Grading and prognosis for brain tumours

Grading tumours

The tumour will be given a grade based on how the cells look compared to normal cells. The grade suggests how quickly the cancer may grow. The grading system most commonly used for brain tumours is from the World Health Organization. Brain and spinal cord tumours are usually given a grade from 1 to 4, with 1 being the lowest grade and least aggressive, and 4 the highest grade and most aggressive.

Unlike cancers in other parts of the body that are given a stage to show how far they have spread, primary brain and spinal cord tumours are not staged, because most don’t spread to other parts of the body.

Grades of brain and spinal cord tumours

grade 1 –  These tumours are low grade, slow growing and benign.

grade 2 – These tumours are low grade and usually grow slowly. They are more likely to come back after treatment and can develop into a higher-grade tumour.

grades 3 and 4 – These tumours are high grade, faster growing and malignant. They can spread to other parts of the brain and tend to come back after treatment.

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your individual prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease.

Several factors may affect your prognosis, including:

• the tumour type, location, grade and genetic make-up
• your age, general health and family history
• whether the tumour has damaged the surrounding healthy brain tissue
• how well the tumour responds to treatment.

Both low-grade and high-grade tumours can affect how the brain works and be life-threatening, but the prognosis may be better if the tumour is low grade, or if the surgeon is able to safely remove the entire tumour.

Some brain or spinal cord tumours, particularly gliomas, can keep growing or come back. They may also change (transform) into a higher-grade tumour. In this case, treatments such as surgery, radiation therapy and/or chemotherapy may be used to control the growth of the tumourfor as long as possible, relieve symptoms and maintain quality of life.

My wife Robyn was diagnosed with grade 4 brain cancer when she had just turned 50. After getting a diagnosis like that, you just go into shock for a couple of days, then you start thinking about how things will change, you evaluate your life and what you need to do to help.

Ross