Patients may therefore live for many years without symptoms apart from epilepsy. However, a cardinal property of low-grade gliomas is their propensity to undergo anaplastic change to a more malignant lesion i.e. to increase in histological grade. This process is common and unpredictable although it occurs more often and earlier in older patients. The prognosis for patients with a transformed glioma is poor with a median survival of only twenty months after radiotherapy, equivalent to patients with de novo anaplastic gliomas. Conventional management of asymptomatic patients with low-grade gliomas is conservative because there is no evidence that early treatment with either surgery or radiotherapy confers any survival advantage or prevents subsequent malignant transformation.
Many neurologists rely on yearly contrast-enhanced scans to detect tumour progression.
However this approach may not be sensitive to the earliest changes of transformation. We are currently setting up a research project to examine this. Neurological Complications of Cancer Information Neurological complications of cancer are common, increasing and disabling. Diagnosis is often difficult and treatments are usually effective. There is a particular interest in diagnosing and treating patients with paraneoplastic neurological syndromes, which are rare but important neurological conditions associated with the presence of a small, often undiagnosed, cancer elsewhere in the body.