Expert: Claes-Gustaf Nordquist, M.D. - 1/24/2010

Question
Dear doctor,
Iīm a very close friend to the patientīs family.
Could you please let us know a hospital/clinic worldwide where there will be - according to your opinion - a hope for the patient to survive if we bring him there?

Patient's name: Christos Kr............
Age: 26

MRI test:

Sizeable invasive tumor which lies in thalamus-hypothalamus, on the left, and extends through splenius of mesolobium to the opposite hemisphere. It extends to the basic ganglia, on the left side, and inferior to the basis of the 4th ventricle and the vermis, through the brain stems.
After the contrast is i.v.. infused, part of the tumor gets enriched . In the perfusion sequence we can see increased vascularity of the tumor. Part of the tumor contains hemorrhagic elements, a fact which prevented the conduct of spectrometry. The tumor pushes, from the left side, the ventricular system and causes light displacement of the structures of the midline.
All the upper findings concludes to a glioma of high malignancy.
Please, do let us know!

Best Regards,
'Thank you' is maybe not enough that you devote your knowledge to the service of humanity...


Answer
Unfortunately at present there is no hope at all anywhere and everywhere. Treatment principles and results are the same all over the world for this type of tumor. The results are depressing everywhere. With this size and location this tumor is probably inoperable. So the only remaining treatment methods are radiation therapy and chemotherapy. But with this kind of tumor even if surgery was possible it would not change the prognosis. Even a combination of surgery, radiation therapy and chemotherapy could only offer a temporary decrease of symptoms and a somewhat prolonged survival time. As it is I estimate his remaining survival time even with treatment to be measured in months. Certainly not in years. Without treatment even shorter. I'm sorry I have nothing better to tell you!
There are at present some interesting experiments going on with mice on this kind of tumor where around 25% of the mice are cured (but 75% of them are not and therefore do not survive - but that is still better than no survival at all). But these are preliminary results on mice NOT humans. Any experiments on humans are still far off.



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