Expert: Claes-Gustaf Nordquist, M.D. - 1/21/2011

Question
QUESTION: It's been five weeks total of RT and my friends wife has two more weeks to go and she will finally be done with her RT. Everything seems to be going Ok but the brain swelling is pretty bad. Her steroid medicine has been increase again. The problem she is having is the amount of weight that she has gained since taking the steroids. She has gain about eighty pounds in about two months or so, and continuing to gain as this process goes by. Doctor, is this normal? She is complaining about pain in her legs and she can't hardly walk because of the weight. Will she be able to lose all this weight and go back to normal? This situation has been a transformation emotionally and physically. She is only  5'2 and weights a little over 210 pounds and counting. She is taking pain medication for the headaches and brain swelling but to add legs pain because of the weight gain it's outrages. Is there anything she can do to avoid weight gain? She is eating healthy but is not able to do much exercise because of the fatigue. She is tired and sleeping a lot.

Also, her Radiation Oncologist feels very positive. They will perform the first MRI and CT in March, hoping that the RT has work. He is even saying she might go back to work in a couple of months. Can this be possible?.

What do you think? Do you still think it is a poor prognosis (18 month)? Miracles do happened? Please let me know your thoughts and advice. I will continue to update you as it progresses.
Thank you.

ANSWER: All the treatment side effects are normal also her increase in weight though somewhat larger than normal. But not enormously so. She MAY go back to work in that time but it is far from certain. Her treatment MAY cure her problem but no guarantees can be given in advance, so we will just have to wait and see. Success is certainly not sure. That is all that can be said at present. Good luck!



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---------- FOLLOW-UP ----------

QUESTION: My friends wife Radiation Therapy doses has been increase one more time. This is the third time since she started RT. The Radiologist Oncologist said that they increase the doses as the weeks go by. She will be done with her treatment next week and that is the reason why they continue to increase the doses as she progresses. Is this true? I thought they set a specific doses, so why do they continue to increase it?? I feel he isn't being as truthful. Please let me know.

I would like to know what is your honest opinion of an anaplastic meningioma grade 3? and prognosis? Have you had any experience with this  type of Brain cancer and if so have you had any positive outcomes?

Thank you for your time, as always and I will continue to update you as we continue with this journey.

ANSWER: That seems strange. Normally you set the doses of each treatment and the final total radiation dose from the very beginning. To me it seems like they are changing the plan. She and her family should ask for an explanation if they want to know.  An anaplastic grade 3 malignant meningioma is fortunately a rare condition (most meningiomas are benign) and it is certainly not a picnic. The outcome is uncertain at best, I can not offer you any promises. Since such tumors fortunately are rare I have not had the opportunity to treat anyone for it.



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---------- FOLLOW-UP ----------

QUESTION: I past the information to my friend and they will meet with the Oncologist on Monday and ask some questions. Her first MRI will be in March but she is still going to a third opinion in Sloan Kettering Hospital in New York in two weeks. We are all hoping the RT has worked.

Doctor do you know the prognosis or estimated survival time?
The Internet states 18 months to 24 months the most. Is this true? DO you agree with this?

Thank you

Answer
Well, the prognosis is not good. At best it can be called uncertain. That time estimate which you mention seems probable.


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