MICHELE NORRIS, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris
Massachusetts Senator Edward Kennedy has been diagnosed with a malignant brain tumor. The 76-year-old senator was hospitalized in Boston over the weekend following a seizure he suffered at his Cape Cod retreat. Tests to determine the cause of that seizure show it is a malignant glioma, a type of brain cancer, his doctor said. The treatment and prognosis for Kennedy, a Democrat and a liberal icon of American politics, is not yet known.
To learn more about his type of brain tumor, we turn to Dr. Andrew Norden. He's a neuro-oncologist at Dana-Farber Cancer Institute. He joins us from Boston.
Welcome to the program, doctor.
Dr. ANDREW NORDEN (Neuro-oncologist, Dana-Farber Cancer Institute): Thanks for having me.
NORRIS: First, could you explain to us what exactly is a glioma?
Dr. NORDEN: A glioma is one of many kinds of primary brain tumors, meaning that it's a tumor that starts in the brain as opposed to a metastatic brain tumor, which might spread from another organ. Gliomas, in general, are the most common primary brain tumors in adults. Malignant brain tumors are quite difficult to treat. We see about 10 to 15,000 of them newly diagnosed in the United States each year.
NORRIS: What generally are the treatment options if they are so difficult to treat?
Dr. NORDEN: In general, there are a number of different types of malignant gliomas, and we don't yet know which type he has. That said, in general, the treatment consists of radiation and chemotherapy. Typically, the radiation and chemotherapy are given together for approximately six weeks, and then there's a brief treatment break. And after that, chemotherapy is given alone in monthly cycles for six to 12 months.
NORRIS: Would there be an effort to possibly remove the tumor via surgery?
Dr. NORDEN: Yes, I think so. Typically, treatment for this kind of tumor begins with what we call maximal surgical resection. What that means is that a surgeon tries to take out as much of the tumor as can be safely done without causing the patient any harm.
NORRIS: Has the senator already undergone surgery?
Dr. NORDEN: He has. We know that he has had a biopsy, according to the press release. Every sort of biopsy involves at least taking some small piece of the tumor and providing it to a pathologist to review to determine the type. The question, I think, is whether he had a more significant tumor resection, or whether they just did a very small biopsy to determine the diagnosis.
NORRIS: The tumor is said to be in his left parietal lobe. What does that tell you in terms of his prognosis and his function since this lobe controls language and sensory comprehension and some visual control?
Dr. NORDEN: Because the parietal lobe is rather large, and because every individual has somewhat different brain anatomy, it's very difficult to say in any individual case exactly what might be affected. It's certainly possible to have a tumor in that location that causes no symptoms whatsoever. It's possible to have a tumor in that location that causes only occasional seizures, which might be managed with medication. Or it's possible to have a tumor in that location that causes very significant numbness of the right side of the body, and perhaps some difficulty seeing off to the right side. Those are the spectrum of kinds of things that one might see.
NORRIS: What about speech?
Dr. NORDEN: With a tumor in the parietal lobe, one would not expect significant speech difficulties. One troubling problem with brain tumors, though, is that they tend to have a fair amount of surrounding swelling. And so, if this tumor in the left parietal lobe has some swelling that is involving speech areas, then it's possible to have difficulty finding words, or it's also possible to have difficulty understanding speech, either spoken or written.
NORRIS: Doctor, the Kennedy family has reported that Senator Kennedy has had no further seizures, that he's in good overall condition, and that he's up and walking around. What does that tell you?
Dr. NORDEN: I think that that's a good sign. It indicates, certainly, that he has not suffered any serious consequences of the surgery. I suspect that he's on some medication to control the swelling, and he's likely on medication to prevent further seizures. And I think the fact that he is able to be up and about and watching television, which I understand he did over the weekend, indicates that he has made a good recovery. And I suspect that he may be ready to leave the hospital in the next few days.
NORRIS: Dr. Andrew Norden is a neuro-oncologist at Dana-Farber Cancer Institute. He joined us from Boston. Thanks so much, doctor.
Dr. NORDEN: Thank you.
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