Expert: Claes-Gustaf Nordquist, M.D. - 12/19/2007

Question
My nephew ( age 18) was recently diagnosed, pathology back today, with Anaplastic Oligo Astrocytoma grade 3.  He is post op by 8 days this go around.  He had grade 2 removal 16 months ago.  Are these types of tumors always considered cancer? What might be expected for life expectancy with Chemo/Radiation OR without?  His initial findings were discovered by the optometrist during a routine eye exam, who in turn called his regular MD and ordered a MRI... Tumor discovered.  I really want to know what to expect physically regarding his mental and bodily changes?

Answer
First of all brain tumors are hard to grade. It may have been a grade 3 all the time. Probably the present diagnosis better represents the true nature of his tumor. While not a cancer in a strict biological sense these tumors do show a very cancer like behaviour so we must for all practical purposes regard them as cancers. These tumors are all killers. The only difference indicated by grade is how long a patient will survive. A grade 1 to 2 can at best live for many years. A grade 3 maybe for a couple of years or a little longer. A grade 4 (worst) case rarely survives much
more than a year. Surgery,radiation therapy and chemo therapy can prolong survival time to some extent and also to some extent and for some time decrease symptoms. But unfortunately no real cure is available at present! So with radiation and chemo he will live longer and with less symptoms - to what extent is impossible to predict in a single case like this. When later on things go bad he will become more confused, maybe get stroke like symptoms, may even get epileptic fits, sleep more and more, then drift into a coma and then pass away. There will be little pain - if indeed any. I'm sorry I have nothing better to tell you!

P.S. His young age and the earlier lower grade MAY extend his survival time somewhat, but that is uncertain.