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Brain Tumor Caused Kennedy Seizure
Senator Edward M. Kennedy's physicians have announced that the seizure that led to Kennedy's recent hospitalization was caused by a malignant brain tumor.
Given that Senator Kennedy had not suffered a stroke, physicians everywhere were already suspicious that some kind of mass was responsible for the seizures. In medical circles it was a pretty big elephant in the middle of the room, but everyone wanted to be hopeful.
During the brain imaging that was performed on Saturday, radiologists quickly identified an abnormal growth involving the left parietal lobe - a region of the brain not far from the left ear. The parietal lobe is involved is many higher-order functions like vision and speech.
The level of sophistication in today's CT/MRI scanners is so good that the doctors at Massachusetts General Hospital likely knew immediately what type of tumor they were dealing with because of its location and because each different kind of cancerous growth generates specific imaging features. Confirmation of the tumor diagnosis was established with a brain biopsy. You're right, nobody mentioned brain biopsy over the weekend, did they?
Pathologists studied the biopsy specimen and called it a malignant glioma. You probably know what the first word means. The term 'glioma' indicates that the tumor is made up of glial cells. Most of the brain is made up of neurons - nerve tissue. Glial cells are the housekeepers. They have odd-sounding names like astrocytes, oligodendrocytes and microglia. Glia insulate the neurons, synthesize important proteins, and generate connective tissue that holds the brain tissue together. They also serve important immune functions for all kinds of nerves. It is glial cells that are replicating in an uncontrolled, malignant fashion; not neurons, not nerve tissue.
You may be asking yourself, "Why not just scoop-out the tumor like an avocado pit?" Believe me, if it were possible the Senator would already be in the recovery room. Glial cells are highly infiltrative, making complete resection extremely problematic. Also, since this mass is situated in an area responsible for such critical tasks, it may not be helpful to further compromise such precious neuroanatomy. Kennedy's doctors are talking about radiation and chemotherapy. Overall survivorship is poor but much can be done to help Senator Kennedy enjoy a quality life in what time remains. Given his age (76) nobody contemplates hyper-aggressive treatments that potentially risk shortening an already-threatened life.
The tumor size is not very relevant. A tiny pea-sized growth in the brainstem will kill you far quicker than a slowly-expanding potato in the peripheral cortex.
Involvement of the parietal lobe suggests that Senator Kennedy's visual fields may be affected. Similar patients often develop a homonymous hemianopia: loss of right field of view in both eyes. Radiation treatments may also contribute to field loss.
Now the real work begins. Senator Kennedy's tumor will be accurately staged with regards to its cellular features, degree of aggressiveness, and areas of involvement. Experts will discuss which specific treatment regimen offers him the most favorable outcome, not necessarily the longest life. Cycles of radiation treatment and chemotherapy will then begin with periodic re-evaluations to assess the effects of therapy and the patient's clinical response. During all of this, other health care team members will monitor Kennedy's nutrition, blood labwork, physical activity and neurologic performance.
It's too early to speculate as to whether of not Senator Kennedy will resign from office. It may not be necessary. Right now he is fully functional and enjoys a spectacular support system. Most Americans diagnosed with malignant glioma find the courage to keep on working for as long as they can. I would expect nothing less from this latest brain cancer victim.
Related Topics:
Given that Senator Kennedy had not suffered a stroke, physicians everywhere were already suspicious that some kind of mass was responsible for the seizures. In medical circles it was a pretty big elephant in the middle of the room, but everyone wanted to be hopeful.
During the brain imaging that was performed on Saturday, radiologists quickly identified an abnormal growth involving the left parietal lobe - a region of the brain not far from the left ear. The parietal lobe is involved is many higher-order functions like vision and speech.
The level of sophistication in today's CT/MRI scanners is so good that the doctors at Massachusetts General Hospital likely knew immediately what type of tumor they were dealing with because of its location and because each different kind of cancerous growth generates specific imaging features. Confirmation of the tumor diagnosis was established with a brain biopsy. You're right, nobody mentioned brain biopsy over the weekend, did they?
Pathologists studied the biopsy specimen and called it a malignant glioma. You probably know what the first word means. The term 'glioma' indicates that the tumor is made up of glial cells. Most of the brain is made up of neurons - nerve tissue. Glial cells are the housekeepers. They have odd-sounding names like astrocytes, oligodendrocytes and microglia. Glia insulate the neurons, synthesize important proteins, and generate connective tissue that holds the brain tissue together. They also serve important immune functions for all kinds of nerves. It is glial cells that are replicating in an uncontrolled, malignant fashion; not neurons, not nerve tissue.
You may be asking yourself, "Why not just scoop-out the tumor like an avocado pit?" Believe me, if it were possible the Senator would already be in the recovery room. Glial cells are highly infiltrative, making complete resection extremely problematic. Also, since this mass is situated in an area responsible for such critical tasks, it may not be helpful to further compromise such precious neuroanatomy. Kennedy's doctors are talking about radiation and chemotherapy. Overall survivorship is poor but much can be done to help Senator Kennedy enjoy a quality life in what time remains. Given his age (76) nobody contemplates hyper-aggressive treatments that potentially risk shortening an already-threatened life.
The tumor size is not very relevant. A tiny pea-sized growth in the brainstem will kill you far quicker than a slowly-expanding potato in the peripheral cortex.
Involvement of the parietal lobe suggests that Senator Kennedy's visual fields may be affected. Similar patients often develop a homonymous hemianopia: loss of right field of view in both eyes. Radiation treatments may also contribute to field loss.
Now the real work begins. Senator Kennedy's tumor will be accurately staged with regards to its cellular features, degree of aggressiveness, and areas of involvement. Experts will discuss which specific treatment regimen offers him the most favorable outcome, not necessarily the longest life. Cycles of radiation treatment and chemotherapy will then begin with periodic re-evaluations to assess the effects of therapy and the patient's clinical response. During all of this, other health care team members will monitor Kennedy's nutrition, blood labwork, physical activity and neurologic performance.
It's too early to speculate as to whether of not Senator Kennedy will resign from office. It may not be necessary. Right now he is fully functional and enjoys a spectacular support system. Most Americans diagnosed with malignant glioma find the courage to keep on working for as long as they can. I would expect nothing less from this latest brain cancer victim.
Related Topics:
- 10 Important Questions to Ask Your Doctor About Brain Cancer
- WebMD Video: Life After a Brain Tumor
- WebMD Video: Brain Tumor Vaccine
