90% of Astrocytomas Are Malignant

…But So Young’s tumor is not. We received the news today from our oncologist that her tumor is of the lowest grade possible for an adult — Type 2. The evaluation was made by a pathologist who evidently is “world renown.” This means that it is “slow-growing” and (in layman’s terms) benign, although to have anything growing in your brain, however slowly, is always a damaging thing, so brain surgeons avoid using that word. (The relative benign-ness or malignancy of brain tumors is based largely on how quickly they grow.) There are a few caveats that I’ll discuss later, but there you have it. Apart from hearing that the tumor has become smaller or gone away, this is the best news a person with a brain tumor can hear. Praise God! This is such a relief to us.

I have included an image of So Young’s tumor below, so you can see what we are up against.

Here are the caveats:

• The pathologist discovered “a dividing cell” in the sample. This might indicate that the tumor, which is large, also contains Type 3 or 4 cells, although it seems unlikely that much if any of it is malignant, because the MRI does not indicate malignancy.
• So Young’s symptoms continue to get worse. She feels that her eyesight is declining, and I see increased impairment in her ability to walk. Also, she is sleeping a tremendous amount, and although you can attribute that to the medications or depression, there is little doubt that the tumor is playing some part.
• The prevailing opinion among the experts looking at our case at Johns Hopkins is that it would be unwise to operate on So Young’s tumor because of the risks. Also, radiation will not likely decrease the size of the tumor. There is some chance it will shrink because of radiation: maybe 25%. This means that she may have to live with the tumor in its current state for the rest of her life. We don’t know whether her eyesight will return.

So there are uncertainties, but there are many reasons to be pleased with this diagnosis. So Young’s prognosis, although not specified by the doctor, is measured in years, not in weeks. Type 4 tumor survivability is indeed measured in weeks. One statistic tells us that 70% of Type 2 patients who receive radiation therapy survive for 5 years after their initial diagnosis. Some brain tumor patients live for 20+ years after diagnosis.

Also, So Young will soon be able to run! Even marathons. The doctor gave her the green light for any kind of exercise and any distance. Now we just need somebody to run those miles with her, since she can’t see. (And if you’re thinking I’m going to do it…)

We are going to start radiation as soon as possible, possibly as early as Christmas week. We are fortunate because So Young may qualify for a clinical trial involving the use of chemotherapy for Type 2 patients. Chemotherapy is not generally used for Type 2 patients but is always used for Type 3 and 4 patients. This would be ideal because of the “dividing cell” issue.

We deliberated about whether to continue going to Hopkins for radiation due to the distance from our home. We decided that we will get the best care possible there. So Young and I couldn’t be more pleased with the team that is working on our case.