Brain cancer treatment

[Jadejo]

My son is 16 years old and was diagnosed in June, through an MRI with a brain tumor.  They initailly thought it was a pilocytic astrocytoma grade, I but when the surgeon removed the tumor he was not so certain.  After 2 histology reports, they said it was a diffuse astrocytoma WHO grade II.  The tumor was 22mm X 16mm big and they were able to excise the whole tumor, but the "tenticles" have remained in the cerebellum.  My question to anyone is regarding his treatment.  He is only 16 years old and the prognoses is that he will never be in remission and that the cancer will progress, slowly, to a grade III and then IV. No chemotherapy or radiation therapy has been offered because the oncologist says those treatments only react to fast growing tumors, so it will have no effect on him.  This wait and see attitude is very contrary to what we are all told about early cancer detection.  We have detected the cancer early, and removed what was seen, but now we must wait for it to get worse before we treat him. Every progressive stage means a dimished life expectancy for him.  I live in Brisbane, Australia, and I was hoping to get some feedback from an Oncologist who specialises in brain cancer.  The Oncologist we saw took 9 phonecalls throughout our meeting and didn't know our file history until we were in his rooms.  He promised to present our scans the following week to a group of other Oncologists, but when I asked for a report on the results he said he didn't present his file.  He forgot to post back our MRI's, twice.  I don't have complete trust in him as  a result of this. He has said he doesn't need to see us again and we should deal with the Neurosurgeon.  Many thanks to anyone who can pass on some advice.


This discussion is related to Grade II Astrocytoma- treatment.

[Jadejo]

Thank you for coming back to me, you have confirmed what I have always thought to be the next step in treatment.  Can you tell me what time frame we have when you say that these tumors lead to frequent recurrences. I realise you can only give me the statistical evidence.  He is scheduled to have an MRI every 4 months, the next one being in December. Thank you once again.

[DrNoopurMD]

Hi,

Thanks for writing in.
The standard course of treatment for WHO grade 2 is removal of as much of abnormal tissue as possible without causing neurologic injury. Research has shown that beginning radiotherapy immediately after diagnosis delays recurrence compared to beginning radiation when there is evidence of tumor growth.
Infiltration is very common with these tumors which lead to frequent recurrences. Radiotherapy and chemotherapy is an option in such cases.
It is difficult to tell without looking at the patient and reports. Please seek a second opinion on this. Take care!