Urgently need 2nd opinion on brain surgery for multicentric glioma

Posted by aasthapuri @aasthapuri, Aug 25, 2016

My father was diagnosed with Multicentric Glioma- Brain Cancer last year. Earlier in the month of May 2015, two lesions on the left frontal area of his brain were identified and were characterized as malignant tumor cells (through Biopsy). He underwent treatment at Apollo Hospital in Delhi, which included Chemotherapy (temozolomide)-(it been almost 1 year) and Radiation for 6 weeks and based he has been on chemotherapy ever since with a small gap. He had been responding well to chemotherapy and the tumor size had marginally reduced. However, last month his speech and cognition have been impacted due to the location of these lesions. The swelling post radiation is causing him to greater loss of speech and cognition especially these days. He is currently admitted in ICU at Apollo and undergoing series for scans to reevaluate his status. With the latest MRI scans show that the swelling and edema has significantly increased and the doctors are planning for awake surgery/craniotomy with de-bulking on Monday 29th August . However, this will have significant impact on his speech and comprehension as it is in a very sensitive area and has risks.

We are really looking for an alternative options to reduce edema/swelling in the brain and not surgery. Are there any options of minimally invasive treatments to reduce the pressure and swelling in the brain. We just have 2-3 days to make a decision. Please advice, will greatly appreciate any support.

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Hi @aasthapuri
How stressful it must be to have to make such decisions in such a short period of time. I'm tagging a few other members from the Brain Tumor group who may be able to offer some thoughts, even if their experience isn't exactly the same as your father's. Please meet @IndianaScott @robinjenkins70 @cynaburst @js119 and @adri.

If you'd like to get a second opinion from experts at the Mayo Clinic, please call any of our 3 campuses, http://mayocl.in/1mtmR63. You will be offered an appointment within 48 hours Be sure to mention the Brain Tumor 48-access program. They can help you navigate your healthcare journey, answer your questions and guide you through the treatment plan.

@aasthapuri - have any options beside surgery been discussed?

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At this point they have not suggested any alternate treatment to reducing swelling/edema or reducing pressure. We are really desperate to know any alternative and minimally invasive treatment for doing so.
As he has undergone Chemo for over a year and radiation (6 weeks) - he had been responding well to chemo however, this swelling has aggravated just within the last few days.

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Have they put him on any steroids to try to reduce swelling? I don't know if that is effective in this situation, but that is what I took for brain swelling.

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Hello @aasthapuri. I am so sorry to hear of your father's challenges. I am Scott and while I have not had cancer, my wife fought brain cancer for 14+ years. I was her caregiver for those years. Shortly after her diagnosis my wife had swelling and the doctors determined the only option for her was surgery to relieve the pressure. The doctors also resected as much of her tumor as they could at the time (it was in her right frontal cortex, but she was also left-handed) and they believe this actually helped with her longevity. She did lose several of her abilities, but with significant rehab she regained all of them, except for higher math skills. I don't know if any of this helps, but I hope it may. Feel free to ask any questions you may have.

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@cynaburst

Have they put him on any steroids to try to reduce swelling? I don't know if that is effective in this situation, but that is what I took for brain swelling.

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he had been taking high dose of corticosteroids for last 3 months

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What about steroids? My husband was put on dexamthasone for his brain swelling and bleeding. Hope it will work in your case.

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