Expert: Claes-Gustaf Nordquist, M.D. - 9/24/2009

Question
My 6 year old son has had his tumor removed, no sign of anything in the CT and the surgeon was very happy, now the doctors want to use radiation, what are his chances without radiation? is it worth the risk ? statistical information seems very hard to decipher!
thanks in advance.  

Answer
Tony, CT (& MRI) scans can only show conditions on a macroscopic level NOT a microscopic one. So there is always a risk - even when all scans are OK - that tumor cells remain close to the surgical site. Several clinical studies do show a decreased risk of a local relapse of the tumor if postsurgical radiation therapy is given. There is also a risk of a relapse due to spread via the cerebrospinal fluid but there prophylactic radiation therapy has not shown any advantage. Nor is there any certain advantage with chemotherapy. However the risk of a local relapse is big enough to justify local postsurgical radiation therapy to the surgical site! If he happened to be my son I would without doubt insist on such treatment! So it is definitely worth any risk here to give him such treatment even if - as usual - no guarantees can be given. Where is he treated? If in Hadassah, please give my regards. In the summer of 1969 I spent time in the oncology department there as an exchange student. Mazel Tov! Shabbath Shalom!