Up-close and Sort of Personal: the Pathologist's Report

View of a Pilocytic Astrocytoma

The past few weeks, Scott has been doing a great deal of blogging but I have been sort of MIA. I’ve felt like I was so busy running from one task to the other that when I sat down; well, I just wanted to sit. This morning I realized that my blogging was not the only thing over due, we had also failed to share with many of you about Scott’s doctor’s appointment Tuesday at which we got the results from the pathologists examination of Scott’s tumor. Now, Scott is convinced that blogging should be relational and emotive in content rather than informational, so I’m giving all of you the warning that this blog is most likely going to be more informational in content as I want to explain to you how the visit went and what the doctor said, answering as many questions as I can along the way. Later, when I have some more time perhaps I’ll share something more relational with you all ;)

Anyway, as I said, Tuesday Scott and I went to meet with Dr. Dacey to get his staples out and for a follow up. Dacey was very pleased with how well Scott was doing (of which I had no doubt); he did his whole battery of fancy neurological tests: walking in a straight line, running your foot from your knee to your ankle, touching your finger to your nose and then the doctors finger, standing with you eyes closed ect. Scott passed them all, and Dr. Dacey declared that he saw no neurological effects from the surgery, which means that his brain seems to be working just like it should be.

Dacey then went over the reports from the pathologist. The short story is that he thinks that Scott had a benign Pilocytic astrocytoma and that he needs to get MRIs in the future but nothing else. We are very happy, that is good news.

 If however, you want to know more about what that all means, here is the long story:

When we first met with Dr. Dacey a couple of months ago, he said that he thought that this was most likely a slow growing glioma. A glioma is any tumor that grows from the glial cells, which are one of the types of cells in the brain. Glial cells make up the non-neurological parts of the brain. That is, they do not transmit information but give structure and support to the brain so that it can do everything that the brain does. For more on gliomas. Now, where it gets kind of confusing is that there are  many different types of gliomas.  It’s like the soup aisle at the grocery store.  If I just asked Scott to go pick up some ‘soup,’ who knows what I’d get back from County Market! Just as we know what kind of soup we're eating because of what we find in the soup, so too do doctors categorize tumors based on what makes up the tumor (ie. the types of cell, structure and how quickly it seems to be growing).

After they removed Scott’s tumor, they sent it to the pathologist, a type of doctor who cuts up the tumor, and studies it under a microscope. The pathologist concluded that the tumor is what is called an Astrocytoma, a type of glioma. (Of course there are many different kinds of astrocytomas just as there are different kinds of chicken soup.) So we will continue to get more specific as we progress-o. These are the tumors that grow along a type of glial cell called astrocytes. Astrocytes got their name because they look like stars. They are most commonly found in the cerebellum (the area of the brain where Scott’s tumor was and in the spinal cord). Astrocytes support, or keep alive cells that line blood vessels in the brain). Though there are many different kinds of astocytomas, the good news is they do not typically spread out side of the brain, meaning they don’t usually metastasis causing tumors in other organs. For more on astrocytomas.

An Astrocyte

Dr. Dacey and the pathologist think that Scott’s tumor was what they call a Pilocytic astrocytoma. For more on pilocytic astrocytomas.  This is one of the slowest growing of the astrocytomas, which means that of all the different kinds of brain tumors Scott could have had, this is one of the better ones. (We lucked out). These are usually considered benign (non-cancerous). The biggest concern with these is that they can become large, causing damage and problems. We were lucky because we found this before it caused symptoms and real damage. It was small, remember we found this accidentally. Because of all of this, and because of Scott’s age, Dr. Dacey is of the mindset that there is nothing more we need to do; he does not think that Scott needs any radiation or anything of that sort.

Now, when the pathologist was looking at Scott’s tumor, it looked a little different than most pilocytic astrocytomas. There is a kind of fiber they normally find in these tumors called Rosenthal fibers, and his tumor did not have many of them. Now of course when they classify tumors, this is not always as much an exact science as we like to think, just as sometimes its hard to tell the difference between chicken noodle soup and chicken and dumpling soup (one can morph into the other as its noodles become bigger). Dr. Dacey did not seem concerned about this, but he did say that he would present this to his tumor board. So, he will take all of these findings and discuss them with all the other doctors in his department to make sure that they are all in agreement. This means, that rather than getting a second opinion, we will get 10 opinions all working together. When we have our next appointment with Dr. Dacey he will tell us how this discussion went. Scott will also have another MRI in 6 months and then most likely every year after. This is all very good news for us.