Thank you for allowing me to create this thread. I am a 31 years old male from Australia.
I recently got diagnosed with a Grade II Astrocytoma with histopathology report as follow;
Clinical Notes: Incidentally found left Insular region glioma
Mitoses: 0/HPF
Immunohistochemical Stains: Block 1
Ki67: 1%
How estimated: Visually and IDH1, Ki67 dual stain
IDH1 R132H: Positive
ATRX: Lost
P53: 10%(moderate/strong staining)
EGFR: Negative
Other Positive: GFAP, PHH3 highlights 2 mitotic figures, however, it remains possible that these cells are not tumor cells hence it shouldn't be used in grading
MGMT promoter Methylation: If clinically indicated. Block 1 Tumor 60%. Patient Agreement required.
I had Gross Total Resection and according to my neurosurgeon, there is no residual tumor left. Size upon diagnosis was around (14mm x 13mm x 10mm).
I had a few questions regarding Histopathology, wondering if you all can help, please?
1) Should I push for a more thorough genetic study on this tumor? Is it worth it at this point in time to get PTEN, MGMT (as it looks like they haven't performed this test) & Ip/19q codeletions? I know it is unlikely for it to be 1p/19q codeleted since it has p53 staining & ATRX loss.
2) Why does it mention mitotic figure: 0/10HPF, then goes on to mention PHH3 highlights 2 mitotic figures but 'possibly' nontumor cells? How do they know that they were nontumor cells?
3) Does Ki67 index & P53 values mean much?
My neurosurgeon has advised holding off any chemo/radiation for the time being and adopt a 'watch and wait' approach. I am happy to hold off chemo/radiation too but I do want to start taking supplements and other medication to possibly delay the recurrence. I plan on taking the following supplements and medication (Please tell if I am mental for doing it).
Supplements:
Curcumin (Longvida)
Vit D (4000IU)
Fish Oil
Vit C (4g)
Magnesium
Resveratrol
Green Tea Extract
Selenium
Milk Thistle
Sulforaphane (From broccoli sprouts)
ZINC: Should I add this? I read on this forum somewhere that it is not really beneficial for people who have enough Zinc levels in their blood.
Medication:
Aspirin daily 100mg daily (COX 2 Inhibitor) or should I consider Celebrex?
Melatonin (10g - 15g daily)
Metformin 1000mg daily (Keeping the blood sugar level down)
I am thinking of using;
Metformin 1000mg daily (Keeping the blood sugar level down)
Betablocker (Propanolol)
Low dose Mebendazole (Cycle off every after a month use)
Angiogenesis Receptor blocker
DCA
Clomipramine
Thank you for pointing out Isosidenib and Vorasidenib Steph!
- I am really worried about my glioma acquiring hypermutation, is it possible that Agios inhibitors can turn IDH1 into Wildtype by how they operate?
- I know no one knows for sure, but is it normal to adopt watch and wait approach for Grade II astrocytoma?
- Are there any clinical trials I should consider? I can't seem to find any trials on LGGs at the moment.
Thank you so much for taking out the time to read this.
Regards
Ruki
