Glioblastoma Multiforme

Playing golf after glioblastoma surgery

Dear friends,
Below is a write up of different types of brain tumors. I find it very educational and would like to share it with you all.


Astrocytomas and oligodendrogliomas are the most common primary tumors of the adult brain. Both tumors are types of gliomas. Primary brain tumors arise from cells of the brain itself rather than traveling, or metastasizing, to the brain from another location in the body. Gliomas can be slowly growing (low-grade, grades 1 and 2), or rapidly growing (high-grade, grades 3 and 4). This material will give important facts about the diagnosis and treatment of high-grade gliomas.
High-grade gliomas are diagnosed by a biopsy

Once a brain tumor is detected on a CT or MRI scan, a neurosurgeon obtains tumor tissue for examination by a neuropathologist (a biopsy). The neuropathologist then gives the tumor a name and grade. The exact name and grade of the tumor determine treatment options, and also give important information about prognosis.

When neuropathologists analyze tumor tissue under a microscope, there are two main questions being asked:
-first, what type of brain cell did the tumor arise from? The answer to this question gives the tumor a name, for example, astrocytoma.
-second, do the tumor cells show signs of rapid growth? This involves assigning the tumor a grade, such as grade 3 or 4 (see below).
These two pieces of information are then combined, as in "grade 4 astrocytoma". Once a tumor has been given a name and a grade, brain tumor specialists can give advice about treatment choices, prognosis, and provide useful health-care information to brain tumor patients and their families.

Tumor name: from what type of brain cell did the tumor arise?
Astrocytomas arise from brain cells called astrocytes. Normal astrocytes are star-shaped cells that give the brain its shape. Astrocytes are the most common cell type to become tumors. Oligodendrocytes are brain cells that provide insulation around the electrically-active neurons. Tumors of oligodendrocytes are less common than astrocytomas. Many tumors contain a mixture of astrocytoma and oligodendroglioma cells. Tumors of other cell types in the brain are less common. For instance, tumors of neurons are very rare in adults.

Tumor grade: how aggressive does the tumor appear under the microscope?
Astrocytomas and oligodendrogliomas come in four grades, with grade 1 being the most benign and grade 4 being the most malignant. The neuropathologist looks at the brain tumor tissue under the microscope for signs that the tumor is growing rapidly. Examples of these features include cells undergoing division (mitosis), the presence of newly-formed blood vessels, and evidence that the tumor is outgrowing its blood supply (necrosis). The more features that are present, the higher the grade assigned to the tumor.

Gliomas have more than one name in everyday usage. The Table gives the common names of high-grade gliomas:
Synonyms for high-grade Gliomas
Anaplastic astrocytoma = grade 3 astrocytoma
Glioblastoma multiforme = grade 4 astrocytoma
Anaplastic oligodendroglioma = grade 3 oligodendroglioma (oligodendrocytoma)
Anaplastic oligoastrocytoma = grade 3 oligoastrocytoma = anaplastic mixed glioma

Why do brain tumors occur?
Tumors form because of the abnormal, unregulated growth of cells. After the human brain completes it development soon after birth, the vast majority of its cells enter a resting state in which they never divide again. One exception to this rule is when a brain tumor develops. The abnormal brain cells re-enter the "cell-cycle" because of alterations in any of a large number of genes that control cell division and growth. Although much is known about the alterations in these genes in brain tumors, the reason why the gene alterations arise in the first place is poorly understood. The MGH has a very active research program in this area.

Are brain tumors hereditary?
The use of the word ‘gene’ invariably brings up the important question of whether brain tumors are hereditary. The answer for almost all patients is no. Although there are conditions in which brain tumors can occur in families, these syndromes are very rare and usually known prior to the development of an individual family member’s tumor.

Types of therapy
There are three standard types of treatment for patients with high-grade gliomas: surgery, radiation therapy, and chemotherapy.
Because grade 3 and 4 tumors have a tendency to grow rapidly, treatment must be started as soon after surgery as is feasible, allowing time for the surgical incision to heal. Generally, this means that patients should be undergoing either radiation therapy or chemotherapy within 2 to 4 weeks after surgery.

While therapies for high-grade gliomas are helpful, at present these treatments cannot cure these tumors. The two major reasons for this are that tumor cells infiltrate into surrounding brain and thus cannot be completely removed by the surgeon, and that most glioma cells are at least partially resistant to radiation and chemotherapy.

The goals of treatment are to:
-remove as many tumor cells as possible (with surgery)
-kill as many as possible of the cells left behind (with radiation and chemotherapy)
-put remaining tumor cells into a nondividing, sleeping state for as long as possible (with radiation and chemotherapy)

High-grade glioma cells almost always start to grow again at some point in time. Patients receive aggressive treatment in order to delay this regrowth as long as possible. Regrowth does not necessarily imply loss of control of the tumor, but it does mean that a new series of treatments should be considered because the tumor is becoming more aggressive.

Norman have just finish his 22nd radiation today. He is feeling fine except for a bee sting on his left fore head. It is slightly swollen and painful to the touch. The Dr suggest to take an anti-histamine.

On another note, I would like to say a big thank you to all our trekkers friends who celebrated Norman's birthay on sunday 20th January. (His actual birthday is on the 22nd). All the ladies are fantastic cooks!! I always look forward to any of our pot luck gathering. Whose birthday is next? I will post the photos another day as it is still in Nicky's camera.

Quote: A merry heart is good medicine, but a crushed spirit dries up the bone. Proverbs17:20

The macrobiotic diet

A macrobiotic diet is a strict whole-foods pesco-vegetarian (a diet that includes fish but no meat or poultry) diet. It is appealing to health-minded people who are practicing a holistic approach to physical and spiritual well-being. It focuses on balancing yin and yang foods, which are described below. There have been numerous anecdotal reports of the macrobiotic diet curing people of cancer or other serious diseases, but very little scientific evidence exists.
· 50 to 60% of your diet should be whole grains, 25 to 30% vegetables, 5 to 10% miso and bean soups, and 5 to 10% beans and sea vegetables.
· Avoid very yin or very yang foods
· The diet includes other principles like eating only when hungry, chewing food completely, and keeping the kitchen tidy.
Best bets: Brown rice, barley, whole wheat, fresh broccoli, cauliflower, chickpeas, tofu, sea vegetables like kombu and nori, and vegetable soups. A few servings of nuts and seafood per week are allowed.
More about this diet
The earliest recorded usage of the term “macrobiotics” is found in the writings of Hippocrates. Translated literally, macro is the Greek word for “great” and bios is the word for “life.” Macrobiotics is used by its practitioners as a tool that allows one to learn to live within the natural order of life. Throughout history, philosophers and physicians from many parts of the world have used this term to signify living in harmony with nature, eating a simple, balanced diet, and living to an active old age.
The modern practice of macrobiotics was started in the 1920s by a Japanese educator named George Ohsawa. Ohsawa is said to have cured himself of a serious illness by changing to a simple diet of brown rice, miso soup, and sea vegetables. At the core of Ohsawa’s writings on macrobiotics is the concept of yin and yang. In Chinese philosophy, the opposing forces of yin and yang govern all aspects of life. Yin—representative of an outward centrifugal movement—results in expansion. On the other hand, yang—representative of an inward centripetal movement—produces contraction. In addition, yin is said to be cold while yang is hot; yin is sweet, yang is salty; yin is passive, yang is aggressive. In the macrobiotic view, the forces of yin and yang must be kept in balance to achieve good health.
The macrobiotic diet, therefore, attempts to achieve harmony between yin and yang. To this end, foods are classified into yin and yang categories, according to their tastes, properties, and effects on the body. The two food groups—grains and vegetables—that have the least pronounced yin and yang qualities, are emphasized in the macrobiotic diet. Eating these foods is thought to make it easier to achieve a more balanced condition within the natural order of life. Foods considered either extremely yin or extremely yang are avoided. The standard macrobiotic diet recommendations are as follows:
· Whole grains—including brown rice, barley, millet, oats, corn, rye, whole wheat, and buckwheat—are believed to be the most balanced foods on the yin/yang continuum, and should comprise 50 to 60% of a person’s daily food intake. Although whole grains are preferred, small portions of pasta and bread from whole grain flour may be eaten.
· Fresh vegetables should comprise 25 to 30% of food intake. Daily consumption of any of the following vegetables is highly recommended: cabbage, broccoli, cauliflower, kale, bok choy, collards, mustard greens, turnips, turnip greens, onion, daikon radish and pumpkin. Vegetables to be eaten occasionally include celery, iceberg lettuce, mushrooms, snow peas, and string beans. Vegetables should be lightly steamed or sautéed with a small amount of unrefined cooking oil,preferably canola or olive oil.
· Beans and sea vegetables should comprise 5 to 10% of daily food intake. Especially recommended are adzuki beans, chickpeas (garbanzo beans), lentils, and tofu. Sea vegetables, including wakame, hijiki, kombu, and nori, are rich in many vitamins and minerals, and are easily added at each meal.
· Soups and broths comprise 5 to 10% of food intake. Soups containing miso (soy bean paste), vegetables, and beans are acceptable.
· A few servings each week of nuts, seeds, and fresh fish (halibut, flounder, cod, or sole) are permissible. Brown rice syrup, barley malt, and amasake (a sweet rice drink) may be used as sweeteners. Brown rice vinegar and umeboshi plum vinegar may be used occasionally. Naturally processed sea salt and tamari soy sauce may be used to flavor grains and soups.
· Fluid intake should be governed by thirst. Only teas made from roasted grains, dandelion greens, or the cooking water of soba noodles are generally considered acceptable. All teas with aromatic fragrances or caffeine are avoided. Drinking and cooking water must be purified.
· To maintain proper yin/yang balance, all extremely yang foods and all extremely yin foods are avoided. All animal foods, including eggs and dairy products, are believed to have a strong yang quality. Extremely yin foods and beverages include refined sugars, chocolate, tropical fruits, soda, fruit juice, coffee, and hot spices. In addition, all foods processed with artificial colors, flavors, or preservatives must be avoided.
· All foods should be organically grown. Produce should be fresh and locally grown.
Macrobiotic principles also govern food preparation and the manner in which food is eaten. Recommendations in this area include: avoid using a microwave oven to prepare food; cook rice in a pressure cooker; eat only when hungry; chew food completely; eat in an orderly, relaxed manner using good posture; and keep the home in good order, especially where food is prepared.

Nutritional Strategies Against brain Tumour

Can cancer patients eat anything they like? Sure … eat anything you like, so say some experts. There is now enough evidence to say that food has got a lot to do whether you get cancer or not. When and after you have cancer – can you still eat anything your like? They say -- Sure, eat anything you like to build up your body! Is this not making the cancer worse? According to one expert, “cancer could not careless what we eat”. Of course cancer couldn’t careless what we eat …. the more we feed the cancer cells with what they like, the happier they are! Yes, the cancer couldn’t careless but our body ought to care … we need to feed our body right so that we can become healthier and DENY the nutrients that would make cancer cells grow and flourish in us. Is it not logical enough?

Fruits and vegetables have been shown to be among the best means to reduce risk of cancer and other diseases … deeply hued fruits and vegetables provide the wide range of vitamins, minerals, fiber and phytochemicals your body needs to maintain good health and energy levels, protect against the effects of aging, and reduce the risk of cancer and heart disease.

Evidence suggests that either a near vegetarian diet or a vegetarian diet is the best Reduction in cancer rates were observed in studies where participants reduced their animal-food consumption. A study showed that some fish added to a vegetarian diet provides benefits … diet containing a significant quantity of animal products cannot be healthy!

A well nourished cancer patient can better manage the disease, has fewer side effects from RT and chemo and increase chances for remission, Norman has completed about half of his 30 fractions of RT and Temodar treatment but he has yet to experience side effects like nausea, vomiting, hair loss and fatigue. At the moment he is still able to work and even treks up Gasing Hill like a breeze! Cool! He and Yam Koh are still racing each other! Oooiiiiiii, slow down abit, will ya?
We are seeing a Dr Pang at USJ9 for guidance on eating a proper diet and taking the correct supplements. She majors in preventive medicine. Her chief objective now is to boost up Norman’s immune system. Her diet plans plus my knowledge from hours of fervent reading online is as follows:

1 The super nutrients juicer
Juice 3 veggie -celery, cucumber, carrot twice a day
Juice 2 fruit- Guava, pineapple, grapes, pear, apple twice a day
Fruits to be taken whole-banana, papaya, red dragon fruit, kiwi, chestnuts
If possible, eat organic fruits. Sometimes I add enzyme powder to the juice too.
Avoid watermelon and durians, they contains too much toxins.

2 Eat organic food
Recommended diet portion of veggie is 1 cup cooked + 2 cups raw veggie for lunch or dinner. Only small portion of fish is permitted. We try to keep to this regime but I usually end up stir frying the veggie instead. I would like to add more variety and spices eg. Organic curry, mixed herbs, oregano, basil leaves, to enhance the flavor of food for Norman.

Norman likes salad. So I try to mix all the veggie, nuts, tomatoes, carrots, flaxseed oil, etc from the organic shop and I call it “Dorothy’s Salad”. So easy, No need cooking. Ha! Ha!

I welcome any vegetarian recipes from anyone. I am now learning to make lui cha fan. I got the recipe from Amy Beh website.

3 Food to avoid
a) Any sweet food. Sugar fuel and strengthen cancer cells. Elevated blood glucose lowers immune system.
b) Avoid all fizzy drinks (including 100 plus), white sugar (substitute with Stevia or molasses sugar), white rice (substitute with millet, cous-cous, brown rice, quinoa), and white bread (substitute with whole grain bread, rye bread).
c) Avoid all diary products and processed foods.
d) Avoid all meat to reduce acidosis in body. Meat like, beef, chicken, pork, lamb are completely out. Small portion of fish is permitted. Beans, nuts and millets will provide sufficient intake of protein.

While on radiation and chemotherapy, Norman drinks wheat grass juice, Millennium juice, coconut water, phyto-berry drink and lots of alkaline water. We just installed a Toyo alkaline water system recently.

Super food-We try to eat these food daily.

Garlic - Scientist find that garlic is deadly to invading pathogens or tumor cells, but is harmless to normal healthy body cells, thus offering the hope of the truly selective toxin against cancer that is being sought world wide.

Cruciferous vegetables – Broccoli, cabbage, spinach, all types of big leafy greens and cauliflowers are able to increase the body’s production of glutathione peroxides, which is one of the most protective enzyme systems in the body.

Mushrooms – Now there is an abundance of scientific evidence showing that Rei-shi, Shiitake, and Maitake mushrooms are potent anti cancer food. Oral extract of Maitake provided complete elimination of tumors in 40% of animals tested while the remaining 60% of animals had a 90% of elimination of tumors. It contains a beta-glucan which stimulates the immune system and even lowers blood pressure.

Legumes – Soya beans, pinto beans, black beans, garbanzo, red beans and green beans provide adequate proteins in the diet. Isoflavones and phytoestrogens in the soy beans have potent anti cancer properties. I boil these together with the millet for dinner. Organic fermented beans like black bean taucu and miso are the best. I use them to enhance food taste instead of salt.

Other food that we eat regularly- seaweed, ginger, snow fungus, black fungus, Inoki mushroom, sweet potatoes

Food Supplements Taken By Norman

Supplements recommended by Doctor

1 AHCC- Active Hexose Correlated compound. Please check online for this very interesting super food from Japan. It is extracted from the myecial threads of a mushroom.
2 Green Tea extract-
3 Prolactar- Friendly bacteria
4 Alpha Lipioc Acid- an antioxidant that increased production of glutathione which helps
dissolve toxic substances in the liver. It can cross the Blood Brain Barrier to go directly where it is needed.
5 Vitamin E
6 Zinc- essential for brain development and function.

Quote of the day!

"Let thy food be your medicine and your medicine be your food."

Hippocrates, father of modern medicine, 400 B.c

Together with good friends

Nurses of University Hospital


Trekking at Bukit Gasing


Breakfast at Mrs Khor's House

Eternal Friendship

The three beauties