What type of Brain Cancer?

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What type of Brain Cancer?

by grazi on Sun Feb 25, 2018 02:33 AM

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Hi All,

I am super new to all of this and hoping to some help to understand what is happening with my dad.
He is 82 years old and in December started having weakness in his left leg. Pass forward a month and in January a CT Scan with contrast showed a tumor (plus two small ones) in his brain. Now due to his age some doctors were against surgery others in favour, but because of the risks he opted to not have surgery.
However doctors are saying that they can't tell what type of tumor it is unless they open the brain to do a biopsy or surgery. And if they don't know the kind of tumor there is no treatment such as chemotherapy or radiation that can be done. Basically doctor jsut gave him steroids to reduce brain swelling. Does anyone have any experience with this? Is is right that surgery is the only treatment? Jis condition seems to be deterirating rather quickly.
I live overseas so am not close in his day to day life. However at the end of January I visited for a week to spend a week with him. I have small children so couldn't stay away for too long. At the end of January, around 3-4 weeks ago he was ok, just with great difficult to walk due to his left leg weakness. His brain is super sharp (he is an author and was still writing every morning) and he is very active. However last week he had what seemed a mild seisure and was taken to hospital where after many tests they didnt find anything new. However the next day he had high grade temp and more tests were done and showed a very strong urine infection. So he took antibiotics for the last week and has been in bed very very weak. Now that the infection has passed he can no longer walk or move his left arm. The paralysis is taking over his left side, I spoke to him this morning and even his speech is a little slow. He is a lecturer so always spoke very clearly and loud.
A part from not undertading why is he not doing any other treatment I am quite anxious not knowing how long he might have left and when would be the time to visit again with the kids this time (I am literally in the other side of the world). On top of all my husband is having surgery tomorrow and clearly I won't be able to leave here for a few weeks. 
If advice will be grealty appreciated,

Thank you 

RE: What type of Brain Cancer?

by grazi on Sun Feb 25, 2018 05:28 AM

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On Feb 25, 2018 2:33 AM grazi wrote:

Hi All,

I am super new to all of this and hoping to some help to understand what is happening with my dad.
He is 82 years old and in December started having weakness in his left leg. Pass forward a month and in January a CT Scan with contrast showed a tumor (plus two small ones) in his brain. Now due to his age some doctors were against surgery others in favour, but because of the risks he opted to not have surgery.
However doctors are saying that they can't tell what type of tumor it is unless they open the brain to do a biopsy or surgery. And if they don't know the kind of tumor there is no treatment such as chemotherapy or radiation that can be done. Basically doctor jsut gave him steroids to reduce brain swelling. Does anyone have any experience with this? Is is right that surgery is the only treatment? Jis condition seems to be deterirating rather quickly.
I live overseas so am not close in his day to day life. However at the end of January I visited for a week to spend a week with him. I have small children so couldn't stay away for too long. At the end of January, around 3-4 weeks ago he was ok, just with great difficult to walk due to his left leg weakness. His brain is super sharp (he is an author and was still writing every morning) and he is very active. However last week he had what seemed a mild seisure and was taken to hospital where after many tests they didnt find anything new. However the next day he had high grade temp and more tests were done and showed a very strong urine infection. So he took antibiotics for the last week and has been in bed very very weak. Now that the infection has passed he can no longer walk or move his left arm. The paralysis is taking over his left side, I spoke to him this morning and even his speech is a little slow. He is a lecturer so always spoke very clearly and loud.
A part from not undertading why is he not doing any other treatment I am quite anxious not knowing how long he might have left and when would be the time to visit again with the kids this time (I am literally in the other side of the world). On top of all my husband is having surgery tomorrow and clearly I won't be able to leave here for a few weeks. 
If advice will be grealty appreciated,

Thank you 

I think the main quwwtion I want to ask is is it teuw that the only way to find outf the kind of cancer and then decide on treatment is by opening the brain?

No treatment otherwise?

RE: What type of Brain Cancer?

by modesta on Mon Feb 26, 2018 02:31 PM

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wow - that is tough - first of all I think he NEEDS to be at a good cancer hospital, maybe MD Anderson - they will surely be able to answer that question correctly.

Prayers

Modesta

RE: What type of Brain Cancer?

by bobarmstrong on Mon Feb 26, 2018 03:49 PM

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Is there any information about the location of the tumor?  Did the doctors say anything about a needle biopsy?  Even if surgery is not or can not be done some radiation might help to extend life for a while.  Without knowing exact location and type of tumor nothing can be done.  

RE: What type of Brain Cancer?

by Kasimon65 on Mon Feb 26, 2018 07:32 PM

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I would encourage him to be seen by a neuro-oncologist. They are the specialists when it comes to brain cancer. Our oldest son (35 years old) was just diagnosed  (for the second time, beat it first time at age 3) with a brain tumor and the regular oncologist and neurosurgeon just wanted to send him home on steroids and keep him comfortable. That was unacceptable when he hadn't even been seen by a specialist. We pushed and he is in great hands now with a neuro-oncologist in Atlanta.

RE: What type of Brain Cancer?

by Mack1994 on Fri Mar 02, 2018 12:39 AM

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On Feb 25, 2018 2:33 AM grazi wrote:

Hi All,

I am super new to all of this and hoping to some help to understand what is happening with my dad.
He is 82 years old and in December started having weakness in his left leg. Pass forward a month and in January a CT Scan with contrast showed a tumor (plus two small ones) in his brain. Now due to his age some doctors were against surgery others in favour, but because of the risks he opted to not have surgery.
However doctors are saying that they can't tell what type of tumor it is unless they open the brain to do a biopsy or surgery. And if they don't know the kind of tumor there is no treatment such as chemotherapy or radiation that can be done. Basically doctor jsut gave him steroids to reduce brain swelling. Does anyone have any experience with this? Is is right that surgery is the only treatment? Jis condition seems to be deterirating rather quickly.
I live overseas so am not close in his day to day life. However at the end of January I visited for a week to spend a week with him. I have small children so couldn't stay away for too long. At the end of January, around 3-4 weeks ago he was ok, just with great difficult to walk due to his left leg weakness. His brain is super sharp (he is an author and was still writing every morning) and he is very active. However last week he had what seemed a mild seisure and was taken to hospital where after many tests they didnt find anything new. However the next day he had high grade temp and more tests were done and showed a very strong urine infection. So he took antibiotics for the last week and has been in bed very very weak. Now that the infection has passed he can no longer walk or move his left arm. The paralysis is taking over his left side, I spoke to him this morning and even his speech is a little slow. He is a lecturer so always spoke very clearly and loud.
A part from not undertading why is he not doing any other treatment I am quite anxious not knowing how long he might have left and when would be the time to visit again with the kids this time (I am literally in the other side of the world). On top of all my husband is having surgery tomorrow and clearly I won't be able to leave here for a few weeks. 
If advice will be grealty appreciated,

Thank you 

Hello grazi, allow me to introduce myself, I'm a 26 year survivor of brain cancer and have had chemo and radiationtherapy and 4 surgeries for resection of tumor. I am also a retired Registered Nurse. 

You certainly have a lot to deal with, living so far from your father and a husband having surgery and children to raise, your probably feeling overwhelmed and it is all overwhelming.

You said your father had a CT scan with contrast, which does show the prescence of tumors, but unlike an MRI with contrast, which can show a great deal more of the tumor structure and how it uptakes the contrast, or does not uptake the contrast is revealing for tumor type if interpeted by a neuro-radiologist or experienced neuro-surgeon.

The standard of treatment presently is resection of tumor, if possible, depending on location, not all tumors are resectable, if resection is not possible then a skilled neurosurgeon will perform a debulking of as much of the tumor as possible, this accomplishes two thing, the removal of some of the cancerous tissue and also provides tissue for pathology to determine the cell type of the tumor and also to for other biomarkers, such as co-deletion of certain components of the chromosomes of the tumor cell along with determing the tumor cells ability to replicate and at what rate to grow.

So much more is known today as was known when I was diagnosed in 1994, most tumors can be treated, but not all can be defeated.

At 82 years old your father is true elderly, and with age the risks associated with surgery of almost any type is greater, what is usually performed is known as risk stratification, the patient is assessed for cardiac function, kidney function along with liver function and for the existence of any other health problems, such as high blood pressure, diabetes, and lung function, a major medical center with full surgical services can competently make such an assessment.

 From your posting it sounds that your father should have a second opinion at a medical center that has experience with brain tumors, along with the full ancillary services to treat the cancer.

In conclusion I suggest 

A second opinion at a medical center that has a full neurosurgery program and hematology/oncology service that can administer the current standard of treatment which is:

Resection of tumor, followed by radiation and chemotherapy.

The prescribing of steriods is appropriate to reduce swelling, and possibly anti-seizure medication to prevent seizures which are pretty common with brain tumors. Please keep me posted as I will attempt to be informative and supportive as possible as well as the other members of this board. I wish and pray for you going forward, this will be a challenging time for you.

My best tyo you

Mack1994

RE: What type of Brain Cancer?

by ToddlerFather on Fri Mar 02, 2018 01:55 AM

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Perhaps radiosurgery would be an option ? SRS/SBRT, CyberKnife etc. 

RE: What type of Brain Cancer?

by drdtc on Thu Mar 29, 2018 03:30 PM

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“No treatment without tissue”, is one of tenets of oncology. That may not be universally true, but it is a strong belief. A brain biopsy, which sounds tough, was quite tolerable for me. This might be reasonable to provide diagnostic information and thus to guide further treatment. As always, talk with his treatment team, especially the neurosurgeon.
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