Reoccurance

My husband got his 1st Brain tumor in 1985, it apparently had been growing for quite some time, it was the size of a silver dollar in cir.  It was removed with Brain surgery.  All was well until 1990, it came back, he refussed surgery, so it was left to grow for 4 years until Radiation was used for this, it never got as big as the other one, and he was told by the radiolgists that the root of that tumor was dead in 1996. This year he was 6 years out and went for his yearly MRI, they found another tumor, with a PET scan it was determined that is was only 2mm x 1", so they are going to do Radiosurgery and they are confident it will work.  My question is the doctor said one day that we bought him more time, probably a poor choice of words because now when I corner him on that comment he won't elaberate.  (they have all been benign)  Do they expect them to keep coming back or the fact that he gets farther out without reoccurance and they are smaller, is that helping his odds.  Is it a fact that they will definately keep coming back or could one of these treaments work permanetly.  He would just love to be able to put this completely behind him and live a normal life.
The other part of the question is,,The radiosurgery (with a halo), why do they feel so confident about this procedure, what is so different about it that makes it work in one application.  They have been very specific about that either, no matter how many questions we ask, except he has been doing it for 8 years with good success.
Thank You, Chris & Dawn Bishop

[CCF Neuro[P] MD, RPS]

Dear Chris and Dawn:

I am really sorry that your going through such a difficult time.  Much of what is said about tumors depends on the location and the type of tumor.  Not knowing what type of tumor, where it was located, etc. makes it impossible for me to tell you much of anything.  Unfortunately, most brain tumors present a problem for us medical people.  With all the progress in diagnosis and treatments, the overall outcome has not been what we would have wanted to date.  "Buying time" is a phrase used alot and in the pure sense of the definition, when taken as a group, that is what we are doing with all cancers.  Some cancers, the time we buy is decades and some are in terms of months.  Obviously, the term needs to be placed in perspective to the tumor type and where it is located, the aggressive nature of the tumor type, etc.  That said, the fact that your husbands tumors are reoccurring just means that despite the attempts thus far, they have not been able to remove 100% of the tumor, therefore it is regrowing.  If it is now located in different locations, that means that it has spread.  That can be not a bad thing depending on the tumor type, for instance, if the tumor is a meningoma.  Here, radiation is known to destroy most of the tumor, but the tumor will likely reappear at that site and others.  Although the tumor is benign in most cases, it still grows and spreads.  The advancements in radiatiion therapy over the years has been dramatic.  The reason for the halo is often to stereotactically pinpoint the tumor and where the radiation needs to be given.  However, there are side effects with radiation.  These can be present early on after therapy and also many years after radiation treatment.  

I hope that I have helped alittle, I am sorry that I could not be more of a help.


Sincerely,

CCF Neuro MD

[Dawn]

I received your answer and it was helpful, I'm not sure exactly of the terms used with his tumor, but Meningoma rings a bell.  And the tumors have all been in the right temprual lobe.  This new one is just a little under the cavity from the brain surgery.

I guess my main concern is for him and his state of mind.  Is the fact that they are taking longer to come back and are smaller in size of any signifgance.  Does that better his odds against reoccurance or will they keep coming back.  He is doomed to a shorter life span than most?  I want someone to give me the real scoop, none of his doctors will and I know why, but we really need to know the odds.

Dawn

[CCF Neuro[P] MD, RPS]

Dear Dawn:

If it is a meningoma, then they will reoccur after radiation therapy and usually will occur in multiple areas.

CCF Neuro MD

[Dawn]

Sorry My husband corrected me when he got home it is a
astrocytoma...that does that change your opinion

We found out they have great success with the radiosurgery, but John Hopkins said that they can not fractionate with the cobalt machine because the paitents head is in a halo, I wish they would use the other machine,,, I want it to work as good and not come back