Glioma diagnosis is grave news for Sen. Kennedy
WASHINGTON (Reuters) - A diagnosis of malignant glioma is grave news for Massachusetts Sen. Edward Kennedy, brain experts said on Tuesday.
A malignant glioma kills half its victims within a year and patients rarely survive more than three years. Even surgery cannot cure such a tumor, which sends fingers of cancerous cells into nooks and crannies of the brain, doctors agreed.
However, Kennedy, 76, has a chance of extending his life with chemotherapy -- the preferred drug is a pill with few side-effects -- and radiation.
"A diagnosis of a malignant brain tumor can be one of the most terrifying diagnoses that patients or their loved ones can hear," said Dr. Keith Black, chairman of the department of neurosurgery at Cedars-Sinai Medical Center in Los Angeles.
Kennedy suffered a seizure on Saturday and has been undergoing tests in the hospital ever since. A biopsy -- a little sample of brain tissue -- confirmed a malignant glioma.
"Glioma is not a specific type of cancer. It is a general category of brain tumor that includes astrocytomas, oligodendrogliomas, and ependymomas. About 42 percent of all brain tumors, including benign ones, are gliomas," the American Cancer Society said in a statement.
But several neuro-oncologists said if the tumor is malignant, it is very likely to be one of two types -- an anaplastic astrocytoma or a glioblastoma multiforme.
"Anaplastic astrocytoma is a better prognosis," said Dr. Lynne Taylor, a spokeswoman for the American Academy of Neurology and a neuro-oncologist at the University of Washington in Seattle.
"It is not as rapidly growing as glioblastoma. Patients can sometimes survive three years. With a glioblastoma it is more classically 9 to 12 months," Taylor said in a telephone interview.
But, Taylor added, cancer is unpredictable. "I have some elderly people in their 70s and 80s with glioblastoma multiformes who realistically should have died within three months and have been alive three years."
There is no hope of a cure, however.
"The prognosis is bad and the therapy is by and large palliative rather than curative," said Dr. Robert Laureno, chair of neurology at Washington Hospital Center in Washington.
"I don't know enough about his case to say, but as a generalization, patients with malignant astrocytomas or gliomas, about half don't survive a year."
Such tumors are hard to remove surgically, Laureno said -- and Kennedy's doctors have not mentioned surgery as an option for him.
"These tumors ... tend to infiltrate, and it is hard to find the edges. It is like it is weaving its way in and out," Laureno said.
Massachusetts General Hospital in Boston, where Kennedy is being treated, said his tumor was in the left parietal lobe of the brain.
Several doctors agreed that surgery in this region could affect not only Kennedy's ability to speak, but potentially his ability to understand language and perhaps could paralyze his right side as well.
"If you have this diagnosis, then chances are great that it will be your terminal illness," Laureno said.
Treatment options include a pill called temozolomide, sold by Schering-Plough Corp. under the brand name Temodar, radiation therapy and perhaps an experimental cancer vaccine.
Genentech Inc's Avastin, an infused chemotherapy drug, can help slow the tumor's growth, Black said.
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