Expert: Claes-Gustaf Nordquist, M.D. - 1/4/2008

Question
dear dr. nordquist,

I had asked a couple of questions earlier. thank you for your concern.

my brother underwent cyberknife therapy and two months after this, now they have taken an MRI. the report says there is no growth in the tumor size, it is about 3,5x3,2x2,8 cm big. But it has not shrunk also...

the report also says that kolin level has risen, and the density of the tumor has also risen. there is more edema around the tumor capsule, with respect to the MRI prior to the radiosurgery.

My questions are:

1. all these indicators sounds bad to me, is it correct?

2. may the increase in the density of the tumor be due to the radiation?

3: is it true that more kolin means more tumor, or more malignancy?

4: should we expect growth in the tumor size in the follwing months, or does it mean that the stability in the tumor size means that we have bought some time after the radiosurgery  

Answer
1. Not necessarily they can actually be interpreted as good signs too. I have too little experience myself with this method to be on the safe side in my evaluation so only time can tell if I'm right or not.
2. Yes and that may be due to damage to the tumour due to the radiation.
3. I'm not at all sure that that is a correct interpretation here. Obviously the tumour cells have been damaged by the radiation. Due to that they may be leaking cholin which results in that more is found. The tumour has NOT grown anyway.
4. Not necessarily. The stability MAY mean that its growth has been halted! Time will tell! The edema is a radiation effect anyway. Good luck!