Expert: Claes-Gustaf Nordquist, M.D. - 1/27/2010

Question
Help. 71year old female grade III/IV anaplastic astrocytoma, ki67 (30-9) 20-25%,gfap positive, phhc positive, neoplasm composed of glial cells with pink cytoplasm round to oval nuclei-surgery, radiation ( in the middle of treatment) temador  What is the prognosis for this type of tumor?  How can we plan for her care?  

Answer
Unfortunately her prognosis is very bad even with full treatment (surgery, radiation therapy and chemotherapy). At present no one in the long run survives this kind of tumor even with full treatment. Treatment can only at most decrease symptoms temporarily and prolong survival for some time. Survival time (even with full treatment) is closely associated with the grade of the tumor. In this case there seems to be some uncertainty with regards to its grade, it seems to be somewhere in between grade III (3) and grade IV (4) - the worst grade you can have. To grade a brain tumor is actually quite difficult. So I estimate her survival time - even with full treatment - to be around 2 to 3 years but it may be shorter. Over time she will become more and more confused and sleep more and more. There may be stroke like symptoms and even epileptic fits. When she sleeps all the time her end will be near. She will then drift into a coma and then pass away. There will be little pain if any. At some point in time she will due to her confusion etc. be totally incapable of caring for herself in any way and every way. At least from that time - and probably earlier - she will definitely be a case for hospice care. For her family to care for her at home will be VERY difficult under those circumstances. I'm sorry I have nothing better to tell you!


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