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Brain Tumors/Grade 3 Anaplastic Astrocytoma


Good evening Dr., I very much appreciate your honesty in the answers I've read.
My son in law is a young 22 yr old in med school. Was doing fantastic until a month ago. Had a Grand Mal Seizure at 2AM. ER. Cat scan, MRI, showed tumor size of golf ball, right frontal lobe. Surgery 4 days later. Told they believed they got it all, it was "Low Grade" most likely not malignant. Dr said he had 30 yrs give or take.... Week later, Oncologist told family he had grade 3 Anaplastic Astrocytoma, but life expectancy would still be 30 or so years. he would be needing another surgery, (3 days ago).  He went to school between surgeries. When the neurosurgeon was asked why he said he had 30 years, Dr. Said, "well, everyone knows someone, who knows someone else who lived that long. (????!!). But did then say typically it's 5 yrs. now that he has had 2nd surgery, he will start radiation and chemo, but is told he can continue to go to med school.
He's doing great, my question is, he has no signs or symptoms of being ill at all, other then the scar. Will at some point he develop symptoms? Do you believe continuing school is the right choice?  How long before it would typically start to grow back?  Is it normal to have no symptoms at all?  He is on steroids, and anti seizure meds. They did get a consult on the slides and MRI etc. from Sloan. Sloan said they would do the same surgery as his present hospital, so he stayed there.  I am assuming Sloan agrees with grade 3.  So in that event, what is to be expected?  Thank you so much for your time.

If indeed this is a grade 3 tumor - grading is hard - his prognosis is not favorable. Grade 1 & 2 are the "good" grades, grade 3 & 4 the "bad" ones. Grade 4 is the worst. The difference between 3 & 4 are mainly with regards to survival times. For grade 4 it is around 1-2 years for grade 3 it is longer but not very much so. I would be surprised if it is longer than 5 years and it may well be shorter. So "good" and "bad" here are very much terms in a relative sense. Survival times here are with full treatment, without it survival time will be shorter. Also grade 1 & 2 are in a real sense not good news. It only means quite longer survival times. At the moment his tumor has been macroscopically removed not microscopically - tumor cells are still there that is why his prognosis is so bad - and that is the reason for his temporary lack of symptoms. His tumor caused his epileptic seizure and his surgery caused more tendency of that and of brain swelling which is why he has his steroids in order of decreasing the swelling. So far radiation therapy and chemotherapy have been unable to remove all tumor cells in brain tumors, they can only reduce their number and thereby extend survival time. I am sorry I have nothing better to tell you but straight questions deserve straight answers whatever they are!

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Brain Tumors

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Claes-Gustaf Nordquist, M.D.


I`m a doctor of medicine and specialist in radiation therapy and medical oncology. I have a long time experience of these tumours.


I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy, educated and trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: . I have no restrictions on the number of questions there. I also answer questions about Oncology (General Cancer), General History, Military History, Breast Cancer, Colon Cancer.

Doctor of medicine, specialist in medical oncology & radiation therapy.

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