" would be, and he said as thus. My inner voice whispered to me like, "no, it's not of Singapore, but of the US."

Dr. Tabei pointed to the part called "EGFR vIII (+)" on the 6th line of the orange part on the photo above. The cursor interferes in the image and the "v" cannot be seen well, but it seems that EGFR is a member of the gene "Epidermal Growth Factor Receptor" and mutates to become "vIII" occasionally. Since this is "(+)", meaning positive, it is the type that "an anticancer drug (temozolomide) for brain tumors works well" (Dr. Tabei). Additional data was what I did not ask then. Despite that, my further research revealed as follows (I am a professional analyst anyway).

・ GBM IDH wild type ... Most glioblastomas are of this type                            ・ MGMT methylated ... DNA repair enzyme O6 methylation (contributing to postoperative tumor shrinkage)

Until this point, I got ripped me off an hour time by Internet research looking up medical terms. On top, I became disgusted by many of the threatening words/phrases, which I should have already known, with my mind torn, such as "Glioblastoma patients have a 5-year survival rate of 10%." That's why I couldn't touch "PD-L1 (IHC) Negative" or "TERT Intermediate". The 7th line in the orange part shows "CARIS Singapore", and this refers to a research institute in the US, not in Singapore, to which Raffles Hospital in Singapore has outsourced (see "Toast to Life" 3rd, September 29, 2020).

The hospital visit on March 17, I also received an infusion of Avastin, the molecular-targeted drug for the treatment, the last one for brain tumors. I then entered the "follow-up period". So far, six anti-cancer drug temozolomide courses have been painful, albeit with a few side effects. Taking the medication for five straight nights was tough, and from the 3rd night (or, after the morning of the 4th day) the vicious cycle of "stomach sickness → loss of appetite → feeling depressed" continues. When I start every course, I weigh 68 kg, but landed not hitting to 66 kg. During the period, I felt that I was getting thinner little by little (the photo below is one night dose of temozolomide, trade name Temodar).

Now I don't have to go to the hospital for another two weeks, but on April 14th (Wednesday), when I have to take an MRI scan to see how my brain will have been doing. 

My treatment then shifts to lung tumors, and will be hospitalized on April 20th for four nights and five days, following PCR (swab) and blood test in the previous day. Surgery is to be done for an infusion hole, a port as is called, on upper part of my chest to insert a catheter. After that, they will give me an intravenous drip for 48 hours. If there is no/few issue, this infusion treatment can be done at home. Family/friends visiting is prohibited in principle in the spread of Covid-19, but fortunately my wife is working in the same neighbor, which relieves me so much.

By the way, a Japanese friend in Singapore knows the word "port". He is working for a US pharma company, and we enjoyed minor amount of alcohol on March 28th. 

(To be continued)