Grade 3 Astrocytoma

[Sonya and Sean]

Dr. Doctor,
My 16 year old brother recently sustained a concusion which resulted in him receiving an MRI.  From this test it was diagnosed that he had a brain tumor about 3 centimeters in size above his eyebrow in the left hemisphere of the brain.  The area his tumor was located was considered a very low functioning part of the brain and prognosis was good that brain surgery would go well.  Surgery took place about two weeks ago and the surgeon felt that he had removed all parts of the tumor.  He returned home after two days in the hospital and has been doing very well.  Yesterday the biopsy results came in and the tumor was diagnosted as a grade 3 Astrocytoma.  After researching on the internet I have learned that this is an aggressive form of brain tumor and the next step will probably be radiation and possibly chemotherapy.  Many of the reports I have read do not give positive prognosis of this condition.  My questions are is it possible for them to have removed all of the tumor or is it likely to be located in surrounding tissue without it showing up on an MRI?  We want the best doctor for this procedure in the United States, how do I research to find a list of doctor's that are possible and what their qualifications are?  Obviously, there is no possiblility in our minds of my brother not making a full recovery but how might this effect his life and could if effect brain functioning in other areas?  I ask this question because currently he is being recruited by division 1 football organizations and is a stellar athlete.  Thank you for your time and consideration in the matter.  

[alaw37]

HI! So sorry about your brother!  I can say that in all sincerity since my brother, on August 18th,2005 was also diagnosed with a brain tumor in the frontal lobe.  He started with focal seizures and thought he just had a sinus infection or something.  On September 19th,2005 he underwent surgery to remove the tumor.  However, his tumor had likely been growing for years and was imbedded in brain tissue(astrocytomas arise from astrocytes which are shaped like stars)  These tumors are very aggressive and have their own blood supply.  My brother's surgeon was able to remove 85% of the tumor.  The path. report came back Anaplastic Astrocytoma - Grade 3.  We were absolutely devastated.  He was 29 years old, professional, very handsome, just bought his first home - we were in such shock.  Two weeks post op - he started radiation x 6 weeks along with oral chemo.  He then did chemo x one year (5 days each month).  He has been through hell and his oncologist says he is his star patient.  Last MRI shows the remaining tumor as stable.  We were originally given a poor prognosis(3 to 5 yrs. survival) These tumors tend to recur.  However, the ones who fair the best are young, and 90% or more can be removed.  My brother is being treated at Emory in Atlanta,GA.  I can't remember his docs names( I know they are Asian).  We pray for him to be healed.  He has done phenomenally well considering the prognosis we were first given.  He has a scan every two months.  Believe me, I feel your pain and I will pray for your brother.  I have prayed so hard for my dear sweet brother who so loves life.  My brother has no major effects from the treatment/surgery except that he has some short-term memory loss.  He also has osteoporosis from the high doses of steroids.  But he works full-time in a very demanding job, he is very active, exercises, etc.  Give your brother all your support.  He will need you and I think based on my brother's experience, sounds like he will do well.  However, this is a diagnosis that will change his ife.  He will constantly have to be monitored for regrowth which almost always happens.  I think every day since my brother's diagnosis is a gift!  Good luck and God bless you and your family!!!!
~Amy in S.C.~

[Jaybay]

You might look into the M.D. Anderson Cancer Center located in the Houston Medical Center.  Here is a link to their web site:  http://www.mdanderson.org/

[Enoch Choi, MD]

Grade 3 Astrocytoma is a high-grade glioma, with initial treatment as surgery, with the goal of removing as much tumor as possible. It's great that your surgeon thinks they got everything.  Surgery can often lessen symptoms and improve brain function, and might prolong survival. Unfortunately virtually no patients with high-grade glioma are cured by surgery alone, adjuvant radiation and chemotherapy are usually recommended, even in patients like your brother whose tumor appears to have been completely removed ("gross total resection"). Adjuvant radiation is the most important factor in improving survival, but adjuvant chemotherapy also improves long-term survival.

Examples of adjuvant chemotherapy include temozolomide, carmustine, or the combination PCV regimen. The optimal regimen and length of treatment for adjuvant chemotherapy are unclear.

Dr. Enoch Choi, MD
Palo Alto, CA