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Test shows brain tumor abuts the dura, fourth ventricle increase in size. Treatment options?

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Brain Tumor abuts the dura and within the posterior fossa, fourth ventricle increase in size measuring 43 mm sagittal, 33mm transverse and 19mm AP compared to previous 36 mm sagittal, 27 mm transverse and 13 mm AP. Female 84 years old. What are the treatment options? What are the pros and cons?
Posted Mon, 26 Aug 2013 in Brain and Spine
Answered by Dr. Chobufo Ditah 1 hour later

Thank you so much for this query. I am so sorry to hear about the diagnosis brain tumor. Though it sounds a devastating diagnosis, we are always better of knowing our problems to better address them. Courage and take on the challenge. I am assuming this should be some one related to you and so would use she/her in my discussion.

From the information you have provided, this tumour is impinging on the ventricles and has started to cause some signs of hydrocephalus as evident on the findings. There is no doubt that this tumour need to be addressed but before we get there, we need some more information.

Please, can you provide more information about the size of this tumour? Its presentation on the scan? This is very important as to decide whether operating n the tumour is possible. Can you please upload the full scan pictures with the complete report?

Secondly, has a biopsy been done? This is very important to know what is the exact tumour type and whether chemotherapy/radiotherapy is going to yield good results.

These said, brain tumors are generally treated with a combination of surgery, chemotherapy and radiotherapy. Its location, type, size and nature greatly influence what option or combination of options would be used. Also, we need to evaluate this patient to see whether she can tolerate surgery and or chemotherapy/radiotherapy before choosing a well adapted plan for her if the decision to treat is made.

The pros and cons depend on the exact treatment used taking into accounts the tumour type. What's common after brain surgery is the likely possibility of loosing some brain functions. Those lost depends on what part of the brain tissue was taken out. The cons for chemotherapy and radiotherapy are essentially the immune suppression they cause and the side effects of the medications like anemia, hair loss, bleeding disorders, vomiting etc.

Don't get me wrong, but given the age of this client, we may want to find out if pursuing aggressive treatment option is advisable and what would be the quality of life after this and not only how many more years we may add.

No matter how much information I provide here, you will need to XXXXXXX a team of oncologists and neurosurgeons to decide what the ultimate approach would be as there are many other things I cannot assess from a distance.

I hope to hear from you before making definite suggestions.
I understand how heavy this is. I wish you courage and her the best of possible outcomes.
Dr. Ditah, MD
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