Brain Tumor Recurrence: Causes and Treatment Options

Brain tumor recurrence

I would like to ask the doctor about the conditions under which brain tumors are likely to recur.
My friend suddenly fainted in November 2014, and bystanders said it was a seizure; this was the first episode, and he had no prior symptoms.
After examination, a brain tumor approximately 9 cm in size was found, classified as stage II, located in the right hemisphere near the frontal lobe.
He had follow-up appointments every three months, but the tumor regrew, leading to a second craniotomy and radiation therapy.
His recovery post-surgery was good, and he continued regular three-month follow-ups.
However, in October 2016, the tumor had grown another 2 cm in the same location, and he is preparing for a third craniotomy.
I would like to know if a 2 cm growth within three months is considered too rapid, and what could cause this? The attending physician mentioned that they would perform a biopsy during the surgery, and if the results are unfavorable, targeted therapy may be necessary.
What does targeted therapy entail? Up to this point, my friend has not exhibited any symptoms typically associated with brain tumors, nor has he experienced any postoperative complications.
Does this suggest that the tumor is benign? The only noticeable change after the surgeries is a scar, and there is some drooping of the tendon near the right temple, making his face appear slightly unusual.
With three surgeries, will there be any issues with skull healing? I look forward to your response.

Ting, 30~39 year old female. Ask Date: 2016/10/23

Dr. Zhang Junwei reply Neurosurgery

To determine the type of brain tumor, whether it is benign or malignant, and the cellular characteristics, is essential for understanding the likelihood of recurrence.
Targeted therapies or chemotherapy should not pose issues for the skull.

Reply Date: 2016/10/23

More Info

Understanding brain tumor recurrence is a complex issue that involves various factors, including the type of tumor, its location, the treatment received, and individual patient characteristics. In your friend's case, the recurrence of the tumor after surgery and radiation therapy raises several important points to consider.

Firstly, brain tumors can be classified into different grades, with Grade II tumors being considered low-grade and generally having a better prognosis than higher-grade tumors. However, even low-grade tumors can recur, especially if they are not completely resected during surgery. The fact that your friend had a 9 cm tumor initially and then experienced recurrence suggests that there may have been residual tumor cells left after the first surgery. This is not uncommon, as some tumors can infiltrate surrounding brain tissue, making complete removal challenging.

The rapid growth of 2 cm within three months is concerning and indicates aggressive behavior of the tumor. Factors that can contribute to tumor recurrence include:
1. Incomplete Resection: If the tumor is not entirely removed during surgery, the remaining cells can proliferate and lead to recurrence.

2. Tumor Biology: Some tumors have inherent characteristics that make them more aggressive and prone to rapid growth. Genetic mutations and the tumor's microenvironment can influence this behavior.

3. Treatment Response: The effectiveness of the initial treatment (surgery and radiation) can vary. If the tumor is resistant to radiation or if the dose was insufficient, it may lead to recurrence.

4. Patient Factors: Individual differences in immune response, overall health, and genetic predisposition can also play a role in tumor recurrence.

Regarding the term "targeted therapy," this refers to a type of cancer treatment that uses drugs or other substances to precisely identify and attack cancer cells, usually while doing little damage to normal cells. Targeted therapies can work by blocking the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. This approach is often used in conjunction with other treatments, such as chemotherapy or radiation, especially if the tumor is found to have specific genetic mutations that can be targeted.

As for the concern about the healing of the skull after multiple surgeries, it is essential to monitor the healing process. The skull can heal well after surgery, but multiple surgeries may lead to complications such as infection, delayed healing, or issues with bone regrowth. Regular follow-ups with imaging studies, such as CT or MRI scans, are crucial to ensure that the bone is healing properly and that there are no complications.

In conclusion, while your friend's situation is challenging, it is essential to maintain close communication with the healthcare team. They can provide the most accurate assessments and recommendations based on the latest imaging and pathology results. If there are concerns about the tumor's behavior or the healing process, discussing these openly with the medical team can help in making informed decisions about further treatment options.

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