Expert: Jeremy Oldham - 1/22/2012

Question
QUESTION: My wife was diagnosed with Grade 3, Anaplastic astrocytoma in January 2008. She had the usual treatment of resection,radiation and temodar at UCSF. The tumor was about 3cm in the right frontal lobe. She is off all meds including Keppra and is seizure free. All her follow-up MRI's have shown some minor enhancement which has been interpreted as radiation change and stable. She was age 57 at the time of diagnosis and in otherwise excellent health. No co-morbidities.
My question is: What is the expected time until the tumor comes back? How long before we should expect the tumor to come back? She is 4 years now. Is there a chance she is cured? Please help me understand this. you may reply to me at . Thanking you in advance for any information.

ANSWER: Tom:
 I understand your concern and your question is a valid one.  Unfortunately, though, these things can be pretty unpredictable.  In essence, the nature of tumors can not always be determined.  Tumors with low rates of recurrence sometimes recur and sometimes tumors with high rates of recurrence do not recur at all.
 Many experts concur that individual risk factors play an extremely important role in post-cancer care and development.  You obviously love your wife deeply Tom and the best thing you can do for her is be the one thing in her life that is stress free.  Meaning, help her live a healthy lifestyle.  Lots of rest, proper diet, low stress, exercise, etc.  I don't think I need to tell you that doing these very simple things has immeasurable value when it comes to boosting the immune system for cancer prevention.
 I hope this answers your question Tom; if you have any others please don't hesitate to ask.  

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

QUESTION: It would be a simple enough study.
All we want to know is average time to recurrence.
These patients are usually treated at a major center and are followed with regular MRI's.
Treatment is pretty standard for most- Resection, Radiation, Temodar.
They are also the subjects of tumor boards.
So contact the tumor boards at the major centers (can't be more than 100).
Ask for the de-identified raw data (no HIPA problems) for Grade 3 tumors. Take all comers. No need to adjust for minutia.
Date of Diagnosis and Date of recurrence for all grade 3's.
Take the average.
Simple, valuable information to the patient.

Answer
Tom:
 You're correct the study could be simple enough. But "average" becomes a doomsday prophecy to most when they hear only "raw data".  Most studies are as accurate as they can be but there are always external factors that can not be taken into account especially in non-laboratory settings.