Expert: Claes-Gustaf Nordquist, M.D. - 9/4/2009

Question
QUESTION: My friend, 32 years old, has a Grade III Anaplastic Astrocytoma and has had it for 2 1/2 yrs. She had radiation and chemo to shrink and has basically been on some form of chemo the full 2 1/2 yrs.  The tumor returned in June 09. How long can her body take these powerful chemo drugs without permanent damage? And if she stops the tumor will grow and kill her. I want to support her and advise her, but not sure how to. She has a small child that continues to be the reason she pushes on. She looks so bad. Liver enzymes up, white blood cells down, now diabetes issues.

ANSWER: Mary, unfortunately her problem is NOT her treatment! Her problem is her brain tumor! Because it will kill her. All what surgery, radiation therapy & chemotherapy can do is temporarily decrease her symptoms & extend her survival time. Even so I doubt that she with this diagnosis will be able to survive one more year. I'm sorry I have nothing better to tell you!


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QUESTION: Update......my friend went in for out patient surgery to put an IV Port in. She has now contracted pneumonia and is in intensive care. I am sure this will be the end. She has no ability to fight this off.  Cancer sucks!!

ANSWER: I'm sorry to receive these sad news! Yes cancer is a bad disease, malignant brain tumors are even worse - beyond any, every and all hope at present. For how long that will continue is anybody's guess.


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QUESTION: I found out yesterday that the pneumonia that she has is brought on by the steroids that she has been taking.  Can she get well from this type of pneumonia?  They have put her on the ventalator for 5 to 7 days in hopes that she can react to the antibiotics, however shortly after putting in the vent, they had to give her blood because of her low white blood count.  I hate to see her go through all this if the outcome is dim and since I am POA, I can stop the poking and proding, but I want to keep trying so her parents won't be upset with my decisions.  I am POA because her parents are divorced and hate each other and she knew that this day would come.

Answer
Mary, please, I'm a Swede living in Sweden and English is not my first language (which is Swedish), not even my second (which was Finnish now sadly mostly but not completely forgotten). In fact I had to learn also Norwegian & Danish before English - which was later followed by German & French. Americans are also very fond of acronyms/abbreviations that drive the rest of us crazy. What is a POA - oh I did figure it out: Power of attorney. But please write such things out FULLY! Do not assume that such things are easy for a foreigner to understand! She may get well but I can NOT promise or guarantee anything in this situation except that her treatment will eventually fail unfortunately but precisely when I can not tell you. She may get temporarily well but her chances of that are not very big. In this situation you probably have to guard your own back too! Her parents may hate each other but they probably hate the fact that an "outsider" has been given this power which has been denied them even more and they will probably look for faults in what you are doing!