Expert: Claes-Gustaf Nordquist, M.D. - 1/2/2010

Question
My sister was diagnosed with an anaplastic astrocytoma in August of 2009.  She is 13 years old.  Due to the location in the center of the brain they say its inoperable, even the biopsy was risky but they had no problems.  She had been having headaches and paralysis of her right arm and leg and even eye problems, that seemed to develop quickly, which is why they took her to the doctor in the first place.  She completed radiation, and the MRI showed it actually looked a little bigger but since her symptoms improved they thought It was just showing swelling.  They had decided against chemotherapy and she is now taking an alternative medicine called Protocel.  She is also on steroids because of the swelling in the brain causing headaches and dizziness, and they tried twice to take her off but they have decided to keep her on them due to the symptoms. Its been close to 2 months since she has been done with radiation.  Shouldn't the headaches be better if she was getting better? Is it a sign of swelling or growing of the tumor? My parents are going to have a 2nd consult done at the mayo clinic in Rochester to see if they can do anything different and she has some appointments in January to take another MRI  I have read something somewhere that talked about radiation causing the tumor to sleep so to speak, how long would that last?  And what id really like to know that no one seems to be saying anything about is how will things progress, if it starts to grow and there is nothing they can do..What will happen, how would death happen? Is it a long process or will it be quick? I haven't been able to find any of that out.  Id rather know ahead of time to prepare myself for the worst so any help or information would be great!  Thank you so much!

Answer
Malignant brain tumors - especially anaplastic ones all have a very bad prognosis. How fast it goes depends to a large part on the GRADE of the tumor. Try to find out the grade and I'll try to help you.

Sorry I did not see that the grade was in the headline. So it is a grade 3 astrocytoma. With only radiation therapy she may survive 2 to 3 years but it may be shorter. There will be little pain - if any. Over time she will be more and more confused and sleep more and more. When she sleeps all the time her end will be near. She will then drift into a coma and then pass away. There may also be stroke like symptoms and even epileptic fits. I'm sorry I have nothing better to tell you!


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