Sunday, September 16, 2007

Malignant or Benign, that is the question.

So, I thought I might take a moment to address this, the most often asked question. In 'normal' (i.e. not CNS (central nervous system) ) tumors, this is an extremely important question. If you have a malignant tumor, it has the potential to spread quickly throughout the entire body and affect every organ - including eventually spreading to the brain. In tumors of the brain and spinal cord (again, the CNS), these criteria don't really apply. Even in the most aggressive malignant brain tumors, they won't spread to the rest of the body (usually). The CNS is a closed system and, ordinarily, the tumors stay within the CNS. The terms malignant and benign are also misleading when it comes to brain tumors because a malignant tumor may be more treatable and in a better spot than a benign brain tumor that is larger, or in a bad spot. Many people breathe a sigh of relief when told their brain tumor is benign, but this label can be misleading. I liked this explanation I found online:

Grade - benign or malignant?
Brain tumours are put into groups according to how fast they are likely to grow. There are 4 groups called grades 1 – 4. The cells are examined under a microscope. The more normal they look, the more slowly the brain tumour is likely to develop and the lower the grade. The more abnormal the cells look, the more quickly the brain tumour is likely to grow and the higher the grade. Low grade gliomas (grade 1 and grade 2) are the slowest growing brain tumours.You may have been told you have a benign tumour or a malignant tumour. As a rule of thumb, low grade tumours are regarded as benign and high grade as malignant.

By benign, we generally mean
*The tumour is relatively slow growing
*It is less likely to come back if it is completely removed
*It is not likely to spread to other parts of the brain or spinal cord
*It may just need surgery and not radiotherapy or chemotherapy as well

By malignant, we generally mean
*The tumour is relatively fast growing
*It is likely to come back after surgery, even if completely removed
*It may spread to other parts of the brain or spinal cord
*It cannot just be treated with surgery and will need radiotherapy or chemotherapy to try to stop it from coming back.

With other types of cancer, these black and white explanations of benign and malignant work well. But with brain tumours, there are a lot of grey areas. Some low grade astrocytomas can spread to other parts of the brain or spinal cord. Radiotherapy and chemotherapy are sometimes used to treat 'benign' tumours. Even a slow growing tumour can cause serious symptoms and be life threatening if in a crucial part of the brain. So, you really need to ask your specialist to explain your own situation to you fully and simply.

We have never been told whether Matthew's tumor is benign or malignant. After reading these simplified explanations, I think I know why. Matt's tumor takes in characteristics of each type of tumor. It should be slow growing, because under a microscope it looks like a low-grade glioma. However it has also spread, pretty dramatically, beyond his hypothalamus, to his brain stem and down his spine. They are also treating the tumor with some heavy chemotherapy and the plan is to begin radiation once he turns 10. So, in short, he seems to have a benign type tumor that is behaving more like, and we are treating like a malignant type tumor.

So, the gist of this whole post is to say that we really don't know, we do care, but it doesn't actually seem to matter...... There, now, does that answer your question? :-)

P.S. Can I just tell you all, how HUGE I am right now! I had a sad/funny moment when I realized I was wandering the aisles of Kohl's looking for clothes to try on and my only requirement was that they have an elastic waist or be that super stretchy material that is popular right now. Oh, of course it could also be maternity, but there wasn't a whole lot in that department! I am in a sad state! This baby is poking out SO far!


K said...

Alli -
You are amazing! We love you all! We love reading your blog - it keeps us up without having to bother you day and night! Love you ALL!

April said...

We have been keeping up on Matt's progress. Our prayers are with you.

I feel for your plight regarding maternity clothes. I was huge with all of mine. I found that I could handle the largest stretchy things from the "regular" clothes department so as not to feel like a circus tent.

Our son carl asks about Matt every day. And prays for him each night.

We hope there are more smiles and up days as the time progresses.

Much Love,
The Agrens (Carl, April, Carl, Ha-Na, and Madison)

Karen and Lew said...

Thank you for clarifying the difference between benign and malignant. I don't think that doctors realize how important these classifications are to the rest of us. To them it might mean a change in treatment, to us it might mean being able to sleep (or not) at night.

I am glad that things are going well with Goodworth Junior. Delight in the fact that stretchy waistbands are on your mind. It means you are still able to find some normalcy in your life. ;)