gilocyte proliferation\or astrocytoma - treatment with Radiation, Chemo or None?

[XiaoGan]

Hoping you can help.  I am from China and my Dad has brain Cancer.   I am struggling with making a decision about treatment.  Hoping to find some answers or suggestions here.  Below is what I know and questions I have.

Previous symptoms:
sometimes there’s slight headache for a few years, but not serious.
In April,2016 : Vomit, headache, dizziness. Went hospital to take CT and MRI, showed serious cerebral edema, Brain central line leaning a lot to the left, diagnosed as Glioma.
MRI : pathological changes area: (right brain) temporal lobe, occipital lobe, insular lobe, basal ganglia,corpus callosum.

After using some mannitol to lower the brain pressure, no vomit happened again, but still felt headache,and nausea, when nausea happened, together with eyesight symptoms(could see some green,red things), this nausea happened twice or three times a day.

After 3months :
August8, 2016   Operation : removed temporal lobe, about 1/3 of the tumor left inside.

Pathology Reports from three different hospitals:

August,2016: “gliocyte proliferation”
it didnt say it’s tumor, it says “gliocyte proliferation”

November,2016:  WHO Grade II - oligo-astrocytoma
in the white matter,there’s oligo-astrocytoma(少枝星形细胞瘤),density of tumor cell is not high, diffused,tumor cell  infiltration in Cortical layer

March,2017: WHO Grade II - astrocytoma
Immunohistochemistry : part of P53(+), GFAP(+), Olig2(+), Vimentin(+), Ki-67 < 1%(+), CD34(-), IDH1(-)

Current Symptoms: headache,nausea but not throwing up. When nausea happens,there are some red green things show up. Nauseu happens once a day, or once in two days. Headache is not severe, but always feel the headache before or after surgery.

About Treatment: didn’t do chemo or Radiation therapy because the first pathological report says”gliocyte proliferation”
After the result from the other two hospitals came out,saying it’s II grade tumor, I’ve consulted a couple of neurosurgeons and two Radiation Therapy specialists.
  Some of them suggested Radiation Therapy, saying chemo doesn’t help .
  Some Doctors support Chemo, and suggested taking the Chemo medicine TZM, take 5days medicine in every 28days doze option.
  And some suggested not to do Chemo or Radiation Therapy, because it’s low grade (II), for grade III-IV, Chemo or Radiation Therapy is necessary, but lower grade, it doesn’t help a lot.


Questions:
1. Chemo or Radiation Therapy ? Or neither of them?


2. Would Radiation Therapy help since the area of tumor is so large ?


3. About Chemo therapy, is TMZ suggested, or there is better option? TMZ has very little side effects?

3. Some doctor mentioned it could be Gliomatosis Cerebri, because the cells are very diffused, and spread in several lobes in the brain. Besides, the first hospital pathology report says it’s “gliocyte proliferation”


4. What reasons that could be causing current symptoms? Because the tumor remained inside ? Is there any way to ease the current symptoms?
Headache and nausea. Patient looks fine, has meals regularly, walks normally, but feels the headache.


5. Would the symptoms be gone or eased after Chemo or Radiation Therapy ?


6, If Radiation Therapy is suggested, Is it wise to defer the post-surgical Radiation Therapy until progression of disease. When Radiation Therapy is indicated, how many Gy the dose should be according to the data?  Or better to do Radiation Therapy as soon as possible ?

[rumpled]

I am not a doctor, so I can't respond to such specific questions. Sometimes the pitfall of asking opinions is that they conflict and now you have to decide which is the best. You kind of have to go with your gut.

From what I know, they have very specific treatment sets for tumors when they know the type. You can look up papers, but we are  "lucky" in that cancer is very studied, and they are learning a lot all the time, just not a cure.

Some types of tumors do not respond to different treatments and that is probably why one doctor is suggesting one thing over another. As well, it also depends on how wide spread it is, and your dad has grade II which is medium grade, a mix of low and aggressive cells, and his cancer is spread widely since it is stage 3 or 4.

His symptoms can be happening simply from the spread of the cancer.