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Bad news

February 19, 2008

MRI of ‘Cranius’

The Neuro-Surgeon dealt us quite a bad blow today. Let’s start with the facts:

  1. The tumor has become more obvious (demarcated) in the functional area for speech. This does not necessarily mean that the tumor has grown but at least it means that the Glioma has changed
  2. The loss of right motor function has become more obvious. This is not necessarily due to the Glioma as rheumatism has kicked in again with full force since I had to stop with a drug called Eternacept (Enbrel)
  3. The results of fMRI and MEG show that the Glioma is about 2 cm away from my speach area and has probably infiltrated the motor area

The first conclusion is that (Awake) Craniotomy in combination with Penfield brain mapping is no longer an option as it is considered too risky. The Neuro-Surgeon explained that he can’t remove a Glioma that has already infiltrated a function area. He does not consider the removal of the Glioma near the speech area and not near the motor area an option (near an option (a chain is as strong as the weakest link). Awake Craniotomy in combination with brain mapping was my best option as it combined a contolled risk with optimal tumor tissue removal.

The two remaining options are “Wait-and-See” (or any other fancy term) and a “Regular” Craniotomy. We had discarded the first option before and now that the Glioma seems to be growing is that still a good choice. The only option left is a Craniotomy and we were informed that although I will not be awake during surgery my motor function will be mapped without my cooperation.

The Neuro-Surgeon described a study that was performed among 200 patients with Glioma. These patients were divided in three groups: “Wait-and-See”, “Craniotomy” and “Awake Craniotomy”. The prognosis for the first group is poor, excellent for the third group and somewhere in the middle for the second group. I will try to obtain less vague information but I guess you get my point. My prognosis today is roughly 50% of last week. Surgery is planned for April-May.

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